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Face coverings, N95 masks and surgical masks: Who they're for and how to use them

The CDC says that everyone should wear non-medical face coverings whenever you're interacting with others during the coronavirus pandemic. But how do those differ from medical-grade face masks?

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People across the world are wearing face masks to protect against coronavirus.

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For the most up-to-date news and information about the coronavirus pandemic, visit the WHO and CDC websites.

Face masks, hand washing and social distancing have become the standard advice for reducing the spread of the coronavirus. "It's going to be critical to continue to embrace the principles of social distancing, hand hygiene, and wearing a face covering in public," said Robert Redfield, the director of the CDC during a briefing on June 12, when talking about what it will take to reopen the US. We are already seeing this become standard practice -- in many states across the country, it is mandatory to wear a face covering when you're in public, or going into a business. 

But it's important to understand that face masks and face coverings come in several different forms, from sterile medical-grade masks to handmade cloth face coverings. 

Medical-grade masks include disposable surgical face masks and N95 respirators. Surgical face masks are used to block large particles and respiratory droplets (which are sent into the air when someone coughs or sneezes) from entering or exiting your mouth. Tight-fitting N95 respirator masks are designed to filter smoke, small particles and airborne viruses. 

Non-medical face coverings include reusable cloth masks, bandanas and scarves, and are used in the same way as a surgical mask, to protect you against large particles and respiratory droplets. Research suggests that these face coverings can reduce the forward distance travelled by a person's breath by over 90% (and more on that later), and thus are a suitable protective measure against transmitting the coronavirus. 

Here's what you need to know about how each of these masks and face coverings protect you.

Surgical face mask vs. face covering vs. N95 respirator

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Surgical face masks don't block small particles, but they can prevent liquid from getting on your mouth or in your nose.

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Surgical mask

If you've ever been to the dentist, surgical face masks will look familiar -- health care professionals use them to prevent the splashing of fluids into their mouths. They're loose-fitting and allow airborne particles in. People commonly wear face masks in East Asian countries to protect themselves from smog and respiratory diseases, but these masks aren't designed to block tiny particles from the air. 

Again, a surgical face mask's main purpose is to keep out the liquid of an infected person's sneeze or cough from entering your mouth or nose (gross, I know). Wearing one can protect you from getting sick if you're in close contact with someone who is ill and could also help prevent you from spreading your illness to someone else, so it's common practice for medical professionals to wear them around sick patients.

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A reusable cloth face mask.

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Face coverings 

Face coverings are meant to protect you in the same way that disposable surgical masks do, by blocking large particles and respiratory droplets. The CDC does not provide specific examples of what should be used as a face covering, but government health officials in the San Francisco Bay Area recommend using bandanas, fabric masks and neck gaiters. 

According to the California Department of Public Health, face coverings should cover the nose and mouth and can be made from a variety of fabrics, including cotton, silk or linen. You can opt to buy a premade cloth mask, or fashion one from household items like scarfs, T-shirts, sweatshirts or towels. 

These face coverings should be washed in hot water and dried on high heat in a dryer between uses to kill any bacteria or viruses that get on them. The CDC does say to be sure to wash your hands before and after handling your face covering because it may have harmful viruses or bacteria on its surface. You also should not touch your face or face covering while wearing it out in public.

Both disposable and reusable face masks can help prevent hand-to-mouth viral transmissions, because you can't directly touch your own mouth while wearing one. Viruses, however, can be transmitted through your nose or eyes and virologists say that surgical face masks cannot block airborne viruses from entering your body.

As far as protecting yourself and others from the coronavirus, there is some promising data showing that face coverings -- including all masks without an outlet, from medical grade to homemade -- can help contain the spread of the virus. Preliminary research from the University of Edinburgh published May 21, 2020 suggests that face coverings cut the forward distance travelled by a person's exhale by more than 90% -- meaning how far your breath travels after it leaves your mouth or nose.

However, jets of air can still escape sideways and backwards, especially with coughing or heavy breathing. Plus, researchers found that only masks with a tight seal around one's face prevent the spread of fluid particles carrying a virus. Still, this is good news regarding how widespread use of face coverings can help us slow down the spread of the novel coronavirus.

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This NIOSH-approved N95 respirator will prevent airborne particles from entering.

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N95 respirators

That's where a respirator, a tight-fitting protective device worn around the face, comes in. When people say "respirator," they're usually referring to the N95 respirator, which gets its name from the fact that it blocks at least 95% of tiny particles, including viruses. Several brands manufacture N95 respirators, and they come in all different sizes. These are the masks people are most strongly requested to save for medical professionals, so it's recommended that everyone not go out and buy them.

You should also know that N95 respirators come in two varieties, ones with an external one-way air valve and ones without it (also called surgical N95 respirators). With both types of respirators, the mask itself filters out the air your breathe in, protecting you from contaminants in the air. Respirators with a one-way valve help keep the mask cool and less stuffy because the warm air you breathe out escapes more easily. 

However, according to the CDC, that means that respirators with a valve also allow unfiltered air to escape and spread into the air around you. This is typically only a concern in sterile environments, like an operating room, but it's led to some cities banning the use of N95 respirators with a valve in an effort to stop the spread of the coronavirus. 

The local governments in the San Francisco Bay Area are telling residents that N95s with a valve are not compliant with the regions's health orders that require wearing a face covering in public. That is based on the idea that if you are sick, or think that you might be a carrier of the coronavirus, these kinds of respirators could still potentially spread the virus.

Do masks and face coverings actually prevent the spread of the novel coronavirus? 

The answer to this is technically yes, but the exact effect is difficult to define -- especially on a large scale. Studies have shown that N95 masks are highly effective in preventing viral illnesses, but only in people who actually wear the masks correctly, which is rare.  

N95 masks are difficult to put on for people who aren't medical professionals. If you've put the mask on right, it gets hot and stuffy, so a lot of people take it off before it can do any good. In fact, some medical professionals believe these masks actually create a more suitable environment for viruses to develop

Another study showed that respiratory masks are helpful in preventing viral infections, but only when combined with frequent hand washing. Dr. Michael Hall, a CDC vaccine provider, told CNET that while N95 respirators are the most protective, surgical masks can help protect you from other people's coughs and sneezes.

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While face coverings do not filter out particles in the same way an N95 mask does, they are now recommended as an effective way of slowing the spread of the coronavirus, especially among people who have the virus, but are asymptomatic and still going out in public to get food or supplies. The CDC says:

The coronavirus can spread between people interacting in close proximity -- for example, speaking, coughing or sneezing -- even if those people are not exhibiting symptoms. In light of this new evidence, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.

Bear in mind that nonmedical face coverings are only effective against spreading the virus if you continue to take social distancing measures and basic hygiene seriously. If you do follow wear face coverings outside, don't let it serve as a false sense of security.

The bottom line? If worn correctly and combined with other virus prevention methods, surgical face masks, N95 respirators and face coverings can help lower the risk of spreading viruses, including the novel coronavirus. But medical-grade protection should be reserved for medical professionals or those who are actively sick and need to leave the house to get medical care. The rest of us should just cover up with a bandana or cloth mask.

Read more: Coronavirus fact check: How to spot fake reports about the disease

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.