Should you double mask?

Last month, 22-year-old Amanda Gorman, the first person to be named US National Youth Poet Laureate, took the world by storm when she delivered a powerful poem at the swearing-in ceremony of US President Joe Biden. There was another notable thing about her though. Her double mask. Wearing a gorgeous yellow coat and a bright-red headband from designer label Prada, Gorman wore a surgical mask beneath her bedazzled Prada version. In fact, not just her, one has often seen the US President, too, wearing a medical-grade mask underneath the black one. Top infectious disease expert Anthony Stephen Fauci, the director of the National Institute of Allergy and Infectious Diseases in the US and chief medical adviser to Biden, has also revealed that he often wears double masks.

Considering the effectiveness of masks, there has been a trend of late of wearing double or even triple masks to protect oneself. But do we really need two masks? Studies are yet to prove that wearing a double mask can protect one from the spread of germs from an infected person. During a White House Covid-19 briefing, Fauci said that although the Centers for Disease Control and Prevention (CDC) has not yet outlined specific guidelines regarding the trend of wearing two masks to prevent the spread of the coronavirus, it could be the “common sense approach”.

According to the Centers for Disease Control and Prevention, which recommends that people wear masks that have “two or more layers of washable, breathable fabric”, face masks can block up to 70% of the coronavirus particles.

Experts, too, feel that wearing double masks is a sign of a mature society. “(It’s for) someone who understands the risks and wants to take corrective action in the face of a global pandemic that comes once in a century. It is comfortable to wear a double mask during the winter months and it increases the protection level. Typically, one will wear a basic certified mask on the inside and a dressy mask on the outside. Even thought the dressy mask is not adequate by itself to protect the wearer or others, as a ‘double mask’ it will add to the level of protection,” says Barun Aggarwal, CEO, BreatheEasy, a service provider for indoor air quality and energy conservation.

Medical experts and current health guidelines suggest wearing a mask that contains at least two-three layers of fabric and can fit and cover the face well. Delhi-based Gurpreet Sandhu, president, Council for Healthcare and Pharma, a premier thinktank committed to the development of sustainable healthcare systems around the world, feels that as long as one has a good-quality mask, which is made up of multiple layers and fits well, there’s no need of donning additional masks. “Layers are always a good option, but the objective can be simply achieved by using a good-quality mask that has multiple layers in it. Using two or three masks in the hope that it will add layers won’t really serve better protection. Wearing additional masks can suffocate people and lead to additional woes. The only people who should consider using more than one mask are healthcare workers who face high exposure or those who experience trouble in finding a good-quality mask which doesn’t fit well,” he says.

Usually, single-layer masks are not as effective in blocking aerosols as their effectiveness lies in the range of around 60%. “Putting a surgical mask under a cloth mask can get you over 91% removal efficiency for air and dust particles. That’s also the reason why we see people wearing double masks or do a version of an N95. Wearing your mask correctly is just as important, even while double masking. Your nose needs to be covered, both masks should go over the bridge of the nose and under the chin. Masks should be cleaned and disposed of properly. Surgical masks are only good for one-time use,” says Yash Javeri, critical care, anesthesia and emergency medicine, Regency Superspecialty Hospital, Lucknow.

However, for people not in the healthcare industry, a cotton mask should be adequate as long as it is used properly and covers the nose up to the chin, feels Gurugram-based Arunesh Kumar, senior consultant and head, respiratory medicine/pulmonology, Paras Hospital. “Masks are very important to break transmission. For healthcare workers who come in direct contact with patients, a triple-layered mask topped up with an N95 mask and covered by facial shield gives adequate protection. Proper use and regular use are key to prevent transmission,” says Kumar.