Coronavirus disease (COVID-19): Masks

Masks are a key measure to suppress transmission and save lives.

Masks should be used as part of a comprehensive ‘Do it all!’ approach including physical distancing, avoiding crowded, closed and close-contact settings, good ventilation, cleaning hands, covering sneezes and coughs, and more.

Depending on the type, masks can be used for either protection of healthy persons or to prevent onward transmission.

Medical masks are recommended for:

• Health workers in clinical settings. See our guidance for more information on the use of personal protective equipment by health care workers.
• Anyone who is feeling unwell, including people with mild symptoms, such as muscle aches, slight cough, sore throat or fatigue.
• Anyone awaiting COVID-19 test results or who has tested positive.
• People caring for someone who is a suspected or confirmed case of COVID-19 outside of health facilities.
  

Medical masks are also recommended for the following groups, because they are at a higher risk of becoming seriously ill with COVID-19 and dying:

• People aged 60 or over.
• People of any age with underlying health conditions, including chronic respiratory disease, cardiovascular disease, cancer, obesity, immunocompromised patients and diabetes mellitus.
  

Non-medical, fabric masks can be used by the general public under the age of 60 and who do not have underlying health conditions.

Find out more about masks, including videos on how to use, on our public advice page.

In areas where the virus is circulating, masks should be worn when you’re in crowded settings, where you can’t be at least 1 metre from others, and in rooms with poor or unknown ventilation. It’s not always easy to determine the quality of ventilation, which depends on the rate of air change, recirculation and outdoor fresh air. So if you have any doubts, it’s safer to simply wear a mask.

You should always clean your hands before and after using a mask, and before touching it while wearing it.

While wearing a mask, you should still keep physical distance from others as much as possible. Wearing a mask does not mean you can have close contact with people.

For indoor public settings such as busy shopping centres, religious buildings, restaurants, schools and public transport, you should wear a mask if you cannot maintain physical distance from others.

If a visitor comes to your home who is not a member of the household, wear a mask if you cannot maintain a physical distance or the ventilation is poor.

When outside, wear a mask if you cannot maintain physical distance from others. Some examples are busy markets, crowded streets and bus stops. 

Even when you’re in an area of COVID-19 transmission, masks should not be worn during vigorous physical activity because of the risk of reducing your breathing capacity. No matter how intensely you exercise, keep at least 1 metre away from others, and if you’re indoors, make sure there is adequate ventilation.

Check for filtration, breathability and fit when choosing a fabric mask. It should be held in place comfortably with little adjustment using elastic bands or ties. There are different mask shapes such as flat-fold or duckbill – find the one that fits closely over your nose, cheeks and chin. When the edges of the mask are not close to the face and shift, such as when speaking, air penetrates through the edges of the mask rather than being filtered through the fabric. Masks with vents or exhalation valves are not advised because they allow unfiltered breath to escape the mask.

Fabric masks should be made of three layers of fabric:

• Inner layer of absorbent material, such as cotton.
• Middle layer of non-woven non-absorbent material, such as polypropylene.
• Outer layer of non-absorbent material, such as polyester or polyester blend.
  

If purchasing a fabric mask from a store, check to make sure it meets national performance standards.

Watch the video on WHO’s recommended fabric mask materials and composition for more information.

How to put on and wear a fabric mask:

• Before touching the mask, clean your hands with an alcohol-based hand rub or soap and water.
• Inspect the mask for tears or holes, do not use a mask that is damaged.
• Adjust the mask to cover your mouth, nose, and chin, leaving no gaps on the sides.
• Place the straps behind your head or ears. Do not cross the straps because this can cause gaps on the side of your face.
• Avoid touching the mask while wearing it. If you touch it, clean your hands.
• Change your mask if it gets dirty or wet.
  

How to take off and store a fabric mask:

• Clean your hands before taking off the mask.
• Take off the mask by removing it from the ear loops, without touching the front of the mask.
• If your fabric mask is not dirty or wet and you plan to reuse it, put it in a clean plastic, resealable bag. If you need to use it again, hold the mask at the elastic loops when removing it from the bag. Clean your mask once a day.
• Clean your hands after removing the mask.

How to clean a fabric mask:

• Wash fabric masks in soap or detergent and preferably hot water (at least 60 degrees Centigrade/140 degrees Fahrenheit) at least once a day.
• If it is not possible to wash the mask in hot water, then wash it in soap/detergent and room temperature water, followed by boiling the mask for 1 minute.
  

