Mask Wearing 101: How to Educate Your Patients

Wearing a mask has become one of the most controversial aspects of the novel coronavirus pandemic. Even so, the science is clear: wearing a mask prevents microscopic droplets, or aerosols, from entering the air and infecting others.

As a nurse or a nurse practitioner, you have a unique opportunity to educate and inform your patients. With so much of today’s news politicized, Americans are looking for unbiased advice from professionals they trust.

Didn’t the CDC and WHO say wearing masks isn’t necessary?

In February and March, when COVID-19 was first making headlines, both the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) released statements saying there was no need for citizens to wear masks. 

There were several reasons for this. First, scientists knew little about the novel coronavirus or how it was spread. Second, many experts feared that mask recommendations might lead to a shortage of N-95 respirators for healthcare workers.  

On June 5, the WHO reversed course and recommended everyone wear cloth facial coverings in areas where social distancing wasn’t possible. Just over a month later, on July 14, the CDC followed suit. 

So, masks really are effective in slowing the spread of COVID-19? 

Yes. It’s important to remember that COVID-19 is caused by a novel –– or new –– coronavirus. Everything scientists know about the virus comes from research conducted over the last six months. Additionally, researchers are learning more every day. 

As more data became available, scientists began to realize the efficacy of masks. For example, a study published in Health Affairs on June 16 compared the COVID-19 growth rate before and after mask mandates in 15 states. Researchers found that in the first five days following mask mandates, daily growth slowed by 0.9 percentage points. Three weeks later, daily growth slowed by more than 2%. 

Another study looked at cultural norms surrounding mask mandates. Researchers looked at 198 countries worldwide. They discovered that in parts of the world where mask wearing is the norm, there are also fewer deaths.

What kind of mask should I tell my patients to wear? 

There are several types of masks that are suitable for stopping the spread of COVID-19. These include: 

• Bandanas
• Face scarves
• Masks made of fabric
• Disposable blue surgical masks
• N-95 respirators 

All these facial coverings can reduce the spray of droplets ejected from the nose and mouth while speaking, singing, or breathing.  

If a patient decides to make their own mask from cloth they purchased at the store, it must include at least two layers of fabric and allow for breathing without restriction. Materials like lace and nylon are not acceptable as they have hundreds of tiny holes that aerosols can escape through. 

When it comes to wearing a mask, what are some good rules of thumb? 

For masks to prevent the spread of COVID-19, they must be worn properly. This means covering both the mouth and nose. Some people who find masks hot or uncomfortable pull their masks down, so they only cover the mouth. If a cloth mask doesn’t cover the nostrils as well, though, there’s no point in wearing a mask at all. 

Is there anyone who shouldn’t wear a mask?

The majority of healthy people should wear a mask in situations where social distancing isn’t possible. This includes activities like visiting the bank, going grocery shopping, or eating a meal out at a restaurant.  

However, there are a few exceptions. The CDC says cloth facial coverings should not be worn by:

• Children younger than two years old
• Anyone who has trouble breathing
• Anyone who is unable to remove the cloth face covering without assistance

If you have patients who are concerned about wearing a cloth facial covering, set aside time to answer their questions and to explain the science behind the mandates.

For patients with serious respiratory disorders or underlying health problems that prevent them from wearing a mask when social distancing isn’t possible, it's better they remain at home.

Mask wearing mandates are meant to promote public safety, but in some places, they’ve caused confusion and alarm. By educating your patients about the benefits of wearing a cloth facial covering, you can alleviate fears and lower the rate of spread in your community.