A guide to wearing face masks and face coverings.



At the start of the year, the sight of someone sporting a face mask in public was fairly unusual. Six months on and they are set to become the norm.

From 15 June it will be mandatory to wear a face covering on public transport in England.

While very young children, disabled people and those with breathing difficulties will be exempt, everyone else will need to take this extra precaution whenever using a bus, tram, train, coach, aircraft, ferry and the London Underground.

The public had already been advised to consider wearing face coverings in enclosed public spaces and whenever they were likely to come into contact with strangers. As a result, we instituted a strict mask-wearing policy for all patients, visitors and staff at our Hospital and Hospice.

Reinforcing the message, the World Health Organization has also updated its advice on the use of face masks saying they should be worn in public whenever social distancing is not possible.

They outline that people over 60 or with health issues should wear a medical-grade mask when they are outside their home and that everybody else should use a three-layer fabric mask.

The WHO’s announcement marked a significant change in stance. They had previously been reluctant to advocate the wearing of masks by the public because of limited evidence that they offer protection. There were also concerns that a surge in mask buying could affect the supply line to frontline healthcare professionals.

Now that you’re likely to need a mask, it’s worth understanding why and having a good grasp of the different varieties available.

What do face masks and face coverings actually do?

There is little evidence to suggest that wearing a mask reduces the chances of being infected by COVID-19. However, wearing a mask does help minimise transmission to others.

Research has shown that people can be highly infectious in the few days before they show symptoms and that some people never show symptoms at all.

Covering your mouth and nose stops the spread of droplets from each. Think of it like turning off a tap. Fewer infectious particles in the air, in theory, means more people have a chance of avoiding infection.

There’s also the added advantage that wearing a mask reminds you to refrain from touching your nose, eyes and mouth, something we all do regularly whether we’re conscious of it or not.

It’s important to remember that face coverings and masks come in a variety of forms and each offers a different level of protection.

Homemade / fabric masks.

The most basic are homemade cloth and fabric coverings. The UK government has guides on how to make a covering out of an old t-shirt and also advice on how to sew a cotton covering. Which? also has a handy video.

While the US-based Centers for Disease Control and Prevention says any covering is better than none, it’s worth bearing in mind that homemade coverings like the above do not tally with WHO advice.

In their recommendations, they stipulate that non-medical fabric masks should have a minimum of three layers with a synthetic fluid-resistant material layered on top of polypropylene and absorbent cotton. While these can be made at home, it is more likely that you would purchase one.

Fabric masks are usually machine washable, reusable and suitable for the average person to wear while shopping and using public transport. They would not be used by healthcare professionals in a medical environment.

Surgical masks.

Surgical masks are disposable devices that create a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment.

Looser fitting, they do not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures. They are also supposed to be replaced as soon as they are damp or after a single use.

The general public is advised against purchasing surgical masks to ensure supplies are freed up for the medical profession.

Respirator masks.

Respirator masks come in a variety of forms. with higher-grade versions providing more protection. They include Euro-certified FFP2, FFP3 and US-certified N95 and N99 varieties and offer between 94-99% aerosol filtration.

Neither are suitable for children or people with facial hair because they require a tight fit. By and large they are disposable and are only considered necessary for health workers in high-risk frontline settings.

Whatever mask or covering you choose, you should avoid touching it while you wear it. When it comes to taking it off, you should do so carefully (do not touch the front of the mask) and if disposable, immediately discard it in a closed bin. After touching a used mask you should also wash your hand thoroughly. If your mask is fabric and reusable, it should be washed after each use and stored in a plastic bag until you need it again.

What else do you need to do to minimise the spread of COVID-19?

As lockdown restrictions start to ease, there’s a temptation to assume that previous advice is no longer important. That couldn’t be further from the truth.

When it comes to minimising the chances of contracting and spreading COVID-19, social distancing remains vital. By reducing the number of people you come into contact with regularly, the better your chances of avoiding infection. If you do have to venture out or choose to meet friends and family, you should continue to maintain a two-metre distance.

Day-to-day personal hygiene remains hugely important. Everybody should wash their hands frequently with soap and water or with a sanitiser gel and coughs and sneezes should be caught in a tissue with the tissue then disposed of immediately. If tissues aren’t available, people should aim to sneeze into a bent elbow.

If you have symptoms of Covid-19, however mild, or you have received a positive test result, you should immediately self-isolate at home for at least seven days from when your symptoms started. If you show symptoms you are now eligible to be tested. Even if you feel well, you should stay at home for a 14-day period if someone else in your household is self-isolating or if you are contacted by the government’s Track and Trace team.