Mask Messaging on Infinite Repeat Until Habit Is Formed
We know what to do: wear a mask, wash our hands, keep our distance, avoid indoor gathering, isolate if positive, exposed, or symptomatic, and get the vaccine when you get your chance. Case numbers and hospitalizations have been dropping recently, but they are still as high as they were in mid November in our area, when the winter surge really took off. Factor in the impact of the new variants which are more contagious, and then we realize how mitigation is even more urgent during the next few months as we work through the long process of getting enough people…

We know what to do: wear a mask, wash our hands, keep our distance, avoid indoor gathering, isolate if positive, exposed, or symptomatic, and get the vaccine when you get your chance.

Case numbers and hospitalizations have been dropping recently, but they are still as high as they were in mid November in our area, when the winter surge really took off. Factor in the impact of the new variants which are more contagious, and then we realize how mitigation is even more urgent during the next few months as we work through the long process of getting enough people vaccinated to achieve herd immunity.

How to read a graph:
Look at how low those incidence rates are compared to the last two months!
Look at how high those incidence rates are compared to everything prior!
The real catch: there is no "what goes up must come down" with infectious disease trends; what goes down can go right back up... unless we are on our guard against infection.

In fact now we're hearing that in line with stepped up mitigation it can be advisable in some situations to wear not one but two masks!

How is that going to work? We can hardly get some people to wear one mask and now they're telling us it might be a good idea to wear two!?!

Dr. Fauci rocking the double-mask look. He's clearly indoors and, unless his wife was the person taking the picture, I'm going to say he was with people from another household...

Here is the basic logic of double-masking. Some of it will sound familiar from the longer discussion of masks posted recently (background links are all in that article). But public health is all about repetition! Let's keep these points in mind and form some good habits together:

  • Cloth masks are good for protecting others from the wearer, but not as good at protecting the wearer from others. That's why the saying has been:  “my mask protects you; your mask protects me.”
  • For universal masking to work we need ~80% mask wearing but we are nationally under 50%, with lots of community transmission.
  • Because so few are wearing masks, those who are need better protection for themselves — look for multiple layers, high filtration, and tight fit.
  • N95s would work, but they still need to be reserved for healthcare workers.
  • KN95, KF94, FFP2, or medical/surgical masks can help to achieve the filtration needed but often don't fit as well. (Also check that they meet protection standards on the FDA Emergency Use Authorization website.)
  • Cloth masks are often less effective at filtering but can help with fit.
  • Double masking combines the filtration from one mask with the fit of the other.
  • In addition, wearing a cloth mask on top of a disposable high filtration one can help both to keep the disposable (non-washable) mask cleaner over time and to prevent the ear loops or ties from breaking, when they're being reused multiple times.
  • For even better fit, consider outer masks that loop or tie behind the head and neck rather than just around the ears.

Does this mean you have to wear two masks at all times??? No. It is appropriate if you are in an area with high transmission (look at the map... that would be a check) AND if you have to be in a high risk situation, namely indoors with people from other households.

Here's a snapshot of the county-by-county risk map from the New York Times from 2/4. The vast majority of the counties in the country are either at very high or extremely high risk now. A handful are in the merely high category and just a few lower than that.

When might one find oneself indoors with people from another household? At school -- yes. At work -- maybe/probably/yes. Out doing errands -- likely yes. Visiting friends at home -- yes. Visiting relatives at their home (which is different from yours) -- yes. Going for a run -- no. Going for a walk outside -- no.

Time for some bargaining. You may be saying, "So how about I wear the mask most of the time when I'm indoors with people from another household, but I take occasional breaks, like for snacks?" Nope. Bad idea. "Well, I've got to eat..." In that case, take it outside! "It's winter!" So we've noticed.

Again for the people in the back, if you are indoors with people from other households for whatever reason and your community is experiencing high virus transmission (i.e 95% of the US currently), you should be wearing a highly protective mask or a combination of slightly less protective ones intended to accomplish the same thing (in other words doublemasking).

To sum up: NO SUPERBOWL PARTIES WITHOUT MASKS! Try a nice quiet (or loud!) Superbowl just with your household. That way you can eat all the snacks yourself and banter with your best buds virtually.

"One option in scenarios when you want extra protection is to wear a cloth mask as well as a regular surgical mask, said Dr. Monica Gandhi, an infectious disease expert at the University of California, San Francisco... She recommended the added protection for people who will be indoors in areas where transmission rates are high." Daily Item, 2/4

And exactly _how_ should you be wearing those double masks when they are called for -- or any other masks for that matter? CORRECTLY! Covering your nose and mouth! Not hanging off one ear... not with your nose hanging out... not under your chin... not in your hand... not looped around your wrist...

Just wear the damn mask(s) any time you are indoors with people from other households!!!

I can hear you now, saying, "so what you're saying is that I don't need a mask at all if I'm outside?" No. If you will be around someone from another household or otherwise in a crowded area, you should also wear a mask outside. Does it need to be double then? Probably not unless you yourself are at high risk.

Alles klar? As mud!

Now this is an interesting picture. This is a federal representative from KY (Massie) who is telling people explicitly that he doesn't want to wear a mask. That's what the words on the mask say and yet, if you look at the picture closely you will also see he is telling people with his actions that he understands double-masking is more protective. If he were just wearing a mask to avoid getting a fine, he could just be wearing the one outer mask. He is not.

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