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Mask Guidance

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Face Masks remain an important tool in helping to limit the spread of COVID-19

Face Masks

Masks remain an important tool in helping to limit the spread of COVID-19.

Current Mandates and Health Orders
The Secretary of Health Mask Order requires wearing a mask in some settings, regardless of vaccination status:
• Health care settings including Long term care facilities
• Adult prison and jail facilities when the county in which the facility is located has a medium or high CDC COVID-19 Community Level

There are limited exceptions to this requirement; these can be found in the Order. All employees and visitors, in addition to the health care professionals, are required to wear a mask when indoors in health care settings. Each person is responsible for complying; businesses
also have responsibilities to enforce this order with employees and customers. 

Public Transportation Settings

WA DOH recommends that workers and passengers two years of age or older wear a well-fitting mask or respirator in indoor public transportation settings, including conveyances (such as airplanes, buses, trains, ferries, subways, taxis, rideshares, and non-emergent medical
transportation) and hubs (such as airports, bus or ferry terminals, train or subway stations, and seaports). These are settings that many people pass through, and they can be crowded and/or poorly ventilated (such as airport jetways). Travelers and workers can protect themselves and
those around them by wearing a well-fitting mask or respirator to help keep travel and public transportation safer for everyone.

Masking Recommendations for Congregate Settings

Indoor mask use is recommended for people two years of age or older when CDC COVID-19 Community Level is medium or high in the settings below:
• Homeless service provider sites
• Commercial maritime settings (e.g., commercial seafood vessels, cargo ships, cruise ships)
• Crowded work settings where physical distancing is not possible due to the nature of the work, such as in warehouses, factories, food packaging and meat processing facilities, and employer-provided transportation
• Shared living areas of congregate living facilities (not bedrooms), including work release sites, transitional housing, juvenile rehabilitation or detention facilities, and temporary worker housing
• Indoors in settings where people incarcerated in adult prisons, adult jails, juvenile rehabilitation facilities, or juvenile detention facilities are present (e.g., court rooms)

    • Note that the Secretary of Health Order requires people five years of age and older to wear masks in adult prisons and jail facilities when CDC COVID-19 Community Level is medium or high.
    • Correctional facilities are recommended to also consider masking when facility level factors indicate increased risk.

If you test positive or are exposed to COVID-19:

People who are immunocompromised, unvaccinated, or feel sick should wear masks to protect themselves and others when in indoor public spaces. Children ages 2-4 are encouraged to wear a mask with adult supervision. Babies and toddlers under age 2 should never wear masks.

  • Wear a snug-fitting, high-quality mask that covers your nose and chin.
  • Wear the best quality mask you can get. Examples, in order of quality are:
    1. Certified N95, KN95, or KF94 masks; or
    2. Surgical masks; or
    3. Cloth masks with multiple layers of breathable, tightly-woven fabric.

Private businesses, organizations, schools and childcares may require you to wear a mask. Thank you for respecting people’s choices to continue to wear a mask.

    The safest way to prevent getting COVID-19 or passing it on to someone else is to get vaccinated, boosted if you’re eligible, and wear a mask when in indoor public spaces. Questions that may help you make a decision about whether to wear a mask include:

    • What health risks do you and your family members have? For example, do you or anyone in your family is an older adult or has an underlying health condition, such as diabetes or heart disease?
    • Do you have young children in your household who are not yet eligible to be vaccinated?
    • Are you fully vaccinated and boosted?
    • How high is COVID-19 transmission in the community?

       

      Masking in Schools

      All information below is listed in:

      Correct use of well-fitting masks protects the wearer as well as others which reduces the risk of spreading the virus that causes COVID-19. When the COVID-19 Community Level is high, CDC recommends universal indoor masking in schools and child care. While masks are no longer required universally in schools or child care settings, there may be situations when a school, child care provider, LHJ, or DOH temporarily recommends or requires wearing well-fitting masks. Consult your LHJ to determine when universal masking is recommended.
      Students, children, and staff may choose to wear a mask at school and in child care settings, with the expectation that others’ choices will be respected. Some may need to wear a mask because they or a member of their household are at high risk for severe COVID-19 disease.

      • Individuals who are immunocompromised, medically fragile, or otherwise at high risk for severe disease should consult their health care provider about whether to wear wellfitting masks or respirators in schools or child care settings. CDC recommends masking for high-risk individuals when CDC COVID-19 Community Levels are medium or high. In addition, people who spend time indoors with individuals at risk for getting very sick with COVID-19 should wear a well-fitting mask. It is strongly recommended that staff who provide care for students and children with disabilities that requires close contact (especially those that are medically fragile) wear appropriate personal protective equipment (PPE) when providing care. See Considerations for Individuals at High Risk and Those with Disabilities (page13).

