Johns Hopkins Medicine
The CDC continues to monitor the spread of COVID-19 and makes recommendations for wearing face masks, both for those who are fully vaccinated as well as those who are not fully vaccinated.
The CDC also recommends that masks and physical distancing are required when going to the doctor’s office, hospitals or long-term care facilities, including all Johns Hopkins hospitals, care centers and offices.
Johns Hopkins Medicine’s current mask safety guidelines have not changed, and we still require all individuals to wear masks inside all of our facilities.
Lisa Maragakis, M.D., M.P.H., an expert in infection prevention, answers questions about face masks.
Can wearing a face mask prevent coronavirus from spreading?
Yes. Although being fully vaccinated greatly reduces your chance of catching or spreading the coronavirus, it doesn’t eliminate it entirely. If you are infected with the coronavirus and do not know it, a mask is very good at keeping your respiratory droplets and particles from infecting others. If you haven’t yet received your COVID-19 vaccine, wearing a mask can also help prevent germs that come from another person’s respiratory droplets from getting into your nose and mouth.
Since the coronavirus can spread through droplets and particles released into the air by speaking, singing, coughing or sneezing, masks are still a good idea in crowded indoor public places that contain a mixture of vaccinated and unvaccinated individuals.
Wearing a mask is still recommended in health care settings and other places where people around you may have risk factors for severe consequences of COVID-19. These include people over age 65 and those living with heart disease, diabetes, obesity, chronic lung disease, immunity problems or cancer.
Do I need to wear a face mask if I currently have COVID-19?
Yes. If you are actively infected with the coronavirus and cannot stay completely away from others in your home, droplets from your nose or mouth could infect another person who has not been vaccinated yet or who has a weakened immune system. Stay away from others as much as possible and wear your mask around others until your doctor says it’s safe to discontinue wearing it.
COVID-19: When should masks be worn?
Why do I still have to wear a mask in health care facilities?
The CDC guidance is that people continue to wear face masks in hospitals, clinics, doctors’ offices and other health care locations. Wearing a mask protects people around you who may have not had their COVID-19 vaccines or who might have a health condition that makes them vulnerable to severe coronavirus infection.
Why do mask regulations keep changing?
At first, researchers and scientists did not know how necessary mask wearing would be among the general public. Later, we learned that wearing masks was an effective way to help prevent spread of this coronavirus. Also, masks were initially in short supply, and it made sense to ensure that those at the highest risk of infection, such as medical caregivers and first responders, had an adequate supply of professional masks so they could protect themselves as they cared for patients.
With more people getting COVID-19 vaccinations, experts are likely to revise mask guidelines as more people in the community are protected.
When a completely new virus like SARS-CoV-2 shows up in humans, recommendations change frequently as we learn more about how the virus behaves.
How effective are neck gaiters and bandanas in stopping the spread of the coronavirus? Are masks with valves OK?
None of these three types of face coverings works as well as a proper face mask. A good mask has a double layer of washable, breathable fabric that helps keep the wearer from spreading potentially infected droplets into the air. A bandanna tied around the face does not work as well as a mask because it is open at the bottom. A gaiter (a tube of thin, stretchy knit fabric that can be worn around the neck and pulled up to cover the nose and mouth) is usually too thin to provide adequate protection. Likewise, masks with exhalation valves can allow your droplets to escape into the air.
Johns Hopkins Medicine does not permit bandanas, gaiters, or masks with exhalation valves to be worn by patients, staff members or visitors at our locations. We do not recommend clear shield-like face masks, which are different than face shields but still have gaps around the face and therefore do not provide the same protection as wearing a mask.
What about double-masking? Do we need to wear two masks or a different type of mask to protect ourselves from variants of the coronavirus?
No, you do not need to wear double masks or an N95 respirator in public settings to protect yourself against the new coronavirus variants. The infection prevention measures are the same for all variants of SARS-CoV-2, the virus that causes COVID-19.
Anytime you are wearing a mask, make sure:
- It is worn consistently and appropriately. A mask that is frequently pulled down to breathe or talk, or is worn under the nose, is not effective.
- The mask conforms to your face without gaps — it is important that most of the air you breathe in and out flows through the mask rather than around the mask through gaps at the sides, top or bottom.
