Cloth masks have become a staple of our pandemic lives. In the earliest days of COVID-19, we followed online tutorials to sew masks from old T-shirts. Soon, companies of all kinds—from Old Navy to designer Christian Siriano—flooded the market with masks, so we could keep a stash handy whenever we stepped out the door. But the era of the cloth mask may be coming to an end.
As COVID-19 continues to surge, accelerated by the delta variant, several European governments and companies are banning cloth masks, arguing that they are not as effective as medical masks in the midst of the current outbreak. Instead, they are mandating medical-grade masks. It’s unclear yet whether American companies will follow suit, but it could be worth preparing for that eventuality by understanding the difference between cloth and medical masks, and figuring out where to buy medical masks.
Many airlines now ban fabric masks on flights. Last week, Finnair was the latest to adopt this policy, joining Air France, Lufthansa, Swissair, Croatia Airlines, and LATAM Airlines in announcing that passengers would not be allowed to wear cloth masks on flights. The reason? “Fabric masks are slightly less efficient at protecting people from infection than surgical masks,” according to Finnair’s statement. Now, all of these airlines are only allowing N95 masks, surgical masks, and respirators that do not have exhaust valves.
At the start of 2021, European countries began recommending the use of medical masks, as more transmissible strains of the coronavirus—like the alpha (or British) variant—began spreading. In France, the government made it mandatory to wear masks in public and recommended that citizens only use disposable surgical masks or N95 masks. In Germany and Austria, the governments mandated that citizens wear filtering facepieces (FFP)—a European standard that offers a similar filtration system to the N95—on public transportation, in workplaces, and in shops. In its announcement, the German government said that medical masks offer the wearer more protection than cloth masks, “which are not subject to any standards with regards to their effectiveness.”
The effectiveness of surgical masks was confirmed in a new study conducted by Yale and Stanford researchers that tracked more than 340,000 adults in Bangladesh. Among the subset of people who wore surgical masks, there was a 9.3% reduction in symptomatic COVID; those who did get sick experienced a 11.9% reduction in COVID symptoms. The study’s authors believe symptomatic infections would have decreased even more dramatically if everybody in the sample group wore a surgical mask.
Here in the United States, even in light of the delta variant, the Centers for Disease Control and Prevention (CDC) still dissuades Americans from using N95 masks, saying they should be prioritized for healthcare workers. But some organizations are encouraging people to use medical-grade masks. Some healthcare systems, for instance, will give patients a disposable surgical mask upon arrival if the mask they came with “does not properly fit or does not provide the appropriate amount of protection.” It is also worth noting that the CDC’s guidance has changed several times throughout the pandemic, and it is possible that the agency will eventually follow Europe’s lead by recommending more protective medical-grade masks.
What’s the difference between cloth and medical-grade masks?
COVID-19 can spread through droplets or aerosolized particles that infected people emit when they sneeze, cough, talk, or breathe. All masks, when properly worn, are designed to catch droplets as they escape the wearer’s nose and mouth, which can protect other people in the vicinity. Dr. Christian L’Orange, a professor of mechanical engineering at Colorado State University whose lab focuses on measuring the effectiveness of masks, points out that if everyone in a community wore a mask, it would curb the spread of the disease. “Everything we can do to decrease total viral load and spread is beneficial,” he says.
The difference between cloth masks and medical-grade masks is how much protection they offer the wearer when they breathe in particles. N95 masks, for instance, prevent at least 95% of airborne particles from entering. In a test conducted by the Environmental Protection Agency (EPA), surgical masks were found to provide 71.5% filtration, but only when they were fitted with ties that provide a close fit on the face. Surgical masks with ear loops only offered 38.1% filtration.
Since cloth masks come in a wide array of materials and designs, it’s hard to make generalizations about how effective they are. The EPA found that a three-layer knitted cotton mask blocked 26.5% of particles and a two-layer nylon mask with a filter insert and a metal nose bridge blocked 79%. Other masks fell somewhere in between. The researchers found that creating a better seal around the wearer’s face by tightening ear loops, for instance, could improve a cloth mask’s filtration ability by between 60.3% and 80.2%. “The most effective cloth masks are made from tightly woven materials and have a close seal on your face,” says L’Orange.
The problem, however, is that unlike medical masks, the majority of cloth masks on the market are not designed and tested to ensure they perform at a consistent level. If you’re wearing a fabric mask that does not abide by CDC-approved standards, there is no way to know whether the particular one you’re using is offering robust protection or not. This is why organizations have decided to ban them in favor of surgical or N95 masks, which are subject to government regulations.
If you’re in a situation where you have to buy a medical mask (for a flight, for instance), L’Orange says it is worth doing a little bit of research beforehand. The market is now flooded with different brands selling masks that claim to be medical-grade, yet some are counterfeits that don’t provide strong protection. If you’re buying an N95, L’Orange recommends checking the CDC’s list of approved N95 manufacturers to make sure you’re getting an authentic product. When it comes to surgical masks, you should pick one that has been reviewed by the Food and Drug Administration (FDA). For instance, DemeTECH and BYD Care surgical masks are both FDA-cleared, and have demonstrated 98% filtration efficiency for particles 0.1 microns in diameter. But remember: These masks need to be worn properly, fitted close to the face without gaps, to actually protect you.