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Updated masking guidance: What you need to know

January 25, 2022 | Safety | Healthy You

Chart showing types of masks from lower to higher quality

Filtering masks like N95 and KN95 masks are recommended over cloth masks

Masking is a critical public health tool for preventing the spread of COVID-19. To protect yourself and others from COVID-19, the Centers for Disease Control and Prevention (CDC) continues to recommend that you wear the most protective mask you can that fits well and that you will wear consistently. This may mean switching from a cloth mask to a respirator-style face covering.

To aid in this switch, the federal government is making 400 million nonsurgical N95 masks available, free of charge, at community health centers and retail pharmacies across the United States. The masks should start arriving in the next week.

Although there may be some styles on the market for children, it’s important to note that N95 masks are generally not intended for use by children.

Cloth, surgical or respirator?

COVID-19 spreads through respiratory droplets when you sneeze, cough, breathe, talk or sing. Masks are a barrier to help prevent your respiratory droplets from reaching others. Studies have shown that masks with two or more layers help reduce the spread of COVID-19, by preventing respiratory droplets from traveling into the air. 

Chart showing types of masks from lower to higher quality

While all masks and respirators provide some level of protection, properly fitted respirators offer the highest level of protection. Wearing a highly protective mask or respirator may be most important for certain higher-risk situations or by some people at increased risk for severe disease.

The CDC’s guidelines state that although respirators may be available in smaller sizes, they are typically designed to be used by adults in workplaces and have not been tested for broad use by children. Any mask that claims to be an N95 for kids is a fake. However, the small N95 sizes might work for some older children. KN95 and KF94 masks have styles made for children.

If wearing a higher-quality mask isn’t possible, the CDC recommends double masking and wearing a disposable surgical mask underneath a cloth mask.

Properly wearing your mask is key

No matter the type of face-covering you choose to wear, look at how well it fits. Gaps can let air with respiratory droplets leak in and out around the edges of the mask. Holes can be caused by choosing the wrong size or type of mask or when one is worn with facial hair.

It is essential to check that it fits snugly over your nose, mouth and chin.

  • Check for gaps by cupping your hands around the outside edges of the mask.
  • Make sure no air is flowing from the area near your eyes or the sides of the mask.
  • If the mask has a good fit, you will feel warm air coming through the front of the mask and may be able to see the mask material move in and out with each breath.

Not all respirator masks are the same

Respirator style masks—N95, KN95, KF94 or FFP2—are widely available at major retailers. Early in the pandemic, there was a shortage of respirator-style masks. The public was discouraged from wearing them and instead to leave them for healthcare workers. There is no longer a shortage of N95s for healthcare workers.

N95 masks are named because they filter out 95% of aerosol particulates. These masks are designed to create an extremely tight seal around the nose and mouth, thanks to elastic headbands and an adjustable metal band over the nose. N95s undergo the rigorous inspection and certification set forth by the National Institute for Occupational Safety and Health (NIOSH). The masks must be marked with “NIOSH” and “N95.” N95s are not in short supply, but the Centers for Disease Control and Prevention says those specifically labeled “surgical” should still be prioritized for healthcare workers.

KN95 masks are the Chinese equivalent of N95 masks. They feature a tentlike shape that creates a little pocket of air between your nose and the fabric, which makes them appealing to many people. They feel somewhat easier to breathe through, less obstructive than N95s. Because KN95 masks are not overseen by NIOSH (they’re regulated by the Chinese government instead), it can be trickier to find reliable brands. Unfortunately, there are many fraudulent models on the market. The Food and Drug Administration (FDA) granted emergency use authorization to several KN95 masks earlier in the pandemic when N95s were in short supply. While the emergency use authorization has since been revoked, the FDA’s list is still helpful for finding reputable manufacturers. The mask must be marked “GB 2626-2006 KN95.”

KF94 masks are the Korean equivalent. The “KF” stands for “Korean filter,” and the 94 refers to the masks’ filtration efficacy. According to the South Korean government’s standards, these masks filter 94% of particles down to 0.3 microns in size. KF94s offer an alternative fit to KN95s or N95s. They feature ear loops, an adjustable nose bridge and side flaps to create a tight fit. For some people, they’re more comfortable and easier to wear. Unlike KN95s, KF94 masks were not granted EUA from the FDA. Still, KF94s are a steep upgrade from cloth or surgical masks. To help ensure you are getting the real deal, shop for brands manufactured in Korea, where the KF94 label is strictly regulated.

FFP2 masks are the European standard for respiratory masks. FFP2s are similar in style to the KN95s and meet the European requirement of 94% filtration of aerosol particulates. Unlike the N95 or KN95 masks, FFP2s are also tested against liquid substances in addition to solids. The effectiveness of FFP2s has led to countries such as Austria and Germany making them a requirement on public transportation. FPP2 masks must be marked with “EN 149: 2001 + A1: 2009 FFP2.

The Centers for Disease Control and Prevention also cautioned about counterfeit respirator-style masks. The Centers for Disease Control and Prevention has a running list of non-NIOSH-approved N95s, KN95s, KF94s and other protective masks that have gone through filtration testing. The list also includes known counterfeits. The agency said consumers should buy from reputable retailers who have vetted the products they sell. If you are buying online, look closely at the seller rating and product reviews to help you determine the quality.

Finally, most manufacturers of respirator-style masks say their masks are single-use only. However, the shortage of N95 masks early in the pandemic resulted in novel ways to clean and wear a respirator. Representatives from 3M, a large manufacturer of N95 masks, say KN95s and N95s can be reused if people care for them, especially if you’re not wearing them for long periods of time.

It is recommended that people store the masks in a brown paper bag between uses and not in a plastic bag as the plastic may trap moisture. If you see dirt on the outside of the mask or makeup or skin oils on the inside or if the mask is damaged in any way, it’s time to toss it. Don’t forget to wash your hands before putting or removing your face covering to prevent contamination.

Source: CDC, WHO