Endemic Guidelines for Using Face Masks to Continue Protecting Yourself & Others

It seems like it's been a long time since the world was at a standstill at the height of the COVID-19 pandemic. Now, everything is slowly getting back to normal, as vaccines have rolled out in full swing across the globe. Lockdowns have lifted, quarantine requirements have eased, and more and more cities all over the world no longer require the use of face masks.

With governments slowly rescinding pandemic precautions, many people think of wearing masks as an inconvenience rather than a safety measure. If they or people they know have not recently contracted COVID-19, they’re less concerned about the risks and more confident in thinking the pandemic has reached its end.

Transitioning from a Pandemic to an Endemic

Is COVID-19 really behind us? A quick visit to the WHO website tells us that COVID-19 still very much exists. In fact, a significant number of cases continue to rise across the US and the rest of the world. However, even though COVID-19 is still present in most countries, its behavior is already predictable, and its cases are no longer spiking. Due to this, many experts are treating the coronavirus pandemic like it has transitioned to an endemic.

The question is: is it wise to let our guard down in complying with simple precautions, such as wearing face masks? In this resource guide, readers will learn about the implications of wearing masks during endemics, the importance of public safety, and expert tips to follow to prevent future outbreaks.

Important Considerations for Wearing Masks During an Endemic

Even before the pandemic, masks were used to reduce the spread of respiratory infections and to protect individuals from exposure to infection. During the pandemic, more scientific evidence surfaced that proved the benefits of masking in preventing the spread of COVID-19.

The coronavirus is airborne, meaning it can spread through respiratory droplets released into the air when a person coughs, sneezes, or simply speaks. Masks help block these particles from being expelled into the air and landing in the mouths and noses of other people, especially in a crowded indoor area.

While many countries have lifted the use of masks, they can be an impactful tool to protect ourselves and others during this endemic.

Should You Wear a Mask?

The Centers for Disease Control and Prevention advises that children aged 2 years and older should wear a mask in public places, as well as when they are in a crowd of people that do not live in their household.

Caretakers of COVID-19 patients are also advised to wear a mask, whether at home or in any non-healthcare setting. People who are sick or suspect themselves to have COVID-19 are also expected to wear a mask when they are around people or animals, even inside their own homes.

Other individuals may be more vulnerable to contracting coronavirus and its symptoms, and thus are advised to wear a mask. These include are the following:

  • The elderly
  • Pregnant women
  • Caretakers and healthcare providers
  • Travelers, especially those traveling internationally
  • People with certain medical conditions (e.g., cancer, lung or heart disease, diabetes, and conditions that affect the immune system)

Who Should Not Wear a Mask?

Children younger than 2 years old are not required to wear a mask. The CDC also advises against it for anyone with trouble breathing, those unconscious or incapacitated, or people with sensory, cognitive, or behavioral problems. If they are uncomfortable or have trouble wearing or taking off their mask, they can try adaptations and alternatives (which will be discussed later in the article).

Types of Masks

Different types of masks and respirators offer different levels of protection. It’s important to choose and use the right ones to ensure they are effective at preventing the spread of COVID-19. Below are some of the recommended and non-recommended mask types.

What Is Recommended?

Disposable or single-use masks

These masks are not the same as surgical or medical masks and can be commonly purchased online or in retail stores. These are great everyday options to use, especially if you expect them to get wet or dirty throughout the day. It’s also easy to bring extra disposable masks in case you need to change your mask.

It’s important to note that if a person is looking to use disposable or single-use masks, they should aim for masks with multiple layers of non-woven material to help with filtering out airborne particles.

Surgical or procedural masks

These are used in healthcare and hospital settings, providing excellent filtration and fluid resistance.

N95s and other respirators

These masks offer a higher level of protection than cloth or surgical masks by filtering out at least 95% of all small and large airborne particles. To ensure their effectiveness, N95s should be tightly fitted against the user’s face.

What Is Not Recommended?

