COVID-19 is once again surging across the country as the highly transmissible omicron variant spreads rapidly. With breakthrough cases soaring, the focus has returned to masking as an important measure to protect against the virus.

The federal Centers for Disease Control and Prevention recommends anyone 2 years or older who is not fully vaccinated to wear masks in indoor public spaces. This also applies to fully vaccinated people in areas of high transmission.

Take a look at the CDC’s recommendations for the three different mask types available and how to maximize protection with each kind.

Respirators (N95s and KN95s)

The CDC recommends choosing National Institute for Occupational Safety & Health-approved N95 respirators instead of cloth masks when supplies are available.

The institute evaluates N95 respirators for specific U.S. quality requirements. They may have a cup, flat fold or duck bill shape, and come with two straps to be worn above and below the ears. A pliable wire on the mask bends to sit securely on the nose bridge.

KN95s are the most commonly available respirators designed and tested to meet international standards.

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Look for the label on the respirator to see what standard they meet. The CDC says about 60% of KN95s in the market are counterfeit and do not meet any quality standards. Here is their advisory on how to spot fake KN95s and here’s how a NIOSH-approved N95 is labeled.

”Surgical” N95 respirators should be prioritized for health care personnel.

A well-fitted, NIOSH-approved N95 can filter up to 95% of airborne particles.

These disposable respirators, costlier than other masks, cannot be washed for reuse. They need to be discarded when wet, dirty, damaged or difficult to breathe through.

Do not double-mask with respirators. The CDC also does not recommend this type of mask for people with certain types of facial hair.

Disposable masks

Disposable masks, sometimes referred to as surgical masks or medical-procedure masks, are widely available. These have a bendable nose wire to securely cover the mouth and nose.

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The CDC recommends double-masking — with disposable surgical masks underneath and a cloth mask on top — for better protection. They also suggest using a brace to secure both masks.

Do not wear disposable masks that are wet, dirty or loosely fitting with gaps on the sides of the face or nose.

Cloth masks

Cloth masks can be made from a variety of fabrics. To be effective, they must have a proper fit over the nose and mouth, preferably with a nose wire.

The CDC recommends double-masking with multiple cloth masks or a disposable mask, and advises that the mask should block light when held up to a bright light source.

Do not wear masks with exhalation valves, or other gap openings on the sides of the face or nose, or thin fabric that doesn’t block light.

Effectiveness of different types of masks

The American Conference of Governmental Industrial Hygienists, an occupational and environmental health advocacy group, interpreted CDC data on masking to show any type of masking offers more protection from the virus compared with no masking at all. The organization estimates an 1-10% leakage for NIOSH-approved respirators, the lowest compared to other masks.

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These results were published last spring, before the omicron variant, which is believed to spread more easily than earlier variants.

Masks for children

The CDC does not recommend masks for children under the age of 2.

For children ages 2 and up, choose a well-fitted, comfortable mask or respirator that fits over the child’s nose and under the chin, but does not impair vision.

A poorly fitted mask or respirator may be removed often or fiddled with, reducing its intended benefits. If using a respirator, make sure to follow the instructions for a proper fit.

A note on safety precautions for children:

Although respirators may be available in smaller sizes, they are typically designed for adults, and have not been tested for broad use among children.

If a child has a medical condition, such as a heart or lung problem, the CDC advises checking with a health care provider before selecting a mask, respirator or an ASTM F3502 mask, designed to protect against aerosols and airborne droplets.

If the fitted mask or respirator causes breathing problems, dizziness or other problems, the CDC advises switching to a regular cloth or disposable mask and continuing other protective measures like social distancing. Consult a health care provider if these symptoms do not resolve.

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