      • Schools and child care providers should provide masks and other appropriate PPE to staff, students, and children as needed or desired. Additionally, staff who provide care for students and children with disabilities that requires close contact (especially those that are medically fragile) should wear appropriate personal protective equipment (PPE) when providing care.

      While correct use of well-fitting masks helps prevent the spread of COVID-19, there are specific exceptions to mask recommendations based on age, development, or disability. See DOH’s Guidance on Face Coverings and CDC Recommendation Regarding the Use of Face Coverings for
      more information. Employees have the right to choose to mask or select more protective masks. Refer to L&I’s Coronavirus Facial Covering and Mask Requirements.

      • Any student, child, or staff member who tests positive for COVID-19 is required to isolate at home following At-Home Isolation Protocol as outlined in this document. Individuals should continue to wear a well-fitting mask for an additional 5 days (day 6 through day 10) if they return to school after the end of their 5-day isolation period. If an individual is unable to wear a well-fitting mask, they should continue to isolate for a full 10 days.
      • Students, children, and staff who spend time indoors with individuals at risk for getting very sick with COVID-19 should wear a well-fitting mask for 10 days after exposure.

      Masks: A well-fitting mask is anything that completely covers your mouth and nose and fits securely on the sides of your face and under your chin. It should be made of two or more layers of tightly woven fabric with ties or straps that go around your head or behind your ears.  Respirators such as N95s may also be used. A face shield with a drape can be used by people with developmental, behavioral, or medical conditions that prevent them from wearing a mask. It should be acknowledged, however, that a face shield with a drape does not provide the same level of protection for the wearer as a well-fitting mask or respirator.

      Are masks required on airplanes and public transportation?

      As a result of a court order, effective immediately and as of April 18, 2022, CDC’s January 29, 2021 Order requiring masks on public transportation conveyances and at transportation hubs is no longer in effect. Therefore, CDC will not enforce the Order. CDC continues to recommend that people wear masks in indoor public transportation settings at this time.

       

      How do I decide if should wear a mask if not required?

      You may decide that wearing a mask is the right decision for you for reasons such as the transmission rate in our community, your own health, the vaccination status of members of your household, and the level of risk you’re willing to take. 

      The safest way to prevent getting COVID-19 or passing it on to someone else is to get vaccinated, boosted if you’re eligible, and wear a mask when in indoor public spaces. Questions that may help you make a decision about whether to wear a mask include:

      • What health risks do you and your family members have? For example, do you or anyone in your family is an older adult or has an underlying health condition, such as diabetes or heart disease?
      • Do you have young children in your household who are not yet eligible to be vaccinated?
      • Are you fully vaccinated and boosted?
      • How high is COVID-19 transmission in the community?
        Green squareAt All COVID-19 Community Levels
        • People may choose to mask at any time. Masks are recommended in indoor public transportation settings and may be required in other places by local or state authorities.
        Yellow squareMedium or High
        • If you are at high risk for getting very sick, wear a well-fitting mask or respirator.
        • If you have household or social contact with someone at high risk getting very sick, consider self-testing to detect infection before contact and consider wearing a mask when indoors with them.
        Orange squareHigh
        • Wear a well-fitting mask or respirator.
        • If you are high risk for getting very sick, consider avoiding non-essential indoor activities in public where you could be exposed.

      How to spot counterfeit masks

      Masks from legitimate sources will have:

      • Tamper-free, sealed packaging. Be wary of masks that are packaged in a bag with a twist tie or zip-lock close.
      • Packaging clearly marked with a legitimate website, physical address, the manufacturing location and expiration date.
      • Proper official language. For example, if an N95 mask is labeled “FDA approved,” that is a red flag. N95s are approved by NIOSH, not the FDA. Counterfeit masks may come with a “certificate of approval,” but NIOSH does not issue such approvals.
      • A company name or logo imprinted directly on the mask material.
      • Effective quality control. Masks that are damaged or have issues that compromise the fit, such as elastic bands that are too loose or a broken nose-bridge, shouldn’t be trusted.

      N95 masks will also have:

      • A NIOSH mark that is easily visible and spelled correctly.
      • An approval number that starts with “TC-84A” followed by four more numbers imprinted on the mask or head bands. If the mask is NIOSH-approved it will be on this list.
      • Elastic bands that go around the head, creating a tighter seal and better protection. Most NIOSH-approved N95 masks do not have ear loops.

      KN95 masks will also have:

      • A GB marking indicating it meets Chinese national standards.
      • KN​95s made after July 1, 2021, must be stamped with “GB-2626-2019.”
      • KN​95s made prior to July 1, 2021, must be stamped with “GB-2626-2006,” and if the expiration date hasn’t passed they are still good.