Masks with vents or exhalation valves

The CDC does not recommend the use of masks with vents or exhalation valves, which may allow respiratory droplets and particles to escape and spread through the air.

Clear or plastic masks

Clear masks or those with clear plastic panels are not recommended for regular use, but may be used as an alternative by those who are deaf or hard of hearing, students learning to read or speak a new language, people who need to see the shape of the mouth when making appropriate sounds, or certain individuals with disabilities.

Situations When Wearing a Mask May Not Be Possible

There may be certain situations where wearing a mask is not possible, or simply impractical. Below are a few of these instances and the alternatives to try instead of wearing a mask.

Dining

Except when actively drinking or eating, the CDC advises individuals to still wear a mask while inside restaurants, diners, or food centers, particularly indoors. This also includes situations like speaking with the restaurant staff and servers.

COVID-19 is more likely to spread in a restaurant or bar setting where interactions with other people are closer than 6 feet,so it’s especially important for diners to wear their masks.

High-intensity activities

Wearing a mask while performing physical activities may cause strained breathing. In such cases, make sure to choose a venue with good air exchange and ventilation. Moreover, it’s important to keep a distance of at least 6 feet from others during the activity.

If the mask gets wet or moist from sweat, make sure to replace it with a clean one.

Water activities

Wearing a mask is not advised when doing water sports or activities, such as swimming at the beach or pool. A wet mask does little to prevent the spread of infections and makes it difficult for the wearer to breathe.

Important Tips to Control Respiratory Infection Outbreaks

While COVID-19 has already transitioned from a pandemic to an endemic, individuals are still advised to remain vigilant and to do their part in preventing its spread, as well as other future respiratory infections. Below are some helpful tips to protect ourselves and others from potential outbreaks.

  • Wear a face mask in public places, crowded indoor venues, and healthcare establishments.
  • Wash your hands regularly with soap and water for at least 20 seconds, especially after coughing and sneezing, or before and after going to the bathroom.
  • If washing your hands is not possible, use an alcohol-based sanitizer with at least 60% alcohol content.
  • Avoid touching your eyes, nose, or mouth when your hands are not washed.
  • Keep a social distance of 6 feet or more indoors or in hallways and waiting areas.
  • Avoid going out of the house when sick.
  • When coughing or sneezing into a tissue, throw the tissue in the bin right away.
  • Clean and disinfect household objects and surfaces frequently.
  • Get vaccinated. COVID-19 vaccines offer up to 94% protection from the virus and its severe symptoms.
  • Get tested for COVID-19. Once symptoms are experienced, make sure to get tested to get proper treatments and prevent infecting others.
  • Minimize close contact with people who are experiencing symptoms of respiratory illness like sneezing or coughing.
  • Maintain proper respiratory hygiene or cough etiquette, and help ill persons do so as well.
  • Avoid sharing personal items, such as toothbrushes, eating and drinking utensils, and towels, especially with sick individuals.
  • Keep living environments clean.

Wearing Face Masks While on Public Transportation Conveyances and Hubs

As of April 18, 2022, the order requiring masks on public transportation conveyances has been lifted. However, the CDC continues to advise people to wear their masks when commuting in public transportation settings at all times.

Properly wearing a high-quality mask or respirator, especially in crowded or poorly ventilated public transport, helps keep the public safe. Everyone is advised to bring a face mask with them to keep them protected during such instances.

The CDC also encourages public transportation and transportation hub operators to practice mask-wearing among all employees.

While the wearing of masks is no longer mandatory in the United States, other countries may still be imposing this precaution when commuting. Individuals are advised to check with their local authorities and with authorities at international destinations when traveling.

To ensure a safe trip, check out these CDC recommendations for domestic travel and international travel during COVID-19.

Importance of Health and Safety in Public Areas

Malls, schools, clubs, and other public spaces and establishments have started to resume operations. However, everyone is advised to remain vigilant and protect themselves in public, particularly in crowded, poorly ventilated spaces. Fine droplets from an infected person can remain airborne indoors for hours, even after a person has left the room.

