Written by 12:13 PM News

Why health experts in the US are recommending ‘double masking’

Healthcare experts, including Fauci, recommend wearing two layers of face masks instead of just one as viruses, in theory, will have a tougher time penetrating both layers as opposed to a single layer. But the US’ Centers for Disease Control (CDC) is yet to officially recommend double masking.

A report published in the journal Med recommends wearing at least a “high-quality surgical mask or a fabric mask of at least two layers with high thread count”. The commentary, authored by Monica Gandhi and Linsey C Marr, shows that wearing a surgical mask under a cloth mask offers better protection against viruses as the surgical mask acts as a filter and the cloth mask provides an extra layer of filtration, while also improving the fit.

“A mask is like an obstacle course for particles to get through,” Lindsey Marr, a virus transmission expert told US NGO AARP. “Adding a second mask adds another obstacle course, increasing the chance that the particle will be trapped before it gets through to the other side.”

Experts say that in places where social distancing is difficult to maintain, such as in a plane or at a busy store or event, two masks will help provide extra protection. While N95 masks are believed to be the best in terms of protecting you against Covid-19 as they are said to filter 95 per cent of airborne particles, these are difficult to come by. But a cloth mask covering a surgical mask is the next best option, medical professionals say.

Another study published in the peer-reviewed journal Matter in July stated that double masking could increase protection from viruses by 50-75 per cent. “We found that the particle removal efficiency of many surgical style masks could be improved by up to 50% by simply snugging the mask material to the face [with another mask],” one of the authors of the study, Dr Loretta Fernandez, told USA Today.

During the initial days of the pandemic, when surgical and N95 masks were hard to come by, people who were not frontline workers were encouraged to opt for cloth face coverings. But now, as new, more contagious variants of Covid-19 continue to spread across the world, many people are stepping away from cloth masks and opting for sturdier surgical or N95 masks.

In some countries, such as Germany and France, all citizens are required to wear a medical-grade or surgical mask while travelling in a bus, train or tram and even while visiting the supermarket. Fabric masks are no longer permitted under the new mask rules in Germany, while in France their use is strongly discouraged.

A study conducted by Duke University last year suggested that a disposable surgical mask made out of a plastic-derived material called polypropylene was the next best option after the N95 respirator with no valve. But according to some studies, a multi-layer cloth mask can offer as much protection as a surgical mask, the CDC website states.

Still, both surgical masks and cloth face coverings may not be effective in blocking very small virus particles transmitted through coughs or sneezes. This is why many researchers recommend double masking for extra security.

Wearing two masks works in the same way—and combining two layers of relatively inefficient material may perform better together than a single poor quality mask. In addition, wearing a relatively loose fitting surgical or other medical type mask with a tightly fitting cloth mask over it may create a better mask “sandwich,” Dr. Segal suggests.

Infectious disease expert Amesh Adalja, MD, senior scholar at the Johns Hopkins University Center for Health Security in Maryland, agrees that the effectiveness of wearing two face masks depends on the mask material. “Where you need to wear two masks depends on the quality of the mask,” Dr. Adalja tells Health. “It depends on the fit of the mask and how well it serves as a barrier.” 

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