Four of the Penn State Health staff members who were photographed in April 2020 as part of the “Face Mask Smiles” project. Credit: Penn State Health The Medical Minute: Don't get lax with the mask

Since March, the COVID-19 pandemic has changed the way we learn, work and socialize. Now, as nearly all of Pennsylvania is in the green phase of reopening, it is essential for people to remain vigilant by continuing to wear face masks and maintain proper social distancing.

The role of masks in controlling COVID-19

"While it's tempting to view green as being back to normal, that's simply not the case," said Dr. Patrick Gavigan, a pediatric infectious disease physician at Penn State Children's Hospital. "The virus is still out there. We still have cases every day."

In June, the Centers for Disease Control and Prevention (CDC) reiterated the critical importance of social distancing, hand-washing and wearing a as key defenses against the transmission of COVID-19. Face coverings are especially important as research has shown that people become contagious with COVID-19 before they start exhibiting symptoms or feeling ill.

Dr. Ping Du, associate director of the Doctor of Public Health Program at Penn State College of Medicine and an associate professor in the divisions of Infectious Diseases and Epidemiology, said that when she's out and about, she sees less than half of the public—especially among young adults—wearing a mask when they should be.

"Current cases indicate that more and more are getting the disease. Maybe they feel they're not at risk or they'll only get a mild form of the disease," Du said. "For whatever reason, they're not wearing their masks. They might have mild symptoms or be asymptomatic, but they can pass COVID onto others who are at greater risk of getting sick. Everyone should be wearing masks."

Tara Simmons, a community health nurse at Penn State Health Milton S. Hershey Medical Center, said she and her fellow nurses at the Medical Center will not go out into the community without wearing a mask. "To be a good neighbor, you need to wear one," she said.

When and how to wear masks

According to the CDC, face masks should be worn by anyone ages two and older in public settings, and in Pennsylvania, mask-wearing is required when entering any business in all counties in the state in both the yellow and green phases of reopening.

Simmons stresses the importance of staying the course of wearing masks whenever recommended.

"As we can see from other parts of our country, there's a correlation with reduced mask usage and social distancing to increased cases of COVID," she said.

How to care for and wear masks

While we've heard a lot about N95 respirators (also called N95 masks) and level 1 medical masks used by medical providers, face masks made of cotton are appropriate for use by the general public. However, they should be cleaned, stored and used properly to be effective.

"People should wash their mask with hot, soapy water after a single use," Du said. "Then throw it in the dryer on a hot setting. That's why it's important to have at least two masks so they'll always have one ready."

Du advises that clean masks be stored in a new paper or plastic bag until ready to be worn. "Never just store in your pocket or purse," she said. "You don't want to risk contaminating it."

Even when washed and stored safely, masks are only effective at helping to prevent the spread of COVID-19 if they're worn correctly.

"I'll see someone wearing a mask that's dangling from their chin and not covering their nose or mouth, which defeats the purpose," Gavigan said. "Both the nose and mouth need to be covered."

Another problem he sees is people frequently touching the that they're wearing. "That is detrimental. Anytime you touch your face, you could be introducing a virus," he said.

A second wave?

While discussions abound about an anticipated second wave of COVID-19 for this fall, Gavigan, Du and Simmons all stress that we aren't out of the initial wave of the coronavirus yet. And they are concerned that people already are becoming too lax with their social distancing and mask-wearing efforts.

"It's easy to get mask fatigue and fatigue from all of the COVID-19 restrictions across the nation," Gavigan said. "But we can't let our guard down. Masks right now and for the foreseeable future remain a key part in keeping us safe and our counties green."