Ask the expert: Current masking recommendations, types of masks

Grabbing a mask as you walk out the door is now as common as grabbing your keys, wallet and cell phone. Now that we're more than a year and a half into the pandemic, we probably all have our favorite mask or type of mask, but what's the difference between the various kinds of masks and which one is best?

We talked to Graham McKeen, assistant university director of public and environmental health at Indiana University, to help us sort out the latest info on masking during the ongoing COVID-19 pandemic.

Question: What are the current recommendations for mask wearing?

Answer: The Centers for Disease Control and Prevention currently recommends wearing a mask in indoor public spaces if you are not fully vaccinated. In addition, in communities with substantial or high transmission, which, at this point, is basically the entire U.S., the CDC recommends fully vaccinated individuals also mask up when inside. And, masks continue to be required on all public transportation, including airplanes and city buses.

Q: Is all this masking working?

A: Yes. There have now been multiple studies, especially in the school setting, showing that universal masking reduces COVID-19 transmission. The CDC reports that K-12 schools without mask requirements are three-and-a-half times more likely to have COVID-19 outbreaks than those that started the school year with universal masking.

Q: What kind of mask is best?

A: Honestly, the best mask is the one that fits your face the best and one that you'll wear properly. An effective mask will completely cover your mouth and nose, and go under your chin. It should fit snugly to the sides of your face and have a nose wire to help with a better fit, so air doesn't leak out the top of your mask.

Q: It feels like there are a million types of masks out there now. What's the difference?

A: There are really five main categories of masks or facial coverings we're seeing today.

  • Cloth masks are simply what they say--a mask made of cloth. To be effective, they should have at least two layers of breathable, washable fabric. Cloth masks may be the traditional fit with loops that go around your ears or could be a gaiter, which goes around your neck and is pulled up over your nose and mouth. This type of mask can be washed and re-used.
  • Surgical masks are disposable and regulated by the FDA. These masks not only help block your respiratory droplets from going into the air, but also protect you from large-particle droplets which may contain viruses. You've likely seen these masks in doctor's offices.
  • KF94/KN95 masks take the filtration level of a surgical mask up a notch, close to what you'd see with an N95 mask. The KF designation means "Korean filter" and the 94 means 94 percent filtration. KN95 masks are similar and are from China with 95 percent filtration. Both are disposable and combine the increased filtration of an N95 mask with the design and fit of a cloth mask. They need to fit well to provide this increased filtration and have a nose wire to help with fit.
  • N95 masks are sometimes called N95 respirators and are meant to have a very tight and specific fit on the face to filter small airborne particles. N95 masks, in order to be used properly, need to be fit tested to ensure the proper fit and are often used in healthcare settings. Right now, you're most likely to see healthcare workers wearing these in the ICU and other units where they're directly caring for those with COVID-19 infections. You do not typically see these among the general public due to the specific fitting needs.
  • Face shields typically have a band that goes around your head and a clear plastic shield that comes down in front of your face. Research is not yet clear on the effectiveness of face shields in preventing the spread of COVID-19 and are not typically recommended. A face shield may be combined, however, with an N95 mask in certain healthcare settings for additional protection.

Q: Will continued masking help end the pandemic?

A: Masking is a simple yet important tool in our toolbox to fight community spread of COVID-19. One prevention measure alone will not get us to the end of this pandemic. Vaccination continues to be the most important thing we can all do to help ourselves and our communities. Beyond that, masking, utilizing social distancing, getting tested if you have any symptoms and appropriately quarantining and isolating will help end the pandemic when we put all of these to use together.

Above all, it's about public health, and it's empathy and respect for each other and our communities.