How to wear a proper mask — properly: Your contribution to slowing down COVID


  • First, to be effective, a mask must sit over your nose and under your chin, and against your cheeks without any gaps.
  • Second, a mask should be made of ‘densely woven cotton fabrics,’ or ‘tight-weave 100 percent cotton.’ To test the fabric, hold it up to a light source. If light passes through, then it’s not dense enough.
  • More evidence is pointing to the fact that you need at least three layers of fabric on a face mask for it to fully protect you. 
  • The US Centers for Disease Control (CDC) had in February updated their mask guidelines to endorse double masking for better protection.

“I wear a proper mask — properly” — should be each person’s contribution to slowing down the transmission of COVID-19 which has gone up to almost 10,000 in the past two days (March 26 and 27).

With the alarming surge in new cases, and after a year of various quarantine lockdowns, people should be more committed to wearing masks — and keeping them on.

It is sad that until today, you’d see people around Metro Manila wearing masks under the nose, dangling over an ear, or only when facing another person.  It’s as if keeping the mask somewhere near you can help prevent the transmission of the virus.

Incidentally, while many of us are still discussing the importance of wearing masks, the US Centers for Disease Control (CDC) had in February updated their mask guidelines to endorse double masking for better protection. The discussion that followed the advisory was on what masks should be used together and which one should be used for the first and the second layer.

But back to the local situation in Metro Manila, where the highest number COVID-19 cases are, we are still trying to instill the importance of wearing a mask.

The most important factors related to the protection a mask gives are — proper fit and proper material.

First, to be effective, a mask should fit tightly and well. “It must sit over your nose and under your chin, and against your cheeks without any gaps,” according to the website of Best Life Online.

“Properly fitting masks are the only ones that efficiently stop large droplets that could spread and infect someone,” Dr. Leann Poston, licensed physician and health advisor for Invigor Medical said in the same website.

Second, a mask should be made of “densely woven cotton fabrics,” or “tight-weave 100 percent cotton.” To test the fabric, hold it up to a light source. If light passes through, then it’s not dense enough.

Knowing those important factors that determine the mask that gives the most effective protection against COVID-19, you can evaluate the proper mask that will protect you. 

Here are the popular types of face masks sold in the market today:

1. Homemade cloth mask. If this is a single-layer mask, then “it may only provide one percent particle filtration. A two-layer cotton mask filters out about 35 percent of small particles, according to Jennifer L.W. Fink, registered nurse-turned-writer. 

2. Three-layer masks.  More evidence is pointing to the fact that you need at least three layers of fabric on a face mask for it to fully protect you.  The latest study showing that three-layer masks were most protective was a study conducted by researchers at Virginia Tech University who tested 11 different types of masks, a Yahoo! News report said.

That is also the opinion of the US CDC which says a mask should ideally have three layers, according to the website of Best Life Online.

3. Disposable surgical masks. These usually come with white and blue sides. “They are primarily intended to stop droplets, sprays and splatters and studies have shown that diligently wearing surgical masks in public spaces can significantly reduce the spread of respiratory infections,” Miss Fink said in her story in the website of Building Boys.net

4. N95. Many articles about the N95 mask say that it offers the most protection against COVID-19 and other respiratory diseases.  An N95 mask protects the person wearing the mask because they filter out 95 percent of particles from the air breathed in, Fink wrote in her story on masks and their protective qualities. 

5. T-shirt mask. Many online tutorials have shown the practicality of making masks from old cotton t-shirts.  Nurse Jennifer Fink said that although masks from T-shirts are comfortable to wear, they are “only one-third as effective as disposable surgical masks.” That is according to a study published in Disaster Medicine and Public Health Preparedness.  

But because T-shirt masks are comfortable to wear because the material stretches and conforms to the face, one can increase its effectiveness by wearing more than one layer.

6. Masks that look cool and fashionable.  One should examine the material and the construction of the mask.  A typical cloth mask is probably at least 50 percent protective, experts say. Choose cloth masks that have filter pockets. Use a folded tissue or commercially-available mask filters to increase its protective value.

7. Masks with valves. Hospitals and many offices now do not allow the use of masks with valves because it allows respiratory droplets to escape from the wearer. If the wearer is asymptomatic and has COVID-19, he can spread the virus.

On double masking

The CDC’s recent update on its mask guidelines to endorse double masking to better protect the user against COVID-19 makes sense especially with the appearance of the UK and South Africa strains which are more infectious. 

Here are a few tips from the CDC on what masks to layer:

1. A cloth mask over a disposal mask is recommended. The top mask should push the edges of the inner mask against the face.  “As long as both masks fit well, researchers have found that they can stop the spread of the COVID-19 with more than 90 percent efficacy.”

2. It is not advisable to double mask with KN95 masks. Paul Hickey, president of PuraVita Medical, a company that manufactures KN95 masks, said layering KN95 masks could be dangerous because the design of the mask could cause difficulty in breathing. KN95 mask is designed to be worn as one layer and not double stacked. Layering a KN95 mask with another mask may also affect the fit of the KN95 mask.

“N95 and KN95 masks are designed to filter 95 percent of aerosol particulates through a tight fit provided by proper wear. Placing another mask on top of these masks would alter the fit and could result in them getting less effective,” Sam Barone, MD, chief medical officer of BioPharma, said.