- It is made from several layers of tightly woven fabric in order to be an effective filter.
- The mask has a flexible nose bridge to conform to the face and prevent fogging of eyeglasses.
- It stays in place during talking and moving, so it can be worn without slipping and so it does not require you to touch it frequently.
- The mask is comfortable enough to wear without adjusting it for the amount of time you need to keep it on.
Following current mask-wearing guidelines is still important as we race to stop viral transmission and get everyone vaccinated before more variants of the virus emerge and threaten the progress we have made.
What type of face mask should I buy?
Unvaccinated people should keep masks on when you’re around others from outside your household. Once you are fully vaccinated, you won’t need to wear a mask everywhere, but it’s a good practice to have extras on hand.
Look for a mask made with at least two layers of fabric. It should cover your nose and mouth without large gaps. The mask should have ear loops or ties so you can adjust it. For people who wear glasses, look for a mask with a bendable border at the top so you can mold the mask to fit the bridge of your nose and prevent your glasses from fogging. Professional masks should be reserved for health care workers caring for patients on the front lines.
Can I make my own cloth mask?
Yes. Johns Hopkins Medicine offers directions for making a homemade adult mask and a child-size mask for use in non-patient-care settings. Masks can be made out of cotton or linen fabric. Cloth masks can and should be washed daily.
What items in my closet can I use to create a face mask?
- Thick, densely woven cotton fabrics are best, such as quilting cotton or cotton sheets.
- Stretchy knits aren’t ideal. Hold the fabric up to the light — the fewer tiny holes you can see, the better it will work to filter your droplets.
- Overall, making a good mask involves finding a balance. You want fabric that doesn’t allow droplets to pass through, while ensuring you can breathe properly with your mask in place.
What is a face shield?
A face shield is a piece of rigid, clear plastic attached to a headband. The plastic piece covers the face, extending to below the chin.
You might have seen face shields on some health care providers, even before the COVID-19 pandemic. Dentists and dental hygienists sometimes wear them when working close to patients’ mouths. Doctors, nurses and technologists might use face shields, together with face masks, when performing procedures that could propel blood or other substances into the air.
At Johns Hopkins, care teams when treating patients wear face shields over masks or N95 respirators for additional protection. We do not recommend clear shield-like face masks, which are different than face shields but still have gaps around the face and therefore do not provide the same protection as wearing a mask.
Should I wear a face shield?
If you are not fully vaccinated, wearing a mask and maintaining physical distancing of at least 6 feet between you and other people when in public places helps protect you from the SARS-CoV-2 virus. In healthcare settings, healthcare personnel often wear face shields or another type of eye protection since they are close to symptomatic patients during clinical care activities. In general, you do not need a face shield in public settings if you are fully vaccinated or wear a mask and maintain physical distancing.
Can I get a face mask exemption or waiver?
No, you cannot get a waiver or exemption from wearing a face mask. Fake cards and flyers claiming the bearer is exempt from mask-wearing regulations because of a physical or mental condition covered by the Americans with Disabilities Act (ADA) that makes them unable to wear a face mask or covering.
The United States Department of Justice issued a statement about these fake mask exemptions, explaining that the cards and flyers are fraudulent.
What are the different types of face masks?
Cloth or Paper Masks
These masks help slow the spread of the coronavirus that causes COVID-19 and help keep people who unknowingly have the virus from transmitting it to others. Thick, densely woven cottons are good materials for cloth masks.
Procedural and Surgical Masks
These are loose-fitting masks designed to cover the mouth and nose.
Do surgical masks protect against the coronavirus?
Although they are not close fitting, blue disposable masks are fluid resistant and provide some protection from larger respiratory droplets from coughs and sneezes. Primarily, they help prevent the wearer from spreading infectious droplets to others. Like N95 respirators, these masks are used by health care workers whose safety depends on an adequate supply. They cannot be washed.
Called N95 respirators, these medical devices help prevent exposure to tiny droplets that can be suspended in the air. Health care workers who wear them undergo a fit-test to find the right make, model and size to ensure a tight seal. N95 respirators should be reserved for health care providers and first responders.