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Deciding who should wear a mask and when

By Dawn Burleigh

Preventing the spread of COVID-19 has resulted in numerous face masks appearing in public from rhinestone blinged out to makeshift scarves.

Several counties in Texas now require a mask if a person is in public. Texas Governor Gregg Abbott has ‘paused’ the reopening of Texas as several areas across the state have reported an increase of coronavirus cases.

At this time of this writing, Orange County does not have a ‘mask required’ order.

Center for Disease Control (CDC) recommends that people wear cloth face coverings in public settings when around people outside of their household, especially when other social distancing measures are difficult to maintain, according to its website.

Cloth face coverings are recommended as a simple barrier to help prevent respiratory droplets from traveling into the air and onto other people when the person wearing the cloth face covering coughs, sneezes, talks, or raises their voice.

This is called source control.

This recommendation is based on what is known about the role respiratory droplets play in the spread of the virus that causes COVID-19, paired with emerging evidence from clinical and laboratory studies that shows cloth face coverings reduce the spray of droplets when worn over the nose and mouth.

COVID-19 spreads mainly among people who are in close contact with one another (within about six feet), so the use of cloth face coverings is particularly important in settings where people are close to each other or where social distancing is difficult to maintain.

CDC recognizes that wearing cloth face coverings may not be possible in every situation or for some people. In some situations, wearing a cloth face covering may exacerbate a physical or mental health condition, lead to a medical emergency, or introduce significant safety concerns.

Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading if it is not possible to wear one.

For example,

  • Individuals who are deaf or hard of hearing—or those who care for or interact with a person who is hearing impaired—may be unable to wear cloth face coverings if they rely on lipreading to communicate. In this situation, consider using a clear face covering. If a clear face covering isn’t available, consider whether you can use written communication, use closed captioning, or decrease background noise to make communication possible while wearing a cloth face covering that blocks your lips.
  • Some individuals with developmental disabilities, sensory integration concerns or tactile sensitivities, certain mental health conditions, or limited cognitive ability may have a negative reaction to wearing a cloth face covering. These individuals may consult with their healthcare provider as part of the decision to wear a cloth face covering.
  • Younger children (e.g., preschool or early elementary aged) may be unable to wear a cloth face covering properly, particularly for an extended period of time. Ensuring proper cloth face covering size and fit and providing children with frequent reminders and education on the importance and proper wear of cloth face coverings may help address these issues.
  • Individuals should not wear cloth face coverings while engaged in activities that may cause the cloth face covering to become wet, like when swimming at the beach or pool. A wet cloth face covering may make it difficult to breathe. For activities like swimming, it is particularly important to maintain physical distance from others when in the water.
  • Individuals who are engaged in high intensity activities, like running, may not be able to wear a cloth face covering if it causes difficulty breathing. If unable to wear a cloth face covering, consider conducting the activity in a location with greater ventilation and air exchange (for instance, outdoors versus indoors) and where it is possible to maintain physical distance from others.
  • Individuals who work in a setting where cloth face coverings may increase the risk of heat-related illness or cause safety concerns due to introduction of a hazard (for instance, straps getting caught in machinery) may consult with an occupational safety and health professional to determine the appropriate face covering for their setting. Outdoor workers may prioritize use of cloth face coverings when in close contact with other people, like during group travel or shift meetings, and remove face coverings when social distancing is possible.

Cloth face coverings are a critical preventive measure and are most essential in times when social distancing is difficult. If cloth face coverings cannot be used, make sure to take other measures to reduce the risk of COVID-19 spread, including social distancing, frequent hand washing, and cleaning and disinfecting frequently touched surfaces.

It is important to remember, cloth face coverings are not surgical masks or respirators. Cloth face coverings also are not appropriate substitutes for them in workplaces where masks or respirators are recommended or required and available.