The guidance, released Feb. 10, 2021, is at least partly in response to new coronavirus (COVID-19) varients that are being found to be more transmissible than previous types of COVID-19.

The CDC’s Your Guide to Masks also provides details on fitting a mask, how to wear a gaiter, and how to prevent fogging up when wearing glasses.

With people worldwide still contracting the novel coronavirus (COVID-19), wearing a face mask when in public or near others, in addition to social distancing of at least six feet between you and others, are things you should do to slow the spread of the virus, according to medical experts.

A study published in August, out of Duke University, compared 14 different types of masks to determine which worked best — and which ones didn’t work so well. The study found that neck fleeces, sometimes called “gaiter masks,” were the least effective, and bandanas and knitted masks weren’t great either — but wearing any type of mask is better than wearing no mask at all. The mask that did best in the study was the N-95 mask, without a valve — as the valve allows exhalation to be released and can, therefore, compromise the protection of people near to the wearer.

You may already be in the habit of wearing a face mask when you go out — but are you sure you are using it correctly? Here are the top seven things you need to know about wearing a mask.

COVID-19 is known to pass from one person to another through respiratory droplets that occur during coughs and sneezes. Masks are primarily used to prevent a sick person’s respiratory droplets from spreading to others.

It is important to wear a face mask even if you don’t feel sick, because people may be able to spread the virus before they begin showing symptoms, which commonly include a cough, fever or shortness of breath.

It’s especially important to wear a mask if you do feel ill — or better yet, stay home and contact your health care provider about appropriate next steps to take.

If your massage practice is open, make sure your workplace follows the new OSHA guidelines regarding COVID-19, which include the use of personal protective equipment (PPE); and the 17 CDC Sanitation Guidelines.

“The use of PPE depends largely on what your local government advises and if you feel that is not enough, then add to it,” said Andrea Fiorello, LMT, a massage therapist in Chesapeake, Virginia, who requires clients to wear masks during sessions.

Clients who show symptoms of illness, such as a fever, should be asked to reschedule their appointments.

Jay Woody, MD, ABEM, FACEP, an emergency-room physician and chief medical officer of Intuitive Health, told MASSAGE Magazine that once masks are worn, they can potentially have viruses and other germs on them, so it’s important not to re-use disposable masks; throw these masks away after one use. Cloth masks, he said, should be machine-washed and dried, ideally after every use.

“Any covering that covers the mouth and the nose is effective; this could be a bandana or cloth mask or surgical mask — they all do the job,” Woody said. “One-hundred-percent cotton bandanas are available for as low as $1 and YouTube is full of other creative ideas.

“An April 24 study published in the American Chemical Society looked at the filtration efficiency of common fabrics. The researchers stated, ‘One layer of a tightly woven cotton sheet combined with two layers of polyester-spandex chiffon — a sheer fabric often used in evening gowns — filtered out the most aerosol particles (80-99%, depending on particle size), with performance close to that of an N95 mask material.’

“The fabric and price point is not the issue, as it is all about preventing your droplets from being spread to others.”

The Centers for Disease Control (CDC) website offers instructions for making cloth masks. Masks should fit snugly and cover your chin, mouth and nose completely. Make sure you can breathe comfortably while wearing the mask. Some companies known in the massage field have taken up production or sales of face masks. Inner Peace, a manufacturer of such products as massage sheets and face cradle coverings, has added a line of cloth face masks. Distributors now selling cloth or paper masks include Massage Warehouse and Universal Companies.

It’s best to wash your hands whenever you handle your face mask, Woody noted. This will help you avoid contaminating yourself with germs masks may have on them.

“Before you put your mask on, wash your hands. Before you remove your face mask, wash your hands. After you remove your face mask, wash your hands,” he said.

The CDC recommends washing your hands with soap and water for at least 20 seconds, or using a hand sanitizer containing at least 60% alcohol.

“If you are not infected with COVID-19, the highest risk of contamination is the front [outside] of the face mask,” said Woody. He noted that masks should be removed from the back according to the protocol outlined by the CDC, which means grasping the ear loops or ties and lifting the mask off and away from your face, not pulling it off from the front.

“Unfortunately, I witness individuals haphazardly removing their masks. Their unwashed hands are touching the inside of the mask and then their hands touch their face. When this happens, the face mask becomes pointless,” he said. “Additionally, if the person reuses the same face mask and has touched the inside of the mask, when they reapply their face mask the germs have direct access to their mucous membranes.” (See #2 above about not reusing masks.)

Take care what you do with single-use face masks after you take them off.

“Cross-contamination is highly probable when individuals leave their masks in their shopping cart, in the parking lot or … in their cars,” said Woody.

“[Disposable] masks should be rolled and tied with the ear straps, ensuring that it cannot come unrolled,” he said. “Wrap the mask in a clean tissue and dispose of it in a lined trash can.”

“While masks do help when worn, removed and disposed of properly, they are only one part of preventing the spread of COVID-19,” said Woody. “Frequent handwashing will always be the first line of defense.”

Editor’s note: For more COVID-19 resources for massage therapists, visit MASSAGE’s COVID-19 Resource Page.

Jay Woody, MD, ABEM, FACEP, is chief medical officer of Intuitive Health and cofounder of Legacy ER & Urgent Care. He is a well-known authority in the field of emergency medicine and a pioneer in the area of freestanding ERs and urgent care centers.

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