General tips:

• Make sure to clean your hands before touching your mask.
• Make sure you have your own mask and do not share it with others.
• Resist the temptation to pull down your mask to your chin or take if off when speaking to other people.
• Do not store your mask around your arm or wrist or pull it down to rest around your chin or neck. Instead, store it in a clean plastic bag.

Watch our ‘How to wear a fabric mask’ video for a demonstration. 

How to put on and take off a medical mask:

• Before touching the mask, clean your hands with an alcohol-based hand rub or soap and water. 
• Inspect the mask for tears or holes; do not use a mask that has previously been worn or is damaged.
• Verify which side is the top – this is usually where the metal strip is.
• Then, identify the inside of the mask, which is usually the white side.
• Place the mask on your face covering your nose, mouth and chin, making sure that there are no gaps between your face and the mask. Place the straps behind your head or ears. Do not cross the straps because this can cause gaps on the side of the mask.
• Pinch the metal strip so it moulds to the shape of your nose.
• Remember, do not touch the front of the mask while using it to avoid contamination; if you accidentally touch it, clean your hands. 

How to take off a medical mask:

• Before touching the mask, clean your hands with an alcohol-based hand rub or soap and water.
• Remove the straps from behind the head or ears, without touching the front of the mask.
• As you remove the mask, lean forward and pull the mask away from your face.  
• Medical masks are for single use only; discard the mask immediately, preferably into a closed bin.
• Clean your hands after touching the mask.
• Be aware of the condition of the mask; replace it if it gets soiled or damp.

Medical masks (also known as surgical masks) are:

• composed of 3 layers of synthetic nonwoven materials
• configured to have filtration layers sandwiched in the middle
• available in different thicknesses
• have various levels of fluid-resistance and filtration
  

Respirators (also known as filtering facepiece respirators – FFP) are available at different performance levels such as FFP2, FFP3, N95, N99.

Medical masks and respirator masks are similar in their protection value. However, respirators are specific for certain procedures and instances because they have a tightly fitted component to them. Respirator masks are designed to protect healthcare workers who provide care to COVID-19 patients in settings and areas where aerosol generating procedures are undertaken. Healthcare workers should be fit tested before using a respirator to ensure that they are wearing the correct size. Wearing a loose-fitting respirator will not offer the same protection to the wearer and may allow small particles to get inside the mask through the sides.

No, WHO does not advise using masks or respirators with exhalation valves. These masks are intended for industrial workers to prevent dust and particles from being breathed in as the valve closes on inhale. However, the valve opens on exhale, making it easier to breathe but also allowing any virus to pass through the valve opening. This makes the mask ineffective at preventing the spread of COVID-19 or any other respiratory virus.

No, WHO does not advise using gloves by people in the community. Instead, WHO encourages the installation of public hand hygiene stations at the entrance and exit of public places, such as supermarkets or public/private buildings. This helps reduce germs brought in by people’s hands. By widely improving hand hygiene practices, countries can help prevent the spread of the COVID-19 virus and other infections.

Health workers are the most likely to be exposed to COVID-19 because they are in close contact with patients with suspected, probable or confirmed COVID-19.

In areas of community or cluster transmission, health workers, caregivers and visitors should wear a mask at all times when in the health facility, even if physical distancing can be maintained. Masks should be worn throughout their shifts, apart from when eating, drinking or needing to change the mask for specific reasons:

• Health workers and caregivers include: doctors, nurses, midwives, medical attendants, cleaners, community health workers, and any others working in clinical areas.
• Health workers must remember to combine hand hygiene with any time they touch their mask or face, before and after putting on and removing their masks, as well as before they touch them to readjust them.

In areas with sporadic spread of COVID-19, health workers in clinical areas should wear medical masks throughout their shift apart from when eating, drinking or needing to change the mask for specific reasons.

Health workers should continue to physically distance and avoid unnecessary close contact with colleagues and others in the facility when not providing patient care.

Respirator masks are recommended for use where aerosol generating procedures are in place for a suspect/confirmed COVID-19 patient. In these settings, WHO recommends the use of airborne and contact precautions.

As health workers have been infected with COVID-19 outside of health facilities, it is critical that health workers, as all people, follow the guidance to protect themselves from infection when outside of a health facility.

Further resources:

• Healthcare workers can complete our OpenWHO course on how to put on and remove personal protective equipment.
• Read our guidance on ‘Infection prevention and control during health care when coronavirus disease (‎COVID-19)‎ is suspected or confirmed’.
  

WHO first issued interim guidance on recommended practices for health workers caring for suspected or confirmed COVID-19 patients in January 2020, which included following droplet/contact precautions: surgical gown, gloves, medical mask, and eye protection.