To make public venues and events safer for everyone, apply the following practices:

  • Avoid the 3 Cs of spaces, as in spaces that are closed, crowded, or require close contact.
  • Choose outdoor gatherings instead of indoor ones, especially if the space is cramped.
  • If meeting in outdoor settings isn’t possible, wear a mask and open a window to allow natural ventilation.

When in public, ensure the proper wearing of the mask with the following tips:

  • Wash hands or apply a sanitizer before putting on and after taking off the mask.
  • Make sure the mask covers the nose, mouth, and chin.
  • Store the mask in a clean plastic or paper bag after taking it off. Discard it properly in a trash bin after use.

Proper Mask Care and Disposal

Germs can survive in a used mask from a few hours to a few days, and the particles on infected masks may be dispersed through the air and transmitted to other people. It’s vital that everyone learns how to properly clean and discard their used masks, because otherwise, they pose a potential health hazard to people who will be exposed.

Depending on the type of mask used, below are some useful tips for proper mask care and disposal:

Surgical and disposable masks

Remove the mask by the strings to prevent the hands from touching the front portion. Then fold the mask in half inwards, ensuring its inner part is not exposed. Fold the mask in half again, and wrap it using the ear loops to avoid unraveling.

For surgical masks, wrap them inside a tissue paper or a polythene bag before discarding them in a yellow waste bag.

Frequently Asked Questions

Experts and government leaders all have different views on the matter, but many virologists suggest that we are nearing the endemic stage of the COVID-19 virus. This happens when we have reached an equilibrium with the virus, whereby it will continue to spread and infect individuals, but it rarely causes severe symptoms because society has developed some immunity against it.

According to CDC metrics, around 70% of Americans live in a place where a mask is no longer needed to protect themselves and others. This figure is based on the rates of new cases, new admissions, and hospital capacity. However, this might not be the case for other countries where COVID-19 is still actively spreading, so it's still much safer to wear a mask in public places or places where people gather.

COVID-19 vaccines are issued for all but are not mandatory. However, everyone is encouraged to get immunization for the coronavirus to protect themselves and others from infection and its deadly effects.

COVID-19 vaccines have been evaluated through clinical trials and are proven safe and effective. Persons 6 months and older are advised to get immunized, and those 5 years and above are advised to get boosted once available.

Unlike in other community settings, being in transportation hubs can expose a person to huge crowds in poorly ventilated areas, increasing one’s risk for COVID-19 infection. It’s highly encouraged to wear a mask as some people using public transport may have not been able to get COVID-19 vaccines, are immunocompromised, or have no other means of transportation.

References

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  • COVID-19 and Travel. (2022, April 15). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/travelers/masks-public-transportation.html
  • COVID-19 Vaccination. (2022, September 15). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/How-Do-I-Get-a-COVID-19-Vaccine.html
  • COVID-19 vaccines: Get the facts. (2022, October 26). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vaccine/art-20484859
  • Huang, P., & Stone, W. (2022, February 26). It’s safe to unmask in many places, says the CDC. These experts aren’t quite ready. NPR.Org. https://www.npr.org/sections/health-shots/2022/02/26/1083210610/masks-mandates-safety
  • Indoor Air and Coronavirus (COVID-19). (2021, December 15). US EPA. https://www.epa.gov/coronavirus/indoor-air-and-coronavirus-covid-19
  • Is COVID-19 reaching the endemic stage? UMass Chan virologist Jeremy Luban weighs in. (2022, August 17). UMass Chan Medical School. https://www.umassmed.edu/news/news-archives/2022/08/is-covid-19-reaching-the-endemic-stage-umass-chan-virologist-jeremy-luban-weighs-in/
  • Respiratory Hygiene/Cough Etiquette in Healthcare Settings | CDC. (n.d.). https://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm
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