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Should we layer two masks on top of each other, as politicians and spectators at the U.S. presidential inauguration did earlier this month? Should we replace cloth masks with medical-grade ones, like some countries in Europe are now recommending? And should we wear masks even when outside?Dr. Anthony Fauci, the chief medical advisor to the U.S. president, said recently that wearing two masks “makes common sense,” but experts say there are caveats to that claim.
The idea behind wearing two masks is to add extra layers of filtration, making it harder for viral droplets to spread from person to person.
Dr. Jane Wang, a clinical instructor at UBC who's studied face masks extensively, said in an email that double-masking might improve fit and can increase that “filtration efficiency.”If the two masks aren't snug around the face, however, that won't matter.
Stephen Barr, an expert in viral pathogens at Western University says masks work by filtering air in and out as we breathe. If too much can sneak through gaps around the sides, “it's not going to be as effective.”So a proper-fitting single mask would be better than a doubled-down approach if gaps are still there.
“Without that seal around the skin, there's no point, in my opinion,” Barr said.Breathability can become an issue with layering masks, and Barr foresees people pulling at or removing their doubled-up face coverings more often, giving them “more chance to get infected.”
Wang agrees double-masking loses its effectiveness if it causes “overheating, poor breathability or (carbon dioxide) retention problems.”The Public Health Agency of Canada (PHAC) doesn't currently recommend double-masking, saying in a statement that “Canada's context is different from that of the U.S.”
“We will continue to monitor the situation and will adapt our guidance if further such evidence emerges,” PHAC said in an email to The Canadian Press.The U.S.-based CDC has also not issued guidance on wearing two masks at once.
Dr. Lisa Bryski, a physician in Winnipeg, isn't aware of any studies on double-masking efficacy, but she still agrees with Fauci's claim.“Anything that increases the barriers or 'obstacle course' as it's being referred to, and is still safely breathable, that does make sense,” she said.Bryski says there are things to keep in mind when layering up face coverings, however. The two masks should be worn with the correct side as inside layer, and “should both fit snugly over your nose, mouth, and chin, with no gaps.
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