Some Doctors Want Us To Wear Two Masks, But What Does That Mean For Kids?
"Two masks is not better than one if a child removes the mask," one doctor tells Romper.
It's no surprise to learn that health experts are recommending face masks to help protect against the novel coronavirus. But as new mutant strains of the virus pop up, many doctors and the CDC are now recommending double-masking, or wearing two face masks at once, as a means of boosting your chances of protection against COVID-19.
While you may not have doubled up your masks just yet (although what are you waiting for?), you've likely already seen this new recommendation in action. A number of guests at Joe Biden's inauguration were spotted double masking, including Pete and Chasten Buttigieg. Since then, First Lady Jill Biden has also been seen wearing two masks, begging the question, are two masks better than one?
Some Researchers Say "Yes"
In a recent commentary on the evidence of using face masks to combat the spread of COVID-19, which was published last month in the science journal Cell, two experts noted that while one properly-fitted mask was good, two were even better.
"For maximal protection, members of the public can either wear a cloth mask tightly on top of a surgical mask where the surgical mask acts as a filter and the cloth mask provides an additional layer of filtration while improving the fit; or wear a three-layer mask with outer layers consisting of a flexible, tightly woven fabric that can conform well to the face and a middle layer consisting of a non-woven high-efficiency filter material," Dr. Monica Gandhi, an infectious diseases expert and professor of medicine at the University of California, San Francisco, and Linsey Marr, an airborne disease transmission expert and a professor at Virginia Tech, wrote in their report.
"If the masks fit well, these combinations should produce an overall efficiency of >90% for particles 1 μm and larger, which corresponds to the size of respiratory aerosols that we think are most important in mediating transmission of COVID-19," the researchers continued.
Fauci Says Double-Masking Makes "Common Sense"
Researchers aren't the only ones to tout the potential benefits of double-masking. In an interview with NBC's Savannah Gunthrie, Dr. Anthony Fauci, the nation's top infectious disease expert, said double-masking was "common sense."
"I mean, this is a physical covering to prevent droplets and virus to get in," Fauci said. "So if you have a physical covering with one layer, and you put another layer on, it just makes common sense that it likely would be more effective and that's the reason why you see people either double masking or doing a version of an N95."
While Fauci has said COVID cases appear to be on the decline, a new variant of the virus, first found in the United Kingdom, has cropped up in more than 20 states and appears to have a higher rate of transmission and infection. "We don't want to get complacent and think, 'Oh, things are going in the right direction, we can pull back a bit,'" Fauci said, noting health experts were also worried about a different variant of the virus that had been found in South Africa.
Even The CDC Recommends It
The CDC officially updated its mask guidelines on Feb. 10 to include recommendations for double-masking, noting it was a recommended way of adding layers of material to keep the wearer’s respiratory droplets in and others’ out. The CDC specifically recommends wearing one disposable mask underneath a cloth mask with the outer cloth mask pushing the edges of the inner mask snugly against your face.
However, the CDC has advised against wearing two disposable masks at the same time, noting that such masks are not designed to have a snug fit, meaning wearing more than one at a time would not improve overall fit. The CDC also recommends against doubling a KN95 mask up with any other type of mask.
What About Kids, Should They Double-Mask?
While children age 2 and older are recommended to wear a face mask when in public, the infectious disease experts behind current guidance for double-masking tell Romper their recommendation to double up on masks doesn't extend to children. "Our recommendation was not at all for children," Gandhi explains via email. "Indeed, children are considerably less at risk for severe COVID-19 than adults and colorful cloth masks can help with compliance."
Additionally, Dr. Aaron Milstone, a pediatrician at the John Hopkins Children's Center and an infectious disease expert at John Hopkins Hospital, tells Romper that when it comes to children and face masks, the most important factors are that they're worn properly and well fitted. "Two masks is not better than one if a child removes the mask or has trouble breathing while wearing the mask," Milstone says. "Finding a mask that fits and that a child will keep on is the priority."
When & Where Should You Double-Mask?
While health experts have said double-masking may offer further protection against new variants of COVID, they noted not every situation warrants doubling up on masks, which could prove uncomfortable for some people. In comments to the Boston Globe, professor of exposure assessment science at the Harvard T.H. Chan School of Public Health Joseph Allen recommended pairing a cloth face mask with a surgical mask when heading to the grocery store, but said folks can leave the second mask at home when simply taking a walk outside.
"I recommend that people select masks based on the activity, and the level of risk for that activity," Allen said. "If going on a walk outdoors with a friend, a simple two- or three-layer mask will do. If you're going to the grocery store or you are an essential worker coming in contact with a lot of people, I recommend wearing a cotton mask over a surgical mask which can catch more than 90% of respiratory aerosols."
Other potentially high-risk activities where double masking might be warranted include flying, riding public transportation, or whenever you may find yourself in close contact and indoors with people outside of your household for longer than 15 minutes.
Gandhi outlined similar guidance for when to double-mask, telling Romper it was recommended for medically vulnerable people in areas of high transmission and for those who work in crowded indoor conditions. According to Gandhi, children, college-age youth, and people who live in areas of low transmission are not recommended to double-mask when out in public.
If you think you’re showing symptoms of coronavirus, which include fever, shortness of breath, and cough, call your doctor before going to get tested. If you’re anxious about the virus’s spread in your community, visit the CDC for up-to-date information and resources, or seek out mental health support. You can find all of Romper’s parents + coronavirus coverage here.
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