The information in this article is correct at the time of writing. Stay up to date with current guidance here.
What is the current guidance?
The government has announced that from 15 June wearing face coverings will be compulsory on public transport. Anyone who fails to do so will face a fine. Very young children, disabled people and those with breathing difficulties will be exempt.
Government advice states that, while there is no evidence suggesting face coverings will protect you from coronavirus, it may provide protection for others if you have the virus. It could be that you're asymptomatic or not showing symptoms yet, so wearing a mask minimises the risk of unknowingly passing on the virus.
You do not need to wear a mask while exercising or in schools. Government guidance doesn’t outline a need for face coverings at work, unless you’re working in a situation where you need PPE. There is also nothing to say you must wear a covering in shops.
What’s the difference between a face covering and a face mask?
A face covering is a piece of cloth that covers your nose and mouth – this includes a scarf or bandana or a homemade face covering made of fabric.
Face masks include surgical masks, dust masks and respirator masks that have a filter built in, known as N95 masks.
The guidance is that you should not be purchasing medical-grade masks as they’re needed for frontline staff who are working in high-risk settings dealing directly with coronavirus patients.
"Health and social care workers are carrying out procedures such as swabs and intubation, and exposed to bodily fluids," says GP Dr William Bird, founder of Intelligent Health. "They are exposed to a high viral load (the amount of virus a person is exposed to) and so it’s important that medical masks and other PPE is available to protect them."
Are there any exceptions to this?
"I would say that a mask would be helpful if you’re caring for someone at home who has coronavirus, alongside keeping your distance and rigorous hand-washing," says Dr Bird.
Why are we being asked to wear face coverings?
The primary reason is to protect others from coronavirus if you unknowingly have it.
"A cloth face covering is to protect the people around you from the droplets coming out of your mouth and nose – something called ‘source control,’ says Trish Greenhalgh, Professor of Primary Healthcare Science at the University of Oxford. "It’s in the same way that we use a handkerchief to catch droplets – it’s soft, pliable and absorbent and even though it’s not 100% effective, it’s much better than not using one."
According to the World Health Organization, people are most infectious in the first three days after onset of symptoms. However, people can be infectious before they become symptomatic and some may remain asymptomatic and unaware that they have it.
"The large droplets that are expelled when we speak, cough or sneeze are heavily infectious if you have coronavirus," says Dr Bird. "When you sneeze, you expel about 30,000 droplets at 200mph."
Do face coverings offer any protection to the wearer?
"They offer some protection to the wearer but they are much better at stopping large droplets from escaping than they are at stopping small virus particles coming in because they’re not fitted to the face and the fabric has relatively large holes," says Dr Bird.
"But they are effective at helping to prevent the spread of the virus – an interesting modelling study done on New York showed that if 80% of people wore face coverings that were just 50% effective, then the death rate from coronavirus over two months may be reduced by up to 45%."
Aside from keeping medical-grade masks for frontline staff, evidence for mask use in the general public is quite weak and they only offer their best protection when used correctly and combined with full PPE. Surgical masks have to be replaced at regular intervals to stay effective and respirators need to be properly fitted with a complete seal on the face.
How do I choose the right face covering?
The most important thing to remember when choosing a face covering is that you want something that is comfortable, especially if you’re going to wear it for a long period of time or multiple times a day. You should only wear face coverings once and then dispose of or launder them.
‘Comfort is important – you’re more likely to fiddle with or remove a mask that isn’t comfortable. This increases the risk of contamination,’ says Dr Sarah Jarvis, MBE. ‘In addition, an ill-fitting mask is more likely to slip down off your nose. This removes most of the protection to those around you. You may find that a face covering with a flexible wire over the bridge of the nose is easier to fit and less likely to slip off.’
You can also decide what fastening you choose for your face covering. You can either opt for elastic that fits around the ears or a covering with straps which you tie behind your head. ‘It’s largely a question of preference and making sure the covering fits closely’, says Dr Jarvis. ‘Again, it’s important that the covering doesn’t slip down over your nose. If you have arthritis or stiffness in your hands, you may prefer elastic that fits around your ears. It’s essential that you don’t touch your face at all with your hands when you are putting on or removing the mask.’
Should I choose a disposable or reusable covering?
Whether you choose a disposable or reusable mask is totally up to you and your preferences. Disposable masks have to be put in the bin after every use, so this is worth thinking about if you are going to use it multiple times a day or want a mask that’s more environmentally friendly.
However, reusable masks require washing after every use. ‘It’s important to remember that you should never put a mask on twice without washing it,’ says Dr Jarvis. ‘For a reusable one, store it in a plastic bag until you wash it and remember to wash your hands after storing it.’
How do I launder my face mask?
If you’re using a fabric face covering, you’ll need to launder it after every use. If you’re going out more than once a day, it’s advisable to purchase two or more reusable coverings.
Katie Mortram, Head of Appliance Testing at Good Housekeeping Institute advises the following for laundering fabric coverings:
‘Wash according to the label at the highest temperature possible with biological detergent. Do not use a quick wash setting as you want the wash to be thorough. Wash after every use and wash your hands after removing the mask.’
Who shouldn’t wear a face covering?
Anyone who would find it challenging or risky to wear – the Government specifies children under two or primary school children who can’t use them without assistance, and anyone who may have problems breathing while wearing a face covering. For example, Asthma UK says that people with asthma should not wear one if they find it hard to breathe through it.
So what’s the upshot?
"Face coverings are an additional measure that do no harm when used carefully and correctly [see below] and can help to reduce the transmission of coronavirus," says Dr Bird. "But it must be remembered that they do not replace social distancing and hand washing – these remain the most effective ways to protect yourself and other people.
"Also, mask wearing of any kind, including surgical masks and respirators, does not eliminate risk of transmission – if you develop symptoms, you and your family must still fully self-isolate at home."
How to use a face covering correctly
• "Wash or sanitise your hands before and after putting it on, and then don’t touch it again until taking it off by using the ear loops only," says Dr Bird. "If you touch the covering while it’s on or as you’re taking it off, you risk passing the virus to your fingers and infecting yourself or others via that route."
• It should cover both your nose and mouth, and you should not be struggling to breathe through it.
• "Don’t re-use the same mask over and again," says Dr Bird. "After using, put it in a bag and then wash it with your laundry. Make a few so that you can rotate them."
How to make your own face covering
There is a whole host of online tutorials on how to make your own fabric face coverings, along with companies that sell them. Those that are made with two layers of cotton cloth will suffice.
The Government has produced a guide on how to make your own face covering and instructions on how to wear it here.
To make one from a T-shirt, all you’ll need is an old T-shirt that you do not want anymore (ideally size small or extra small) and a pair of scissors. To make a sewn cloth face covering, you’ll need two 25cm x 25cm squares of cotton fabric, two 20cm pieces of elastic (or string or cloth strips), needle and thread, and scissors.
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