Just FYI: Sometimes it's more complicated than a quick yes-or-no answer.

By Jessica Migala
May 19, 2020
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The discourse around wearing face masks has been confusing, to say the least: Back in February—when COVID-19 was still mainly confined to China, with just a few travel-based US cases—the CDC recommended face masks and respirators only for those in the health care industry who were coming into contact with potential cases. But after that, things changed: The novel coronavirus began sweeping across the US, and in April, the CDC started recommending the general public to wear cloth face masks for when social distancing wasn't an option.

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That's where we're currently at: In larger cities, like New York and Los Angeles, face masks are mandatory when you go outside; and other states have mandated face mask use for when residents are out in public and unable to maintain social distancing. Even if you feel fine, the general rule is to “wear a mask when you’re less than six feet away from another person, unless it is somebody from your inner circle that you trust,” says Antonio Crespo, MD, medical director for Orlando Health Infectious Disease.

Overall, more mask use is a good thing, according to doctors: "Wearing a mask helps prevent respiratory droplets from spreading as far as they otherwise would without a mask,” says Lisa M. Lee, PhD, a public health expert specializing in infectious disease epidemiology and public health ethics at Virginia Tech. “If a person has a respiratory infection—in this case, SARS-CoV-2, which causes Covid-19—breathing, coughing, and sneezing can spew droplets that travel six to 14 feet away. Wearing a mask reduces the amount of space these droplets travel and will help prevent transmission,” she explains.

Another important reminder about masks: They work best when everyone wears one (that means, you protect others when you wear a mask, and vice-versa). So while mask-wearing may appear to be a personal choice, your decision to don one is a step you can take for the health of your community.

Mask-wearing policies still vary by state—as do social distancing guidelines—so there isn't always a clear answer as to when you need to wear a mask during specific situations, like when you're in your car or when you go for a run. To help clear things up, Health asked three different infectious disease or public health experts for their takes on the best public health practices regarding wearing face masks right now, during specific situations, regardless of where you live.

The experts:

Catherine Troisi, PhD, infectious disease epidemiologist at The University of Texas Health Science Center at Houston.

Lisa M. Lee, PhD, public health expert specializing in infectious disease epidemiology and public health ethics at Virginia Tech.

Suzanne Willard, PhD, associate dean for global health and clinical professor division of advanced nursing practice at Rutgers School of Nursing

Should you wear a mask at the grocery store? 

Catherine Troisi: Definitely wear one when you go to the grocery store, which does not mean you don’t need to keep that six-foot distance as well. If I was in a grocery store, I’d wear my mask to protect others. But if someone isn’t wearing one to protect me, I’d steer as far away from them as I could.

Lisa M. Lee: Yes. We also don’t want to give people the idea that if you wear a mask you can do whatever you’d like. It’s not a perfect fix, but it does help a lot. Be careful and keep your distance as much as you can.

Suzanne Willard: Yes. Often, it’s difficult to maintain social distancing while shopping at a store. While you should wear a mask to protect others, you’ll also want to have a list with you to decrease the time you’re in there. Don’t go just to shop, but be purposeful while you’re there.

Should you wear a mask while driving?

Troisi: If you are in the car by yourself or with members of your household, there’s no reason to wear a mask. That said, you should keep a mask on your seat or in your purse in case you go to the store to pick up food. Also, you probably shouldn’t be driving around people who are not members of your household in your car.

Lee: If you’re with family members in your household, there’s no reason to put a mask on. When you interact with someone who is not in your physical distance sphere, put one on. Carry one in your car in case you need to get gas.

Willard: No need to wear one in your car. Don’t drive with it on if you’re in your own car. If you’re doing curbside pickup or getting gas, put that mask on and keep hand sanitizer around to clean your hands with after.

Should you wear a mask in your own home?

Troisi: Not normally. However, if you’re a health care worker who is exposed at work, then yes, wear one because you’re at a high risk of infection and you want to protect your family members. Another reason you might is if someone in your family is sick with the novel coronavirus. And lastly, if someone comes into your home, you can wear a mask. Or, go outside while they’re over. We needed a repair person, and I sat outside on my outdoor back porch.

Lee: There’s no need to wear one in your own home. Unless someone comes into your home, then both you and they should be masked.

Willard: Nope. Unless you are unable to social distance and have a lot of housemates who are going and coming all the time. In those scenarios, you should all wear a mask.

Should you wear a mask while visiting a friend's home?

Troisi: Right now, I wouldn’t visit a friend’s home. I do go visit a friend, [but] we sit outside six feet apart. I haven’t been in her house in months, and she’s a good friend. If you felt that you had to go to a friend’s house, then it’s a good idea to wear one.

