As governments, schools and airlines drop mask mandates, questions around masking are not going to disappear. And for good reason: COVID is still with us.

Becky DeCamillis is wearing a lab coat and smiling
Becky DeCamillis

For people who are wondering where we go on mask-wearing from here, we spoke with Becky DeCamillis, a physician assistant with Novant Health Infectious Disease Specialists in Winston-Salem.

Most of us know the drill by now but just to keep everyone on the same page we’ll say it one more time: Science dictates that we change behavior as situations evolve or new information becomes available. Guidance may shift again if a tough new variant emerges.

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The CDC says many Americans can stop wearing masks. What would your advice around masking be?

As community transmission remains low in most of the country, we are continuing to see mask mandates being lifted for the majority of us. There are some exceptions, of course, in big cities where cases are trending up. It’s important to remember that just because a mandate is no longer in effect, it doesn’t mean that you have to stop masking. Individually, you may always choose to keep masking for an added layer of protection depending on your risk factors for severe disease and those of your family. I suspect we’ll continue to see local jurisdictions across the country re-impose or remove mask mandates as cases wax and wane in their area.

What’s your advice to people who aren’t sure what to do?

I would say that masking continues to provide an extra layer of protection from contracting the virus in addition to getting vaccinated and boosted. While masks are most effective when we all wear them, they can still offer some protection even when others around you have stopped.

The absolute answer about when to unmask may not be the same from person to person, given their individual risk for severe disease and that of their family members. For example, is everyone in your household vaccinated? If not, or if they have an immunocompromising condition in which vaccination may not be as effective, you may elect to continue wearing a mask.

When will you feel comfortable not wearing a mask?

Personally, the two keys to unmasking for me are a low level of community transmission in my area and vaccine eligibility for each of my family members. I think we've hit the first target, but I have an infant son who is not eligible for vaccination yet but hopefully will be soon.

At this point in the pandemic as omicron continues to ebb, what’s the ideal mask to wear?

If you choose to keep wearing a mask, strictly speaking, an N95 provides the best protection followed by KN95s or KF94s. A surgical mask also provides good protection but doesn’t quite have the filtering power as the others. Cloth masks provide the least protection but are better than no mask at all.

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When it comes to purchasing N95 masks, are there certain attributes or ratings to watch for?

If you’re looking to purchase N95 masks, I would recommend a reputable source like Project N95. Also, look for masks that are “NIOSH approved,” which should be visible on the packaging. You can be confident that various big box stores like Lowe’s or Home Depot sell legitimate N95 masks as well.

The vast majority of people will have a good fit with the standard N95 mask on the market if they put it on correctly. You just want to ensure there’s a good seal around the nose and mouth.

N95s are a lot more expensive. What if you can’t afford them?

If cost is an issue, you could consider layering a cloth mask over a surgical mask.

Is there any way I can clean an N95 mask? If so, how often would you clean?

I wouldn’t advise the general public to undertake cleaning an N95 mask. Depending on how long you wear an N95 at one time, you may be able to use it for a few days as long as it still fits snugly on the face and isn’t visibly soiled. You should store it in a clean, dry place in between uses.

What’s your take on the value of cloth masks? There seems to be a fair amount of debate among public health experts around this.

Cloth masks are better than no mask at all, if that’s all that’s available to you. As the virus has evolved to be more transmissible like we saw with Omicron, the protective power of cloth masks has waned, which is why many experts are recommending against their use these days.

If you were sending a child to school would you have her wear a mask and if the answer is yes, what kind?

The answer to this question will vary from person to person and depend on factors such as: are cases really high in your community? Is your child vaccinated? How old is your child? How good are they at wearing a mask? N95s aren’t approved for kids, but there are KN95s in kids’ sizing.

In a scenario where there is high community transmission and your child is unvaccinated or at risk of severe disease, she would ideally wear kids would wear a KN95 or surgical mask but if that is too uncomfortable for them and they’re constantly taking the mask off or readjusting it, then that obviously limits the utility of it. On the other hand, if they will more consistently wear a cloth mask, then that actually may be a better choice.