      How to verify before you buy:

      • Try to purchase masks directly from a supplier instead of a third-party online seller.
      • Check NIOSH’s list of approved N95 respirators and their manufacturers.
      • Check the NIOSH database of foreign-made respirators sold in the United States. These masks do not have NIOSH approval and aren’t recommended for use by health care workers, but they are suitable for the general population during everyday activities.
      • Be skeptical of companies that overuse words like, “genuine,” legitimate,” or “reputable” when describing their products.

      What mask should I wear?

      A mask or face covering is anything that completely covers your mouth and nose, and fits securely on the sides of your face and under your chin. It should be made of two or more layers of tightly woven fabric with ties or straps that go around your head or behind your ears. More protective coverings, such as masks or respirators may be required in the workplace.

      Guidance from the Centers for Disease Control and Prevention (CDC) recommends strategies to improve mask fitting to more effectively slow the spread of COVID-19. These strategies include wearing a cloth mask over a medical procedure mask, knotting the ear loops of a medical procedure mask, using a mask fitter, or using a nylon covering over a mask. In addition, DOH does not recommend the use of masks with exhalation valves or vents, or single layer bandanas and gaiters.

      Layered prevention strategies — like staying up to date on vaccines and wearing masks — can help prevent severe illness and reduce the potential for strain on the healthcare system. Wear a mask with the best fit, protection, and comfort for you.

      There are a lot of options when it comes to masks, like cloth surgical, KN95’s, the list goes on.

      Cloth masks

      • Washable, reusable and stylish
      • Provide more protection when wearing a surgical mask underneath

      Surgical Masks

      • Provide protection against large droplets
      • Intended for one-time use
      • The more layers the better, check for multiple-ply when reading the label

      KN95 KF94 KN90 Masks

      • Products are typically foreign-made, usually China or Korea.
      • The KN90 and KN95 meet China’s standard of quality requirements. The number 90 signifies the effectiveness of the mask to filter out at least 90 % of airborne particles.
      • The KF94 mask are made in South Korea and meet Korea’s standard of quality requirements.  They ideally filter at least 94% of airborne particles.
      • Can be used multiple times with proper care.
      N90 and N95 Masks 
      • Ideally they will filter at least 95% of airborne particles with the proper fit.
      • Approved by CDC National Institute for Occupational Safety and Health (NIOSH)
      • Provide highest level of protection
      • Can be fitted to seal tightly

      Here’s how your mask options stack up:

      • Best – N​95 respirators
      • Better – KN​95 or KF​94 respirators
      • Good – Double masking with a disposable surgical mask under a cloth mask. Do not layer two disposable masks.
      • Fair – A single disposable surgical mask offers better protection than a cloth mask.
      • Least protective – A single cloth mask provides the least protection but is better than no mask all.

      People are encouraged to use the mask that’s appropriate for their current situation.

      Lastly, having a clean mask is always a good idea too, not to mention it’s better for your skin.

      General Mask Tips

      • Wear a mask that fits over your nose, mouth and under your chin.
      • Choose a  mask that offers high protection and is comfortable to wear.
      • Pick a mask with at least 2 layers to keep droplets out
      • Make sure you can not see light through your mask
      • Do not use a wet, ripped or torn mask.
      • Consider using a mask with greater protection when caring for someone with COVID-19, around others at increased risk of severe illness and when in crowded indoor settings.

      CDC Guide to Masks

         

         

        Studies Supporting Mask Efficacy

        Masking Efficacy—Studies and Links

        Masks work

        Filtration efficiency of common cloth mask fabrics | Argonne National Laboratory (anl.gov)

        Full article: Efficacy of face masks, neck gaiters and face shields for reducing the expulsion of simulated cough-generated aerosols (tandfonline.com)

        COVID-19 Fact Sheet: Workers Need Respirators – ACGIH

        Zooming In: Visualizing the Relative Size of Particles (visualcapitalist.com)

        Science Brief: Community Use of Masks to Control the Spread of SARS-CoV-2 | CDC

        Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis | The BMJ

        https://pubmed.ncbi.nlm.nih.gov/18612429/;

        https://pubmed.ncbi.nlm.nih.gov/32737790/;

        https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext

        Here’s a list of over 70 studies highlighting the efficacy of masks—this was published in July 2020, so there have been numerous more since.

         

        Masking In Schools

        American Academy of Pediatrics endorsed use of masks for children.

        https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/cloth-face-coverings/

        Mask requirements have an impact on school related COVID-19 outbreaks

         

        Masking and Co2 levels

        While Co2 levels may increase with a mask on, the levels we breath while masked remain within safe limits

        Constitutionality of Mask Mandates

        As to the constitutionality of the mandates, if there’s a health emergency, the state constitution allows for a Governor or Public Health Officer to implement mitigation strategies such as masking to limit the impacts of a pandemic. See RCW below.

        RCW 43.06.220: State of emergency—Powers of governor pursuant to proclamation. (wa.gov)  

         

        References