Lee: Yes. You don’t know if the friend you’re visiting is infected—they might not know. Even if you feel sure that they’re okay to be around, you really can’t tell just by looking at someone. Until we have a better sense of how to treat people when they get sick, we have to be more careful about our respiratory hygiene. Any instance where you’re pushing breath out, including talking, will put respiratory droplets into the air.

Willard: Yes, and stay six feet apart. But, aren’t many of us still on staying-at-home orders? There’s a risk if you enter someone else’s home. You don’t know what the other person has or whether you have it because testing is still not where it needs to be.

Should you wear a mask at the doctor's or dentist's office?

Troisi: First, you should avoid routine care if possible. For example: I’m due for a dental cleaning, [but] I’m not going—it can wait! The hygienist is right in your face, and they might be masked, but there’s no way you can be. On the other hand, if I had a toothache, I’d take the risk and go for an appointment. Consider the risk-benefit ratio: are you in one of those vulnerable groups or are you taking care of someone who is? Not to say that the infection can’t be serious for everyone regardless of age and health status, but for some groups, it’s more likely to be serious.

When it comes to the doctor, the same is true. I’m supposed to have a routine bone density scan, but I’m putting it off until the fall. If I were really sick and needed to go in, I’d call my doctor first. Don’t just go to the doctor, especially if you might have COVID-19—call. If I were to go in, I’d definitely wear a mask. In some places, they have new practices in place, like they ask you to wait in your car until it’s your time to come in. Things can be done to reduce the risks.

Lee: Yes. A health care provider will be the most knowledgeable about how to avoid getting infected with COVID-19. They’ll likely have one patient in at a time and require everyone to wear a mask unless you’re getting something done that requires your mask to be off. If you have the urgent need for medical care—you broke your leg, feel like you’re having a heart attack or stroke, or need routine treatment like dialysis--there’s no question you should get medical care. But if I had something like a bothersome skin tag or ingrown toenail, I probably would wait to get it taken care of.

Willard: Yes, when going to the doctor’s or dentist’s office, you would wear one and then the dentist can direct you to take it off when needed. This is the time to practice good dental hygiene so you can avoid going to the dentist if possible.

Should you wear a mask while getting your hair or nails done? 

Troisi: Hair and nail salons have opened in Texas. They can only have 25% occupancy, and they’re cleaning a lot. Unless your stylist has six-foot arms, they’re going to be close to you, so you should wear a mask. Honestly, my hair looks horrible, and I’m doing TV interviews. I’m not getting my hair done right now because the risk-benefit ratio is not worth it. It’s something you have to consider for yourself.

Lee: As a person who needs a frequent haircut, I feel the pain of not going, but I’m trying to survive without that appointment. These are services that require close contact with customers, and they and you should wear a mask. Many places are taking additional steps to prevent infection, like having one person in at a time, no congregating in the waiting area, having people wait in the car, and cleaning after each client. A mask alone won’t fix everything, but it is an important part of a system to keep everything safe.

Willard: Yes, you should wear a mask. But I don’t think you should be going to get your hair or nails done right now.

Should you wear a mask during a walk, run, or bike ride outside? 

Troisi: I’m less worried about transmission outside. There’s still a lot we don’t know about transmission, but we are fairly confident that it’s more likely to spread in a contained environment, like an office or house, rather than outside. I don’t wear a mask outside exercising. In my neighborhood, people are very good at maintaining distance when they come upon someone going the opposite direction. You still need that distance, so you should be in a place where it’s possible to maintain that separation and isn’t so crowded.

Lee: If you’re the only person out there, you don’t need a mask. You won’t get COVID-19 from the trees! If you’ll be within six feet of others—or maybe 10 or so feet if you’re running—you’ll want to wear a mask because the heavier you breathe through your mouth, the further respiratory droplets will go. Some people will wear a bandana around their neck and then pull it up when they come across someone else. I think that’s a good idea.

Willard: You have to look at the density of where you are. So, this depends: If no one is around, there’s no need. But if it is a crowded park, then yes. Regardless, always have a mask with you.

Should you wear a mask if you have to take public transportation?

Troisi: If you don’t have to take public transportation, don’t. But many people don’t have that option. I’d definitely wear a mask and try to keep myself away from other people. As women, we’re taught to be polite. If someone sits next to you without a mask, my inclination would be to suck it up. But we have to get over that. You can politely remove yourself. If you get up and move, it’s protecting your health and theirs.

Lee: Doesn’t matter if it’s a train, bus, or car [with others]. Wear a mask. In a public place where other people have touched things, these are all opportunities for transmission. Masks alone won’t do everything, you still need to stay six feet away from others when possible and wash your hands after coming off of public transportation.

Willard: Yes, yes, yes. Wear a mask, especially on public transportation. And watch where you’re putting your hands, and be careful to avoid touching your face.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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