Avian Flu Diary: The CDC's Updated `Consumer Information' On Masks and Face Covers

#16,512

Long before the COVID pandemic emerged - and months into this crisis - the CDC, the WHO, and many other public health entities around the world remained well behind the curve on the subject of masks and face covers for both the public and Health Care Workers.

I've written about the need for better respiratory protection for HCWs often, even before the 2009 H1N1 pandemic (see 2008's PPE's: How Much Is Enough?), and about the inevitable massive shortfall in PPEs we'd see during any respiratory disease pandemic (see 2009's Caught With Our Masks Down).

In 2009's The Man In The Ironed Mask, we looked at the inevitable PPE shortages that would arise during any severe pandemic, and a design - published in a 2006 CDC's EID Journal article - of a Simple Respiratory Mask' that could be made at home out of Tee shirt material.

A year earlier (2008) we looked at another study published in PLoS One (see Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population by Marianne van der Sande, Peter Teunis, Rob Sabel) that concluded:

The bottom line: Any type of general mask use is likely to decrease viral exposure and infection risk on a population level . . .

But many public health agencies - at least those outside of Asia (see HK CDW: Surgical Masks For Respiratory Protection) - have long discouraged the public from wearing face covers during any outbreak (see 2013's The Great Mask Debate Revisited), citing their `ineffectiveness' if not worn properly.

Even after the COVID outbreak began, the WHO Interim Advice On The Community, Home, Healthcare Use of Masks For nCoV2019 and the following infamous Feb 29th, 2000 tweet by the U.S. Surgeon General both sought to discourage their use.

By early April of 2020 the CDC reversed their position on cloth face covers for the public (see The CDC's Cloth Face Cover Recommendations), and the WHO would follow suit a couple of months later.

While offering less protection than an N95 - which were still in critically short supply - cloth face covers were nearly universally recommended by the summer of 2020, and their use no doubt helped reduce both COVID and influenza transmission last winter.

For most of the pandemic I've employed a `double mask' strategy - with a disposable surgical mask over a cloth mask (see Double Masks (Revisited)), but since last summer I have used a KN95 with a surgical mask.

In the spring of 2021, the CDC issued updated guidance for When You’ve Been Fully Vaccinated that essentially liberated most individuals from needing to wear face masks in most indoor settings. In that blog I respectfully offered my reasons for continuing to wear a face mask in public, even though I was fully vaccinated.

Barely two months later, the CDC reversed that guidance (see The CDC's Updated (Jul 27th) Interim Public Health Recommendations for Fully Vaccinated People), after it became apparent that `breakthrough infections' were more common than initially hoped.

Since then, the CDC's advice on face masks has barely changed. Cloth or surgical masks have been `recommended' for the public - but discussion of `better masks' (i.e. N95 or KN95) for the public - even in the face of a more transmissible Omicron variant, has been absent.

On Friday afternoon, the CDC quietly announced an update to their consumer mask website - one that isn't exactly `guidance', and falls short of recommending one type of mask over another - but compares the advantages of different types of masking options (i.e. cloth, surgical, KN95, N95) for the public.

You can find this updated information at:

Types of Masks and Respirators

Updated Jan. 14, 2022

Summary of Recent Changes

Added information to present similar content for masks and respirators
Clarified that people can choose respirators such as N95s and KN95s, including removing concerns related to supply shortages for N95s
Clarified that “surgical N95s” are a specific type of respirator that should be reserved for healthcare settings
Clarified that some types of masks and respirators provide more protection to the wearer than others

View Previous Updates

On This Page

Masks
Choosing a Mask or Respirator for Different Situations
Respirators
Considerations for Children
Alternative Masks for Special Situations

Key Messages:

Masking is a critical public health tool for preventing spread of COVID-19, and it is important to remember that any mask is better than no mask.
To protect yourself and others from COVID-19, CDC continues to recommend that you wear the most protective mask you can that fits well and that you will wear consistently.
Masks and respirators are effective at reducing transmission of SARS-CoV-2, the virus that causes COVID-19, when worn consistently and correctly.
Some masks and respirators offer higher levels of protection than others, and some may be harder to tolerate or wear consistently than others. It is most important to wear a well-fitted mask or respirator correctly that is comfortable for you and that provides good protection.
While all masks and respirators provide some level of protection, properly fitted respirators provide the highest level of protection. Wearing a highly protective mask or respirator may be most important for certain higher risk situations, or by some people at increased risk for severe disease.

CDC’s mask recommendations provide information that people can use to improve how well their masks protect them.

This page describes different types of masks and respirators that you can use to protect yourself and others from getting and spreading COVID-19. Masks and respirators can provide varying degrees of protection, with well-fitting National Institute for Occupational Safety and Health (NIOSH)-approved respirators offering the most protection. Masking is a critical public health tool for preventing spread of COVID-19, and it is important to remember that any mask is better than no mask. This page presents options in order of least to most protective. To protect yourself and others from COVID-19, CDC continues to recommend that you wear the most protective mask you can that fits well and that you will wear consistently.

(Continue . . . )

While I'm gratified to see the message I've been espousing in this blog for nearly 15 years (see 2007's Any Mask In A Viral Storm?) being embraced by public health, I would have liked to have seen - at this stage of the pandemic - a stronger recommendation for `better masks' for the public.