Face Coverings: Common Questions and Answers

August 19, 2020
school aged child wearing colorful mask

By: Alecia Good, MEd, ATC
Athletic Trainer

MUSC Health Sports Medicine

Schools are busy preparing for many new guidelines due to COVID-19. One point of emphasis is the requirement to wear a face mask. I am the head athletic trainer and teacher at Pinewood Preparatory School. Due to my role at the school I have been asked many questions regarding face coverings. In this article, I will share some of the latest research and guidelines.

When should I wear a face mask?

Face masks have been shown to prevent the spread of COVID-19 by infected individuals to others by limiting respiratory droplets that enter the air when you cough, sneeze, or talk. The CDC currently recommends face coverings be worn when in public or around people that do not live in your same household. Masks should especially be worn when social distancing guidelines of at least six feet cannot be maintained. COVID-19 spreads mostly when people are in close contact with one another. Properly wearing a mask can reduce the spray of droplets in these situations and thus limit virus transmission.

What type of face covering is best?

Face coverings should fully cover the mouth and the nose. Face coverings should snuggly fit on the nose, around the face, and under the chin. Adjustable nose bridges may be helpful to get a good fit especially for individuals who wear glasses to prevent fogging. Masks can be secured by ear loops or full ties behind the head. The gaiter-type masks worn around the neck and bandanas have not been shown to be as effective. Additionally, masks with an outlet valve have been shown to be counterproductive and are not recommended. Masks should be made with at least two layers of fabric and may or may not include a pocket for a filter. Although not exactly scientific, the “candle test” (ability to extinguish a candle from one-foot distance while wearing the mask) has been often sited to establish the effectiveness of the mask in allowing respiratory droplets to escape. Regardless of design or material, individuals should be able to breathe easily and talk freely when wearing a mask. Ultimately personal comfort and preference will determine which mask is best.

Can I wear a face shield instead of a face mask?

Face shields are recommended to be worn in conjunction with face masks, not necessarily in place of face masks. Face shields have not been shown to protect others from respiratory droplets and prevent the transmission of COVID-19. It is an extra layer of protection for the person wearing the shield so that the droplets do not have an entering point, but it does not block the exit point when talking, coughing, and sneezing. Face shields should fully wrap around the side of the face and extend below the chin. The CDC does not recommend the use of face shields as a substitute for masks.

Is it safe to exercise in a face covering?

Certain considerations must be made for whether a person should wear a mask while exercising. Intensity of the activity must be closely monitored to ensure that the participant is breathing normally and feeling well while exercising. Exercise in a mask should be discontinued if there is any sign of dizziness, shortness of breath, or lightheadedness. Exercising in a mask may require the individual to perform shorter and/or less intense workouts until the individual becomes more accustomed. Clean, dry masks should always be used. It may be necessary to swap masks if it becomes damp. Persons with pre-existing respiratory and cardiovascular conditions such as asthma should take caution and consult their doctor before exercising in a mask.

Diligence in mask wearing, while receiving much attention, is only one factor in the prevention of virus transmission. It should not overshadow the focus on hand washing, avoiding touching your face, nose and mouth, cleaning and disinfecting surfaces and shared equipment, and maintaining social distance as much as possible. Finally, individuals have a personal responsibility to stay home if they are not feeling well and seek the advice of a medical professional if they are symptomatic.