Are DIY Fabric Masks Really Effective At Protecting Against The Novel Coronavirus?

Until now, the U.S. Centers for Disease Control and Prevention (CDC) has maintained that Americans need not wear masks in public, but as CNN reported on Wednesday , most members of the coronavirus task force have come to an agreement that we should all start wearing face coverings to prevent the spread of the novel coronavirus. Fabric or homemade face masks, while not as effective as N95 respirators, could potentially prevent asymptomatic people from unknowingly passing the virus to others, experts believe.

Dr. Robert Redfield, the director of the CDC, confirmed on Monday that the agency was reevaluating its guidance on face masks, and throughout the week, instructions on creating homemade fabric face masks have been circulating social media and handmade versions have been appearing on Etsy .

The big question is, are fabric face really masks effective against the novel coronavirus?

As long as you're not a healthcare worker, the answer is yes. "Theyre effective for the risk youre assuming as a [member of the general public]," says Dr. Shan Soe-Lin, PhD, a lecturer in global health at Yale University. Dr. Soe-Lin was among the first to speak out against the CDC's initial guidelines warning against face mask use by the general public, co-writing (along with Dr. Robert Hecht) a viral op-ed in the Boston Globe titled, "Guidance against wearing masks for the coronavirus is wrongyou should cover your face."

There are a few reasons why face masks are now necessary to the general public:

They may help prevent the spread of novel coronavirus, particularly from asymptomatic carriers.
Face masks can discourage wearers from touching their face.
They can serve as a public reminder to practice caution, good hygiene, and social distancing.

Just to be clear: You shouldn't be wearing an N95 mask.

Medical masks, particularly N95 respirators, should stay reserved for medical professionals battling COVID-19 on the front lines. Anyone whos not a frontline health worker should absolutely not be wearing an N95 or surgical mask," Dr. Soe-Lin says. "My brother is an ICU doc, and I have many dear friends here in Boston who are working in the ICU, and they have one N95 mask to last them the whole week. Theyre taking care of patients and they know theyre going to get infected. When I see people in the general public just hanging out and wearing N95 masks, it really drives me nuts. Those people are risking peoples lives out of selfishness.

How should a fabric face mask fit?

First, the mask should fit snugly, with no gaps between the fabric and your face.

What you should look for are masks that completely cover your nose and mouth," Dr. Soe-Lin says. "I find that the masks that work better for me are the ones that come up right under my eyes and go deeply down below my chin. They slip less and stay on better."

Ear loops are also an important componentDr. Soe-Lin has seen some designs online that seem difficult to put on and take off, which would defeat the purpose. "Make sure you can take your mask on and off just by the ear loops without touching your face, she says.

Plus, any mask with two layers of fabric is better than one layer of fabric. Word to the wise, you should wash a fabric mask every day, so it's a good idea to have a few options in rotation.

Can I use a bandana or a scarf instead?

Scarves and bandanas are still better than nothing, Dr. Soe-Lin says.

If you have a choice between a scarf and a bandana you should use a scarf, Dr. Soe-Lin says, noting that thicker fabric is always better than thinner. Very thoroughly wrap your face a couple of times with it, and tie it under your chin so it stays in place. Sometimes, Dr. Soe-Lin says, she sees people ducking their face in and out of their scarf nest, which defeats the purpose. Once you cover your face, it should stay covered until youre safely back home.

If you do use a bandana, double up so you have a few layers of fabric catching aerosol droplets.

Can I improvise with other household items?

Anna Davies co-authored a study on homemade face masks published in Disaster Medicine and Public Health Preparedness back in 2013 that's now drawing lots of attention.

We put ourselves in the position of, if I was at home, and there was an outbreak of an infectious disease, and I wanted to wear a mask, what would I make it out of?" Davies says. "We used a t-shirt, a linen dish towel, a pillowcase, a scarf, and a vacuum cleaner bag, and compared them against a surgical mask."

The t-shirt, linen dish towel, pillowcase, and scarf were all about equally effective at filtering bacteria and viruses, whereas the vacuum cleaner bag (a piece of it, not the whole thing) was more effective, but may be harder to come by.

Since her study has been receiving so much attentionin part, she believes, because there are so few studies on improvised face masksDavies also published a Frequently Asked Questions document last week on ResearchGate.

Remember: A mask doesn't make you invincible.

Even if you wear a mask, you still need to follow social distancing and hand-washing guidelines.

A mask is not a replacement for social distancing, hand hygiene, and isolation if symptomatic, Davies said. If you share a home with someone who is infected, its worth considering wearing a fabric face mask at home, too, she added.

"I think masks are an important part of what I consider the 'triangle of protection,' along with social distancing and hand-washing," Dr. Soe-Lin says." Its important to note that masks dont make you invincible, and you still really need to keep doing the other two things as well."

They might, however, make it easier to stop touching your face.

Face masks can also serve as a visual reminder that we should all be cautious right now.

When Dr. Soe-Lin first started wearing her face masks three weeks ago, she says people assumed she was sick, and would move away from her. But now, she's noticing more and more people adopting masks. Its a visible message to everyone else around you that this is not a normal time and that we all need to be working together to protect our own health and also safeguard the health of our neighbors," she said.

Plus, it is actually possible for every single American to wear a fabric face mask. I think the great thing about masks is theyre the only intervention I can think of that's completely equitable," Dr. Soe-Lin said. "Everyone can use it, everyone at least has a t-shirt... Whereas, with the social distancing and the hand-washing, if youre a grocery worker, you cant always socially distance. You dont always have time in your shift to keep washing your hands.