Coronavirus in Context: The Importance of Facial Coverings and How to Make Our Own

Hello, I'm Dr. John Whyte, Chief Medical Officer at WebMD, and welcome to Coronavirus in Context. Today, we're going to talk about whether you should be wearing something over your face: mask, covering, whatever it should be. And I'm delighted to be joined by my friend and colleague Dr. Neha Pathak, who is medical editor at WebMD. Neha, thanks for joining me.

Thank you so much for having me.

Let's start off with what's the difference between a mask and a covering?

Sure, so generally facial masks fall into two categories, the N95 respirator, and the surgical face mask. The N95 respirator and the surgical face masks we're really trying to prioritize for health care workers at this point, so that's where we have this new addition called the facial covering.

And actually, people have been using facial coverings for a very long time. But essentially, it's anything that you can, um, use to create your own covering that is going to cover the mouth and the nose to protect you from droplets that are incoming, and then to also protect others around you from droplets that are outgoing from your mouth.

Now we have a new recommendation from the CDC that just came out recently that talked about cloth facial coverings in public settings where other social distancing measures are difficult to maintain, such as grocery stores and pharmacies, and in areas of significant community based transmission. It's a voluntary recommendation. Why do you think this occurred?

So I think this is a great question. I think that, I've really been doing a deep dive into the literature around face masks, facial coverings, and then transmission of this new coronavirus. So I think all of that taken together really led the CDC to change this recommendation, which I think makes a lot of sense. And I think there's two pieces of information about this particular virus that really sort of warranted the CDC to re-evaluate their understanding, or their recommendations around face masks

So the first, I would say, is really the understanding around asymptomatic and pre-symptomatic transmission. So now they're really in the literature, so much evidence of this type of transmission. And in some cases, it seems to be substantial in some populations.

And asymptomatic is the person doesn't have any symptoms, correct?

Correct. Correct. So asymptomatic and -- those two groups are kind of grouped together right now. We don't know what proportion are completely without symptoms, what proportion eventually go on to develop mild symptoms, where they may not even realize that they've been sick. But given that there's so many people that fall into that category, and we have evidence now from Germany, from China, from Singapore, where this group seems to play a large role in transmitting the virus to people that are then vulnerable and may have significant complications.

So I think that's one big piece of information that has led people to think of ways that we can protect ourselves beyond social distancing and sheltering in place, because there are situations where we do have to go out for essential errands. I think the other piece of information is this question of exactly how are we transmitting this virus. So we all know about droplet transmission.

So droplets essentially are larger sort of, viral droplets are essentially a way for a virus to spread out --

Yeah.

-- to other people --

[INAUDIBLE].

-- when we sneeze and when we cough. And that's generally what we think of. Now, these droplets are large in size, so they generally settle out of the air within a few seconds. They're not hanging around in the air. And then the six feet rule really comes from the fact that within six feet, these droplets have generally fallen to some surface.

Those two hand lengths. But, but what about people -- or, arm lengths I should say. But what about those people that say, you know, Dr. Pathak, that's a false sense of security by me wearing this facial covering. And again, as you said, it's not a mask, because we don't want people to take up those masks that health professionals need. But are we having a false sense of security?

Yeah, I think that that's a great question. So essentially you have a false sense of security if you don't abide by the social distancing. If you're think, well, I'm wearing some sort of facial coverings, so let me go out into a group of people. I can have a play date as long as I have my facial covering on.

And the reason that is a false sense of security is because there is a potential that even smaller droplets can be coming out of our mouths when we're breathing or when we're talking. And the facial covering may not necessarily protect us from that, so we still do need to keep a distance from people. The other thing to remember is that it does not in any way, wearing a facial covering, take away from the fact that we still need to be washing our hands.

Mm-hmm.

And as we said, really keep -- maintain that social distance if we are out in an area with a lot of people. And I would say that there's a couple of times you want to wash your hands when you are putting on this facial coverings. So one is before you go to create your facial covering, and we'll talk some about that, um, and then once you have it on, you do not want to continue to adjust it, and touch your face, and touch the covering, because then you've contaminated it.

When you get home, you also want to wash your hands before you touch the facial covering. And that is to make sure that any virus that may be on your hands doesn't now contaminate the facial covering. So once --

You could be making it worse.

Exactly. And then once you remove the facial covering, you want to wash your hands again, because now anything that was on that face mask or the facial covering could be on your fingers.

Use it once? Single use?

Yeah, so it's the one time that you're out and about. You come home and then you want to make sure that you clean that facial covering. This is -- again, the moisture from your mouth creates a great environment for other germs to live. So really where -- this is not a one time and I'm going to keep using it until it's soiled.

Sure.

This is I'm home. I was out. Let me wash it. And really, putting it in your, um, the way you would wash any type of laundry, as long as you're putting it on a high heat setting when you're drying it should be sufficient to kill any virus.

So we use hot water. Now, we've been talking about, uh, online that people are making their own. There's a lot of DIY. And you're going to show us how to make our own facial covering.

Yes, so this is a t-shirt that I've borrowed from my husband. But essentially, you want to fold the t-shirt in half. And then what you want to do is you want to bring down the piece that, uh, where the collar is.

OK.

Bring up the bottom piece that you have.

Can you lift the -- yeah. Mm-hm.

Bring up the bottom piece. And now you have a rectangular facial covering. Um, and then two rubber bands should be sufficient. And you want to put it around the edges of your newly created facial covering. And once you've done that, you've essentially created loops for your ears. So you can then put the covering over your mouth and loop it around your ears.

That didn't seem very hard to do.

[LAUGH]

Not too bad.

All right. Well, Dr. Pathak, I want to thank you for taking the time to talk to us about the importance of facial coverings and really helping us make our own.

Thank you so much for having me.

And thank you for watching Coronavirus in Context. I'm Dr. John Whyte.