Should you double up on your face masks? Experts weigh in

TORONTO — Some experts say Canadians might want to consider upgrading their face masks, doubling up mask layers, or wearing one while outdoors as more contagious COVID-19 variants continue to spread.

Dr. Gerald Evans, chair of Queen’s University’s infectious diseases division in Kingston, Ont., told CTVNews.ca on Thursday that better quality masks and masking practices may be necessary as the coronavirus pandemic continues.

“There’s always been a strong suggestion that a ‘better’ barrier [regarding] masks is likely to be more efficient at reducing transmission from droplets and short-range aerosols,” Evans said in an email.

“So generally speaking, medical masks are better than non-medical masks, and multiple layers [or] three non-medical masks are better than three-layer non-medical masks,” he explained.

With this in mind, Evans said wearing two masks, a medical mask underneath a reusable fabric mask, “might be better than a single mask.” However, he noted that “no current evidence supports that variants require ‘more’ PPE or masking to reduce transmission.”

“As long as PPE is used properly and consistently, it will be effective,” Evans said.

The Unites States’ top infectious disease expert Dr. Anthony Fauci suggested to NBC on Monday that double masking could increase the level of protection from COVID-19 and its multiple variants.

“If you have a physical covering with one layer, you put another layer on, it just makes common sense that it likely would be more effective, and that’s the reason why you see people either double masking or doing a version of an N95,” Fauci said.

However, Fauci appeared to backtrack on his comments at a town hall appearance on CNN on Wednesday, stressing Americans follow CDC guidance, which does not call for wearing two masks.

Canada’s Chief Public Health Officer Dr. Theresa Tam suggested in November that Canadians start wearing face coverings that are made of three layers with one being a filter.

According to the Public Health Agency of Canada (PHAC), a non-medical mask should be made of at least three layers, two of which should be tightly woven material fabric, such as cotton or linen. The third, middle layer should be a filter-type fabric, such as non-woven polypropylene fabric.

Reusable masks with a non-woven filter layer already built in should be washed daily, and can be washed multiple times. Those with disposable filters should be changed daily or as directed by the manufacturer, according to the updated guidelines.

Dr. Anna Banerji, director of Global and Indigenous Health at the University of Toronto’s Temerty Faculty of Medicine, suggested that Canadians may also want to consider wearing face masks while in certain circumstances outdoors to help reduce possible transmission.

Banerji explained to CTVNews.ca on Thursday that certain areas may become unexpectedly busy, and in those situations, she says Canadians may want a face covering if physical distancing is no longer possible.

“If you’re outside and you’re in a place where you’re walking near people then it’s a good idea to mask up,” Banerji said in a telephone interview.

Regardless of how many layers one’s mask has, Banerji says wearing one at all remains critical as variants emerge.

Banerji explained that PHAC’s updated guidelines do not mean that fabric masks or two layer masks are no longer effective. She said these masks still work, however, more layers will provide more protection.

She said those who don’t have a three-layer mask with a filter should consider wearing a disposable, surgical mask under their cloth mask.

MORE THAN MASKING

Although COVID-19 variants first identified in South Africa and the U.K. have started to spread in Canada, Colin Furness, an expert in infectious disease epidemiology from the University of Toronto, told CTVNews.ca on Thursday it is important to maintain adherence to all public health guidelines.

The variant discovered in the U.K., known as B117, is estimated to be at least 56 per cent more transmissible between people than the original coronavirus strain as a result of a series of mutations. In recent weeks, European countries have begun mandating medical-grade masks in public settings to help combat the variant.

However, Furness cautioned that there isn’t enough data on the new variant yet to know whether double masks of multiple layers are, in fact, effective.

“A better quality mask, a three-layer mask, might provide a little bit more protection for the wearer. I mean that’s the idea… But we don’t have data about the more contagious variant, we don’t have experience with it yet,” Furness said in a telephone interview.

While researchers have learnt more about the behaviour of the latest variant from outbreaks in the U.K. and Ireland, Furness stressed that those countries have different climates, different populations, different cultures and different health restrictions that impact how COVID-19 spreads.

Furness said the best way to protect against this variant would be to limit one’s contacts.

“If you’re trying to improve your personal safety, your mask doesn’t matter nearly as much as staying away from other people. When you improve your mask, you’re mostly improving the safety of people around you,” Furness said.

He added that having a better quality face covering or a mask with more layers does not permit Canadians to gather with friends and family.

While there is “reasonable evidence” that this variant is more transmissible than the original strain, Dr. Matthew Oughton, an infectious diseases specialist at the Jewish General Hospital in Montreal, told CTVNews.ca in an email that continuing to follow all public health guidelines should provide adequate protection.

“This is still SARS-CoV-2, and the preventative measures which work, including physical distancing, masks and face coverings, good ventilation, and hand hygiene all still apply. A prudent approach would be to reinforce the importance of those fundamentals regardless of what variants may or may not be present in a population,” Oughton said.


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