Which Mask Should You Wear Amid the Omicron Surge?

Early this week, an official stated the Centers for Disease Control and Prevention (CDC) was weighing whether they should update their mask guidance to recommend switching to N95 or KN95 masks to improve protection against the Omicron variant.

However, CDC director Rochelle Walensky said on Wednesday that there are no plans to change mask guidance to advise Americans to wear higher quality masks. The agency stands by its “any mask is better than no mask” guidance.

But because of the Omicron surge, experts stress that cloth masks may no longer provide enough protection. It might be time to upgrade your masking routine.

Here’s how cloth, surgical, and KN95 and N95 masks compare in terms of protection against the virus.

Mask Effectiveness Against Omicron

“The increased transmissibility of the Omicron variant may be due to several factors: a greater number of viruses being generated by the infected person, fewer number of viruses needed to infect a susceptible individual, greater ease of transmission through the air, or a combination of the above,” Vincent Hsu, MD, executive director of infection control at AdventHealth, told Verywell. “Regardless of the reasons, this heightens the need for individuals to protect themselves with better masks.”

Wearing any mask is certainly better than nothing, but with the circulating Omicron variant, it’s important to wear an effective one that can adequately protect you.

Cloth Masks

Cloth masks are reusable face coverings that greatly vary in terms of material, fit, and quality, so it can be difficult to gauge their overall effectiveness. Some cloth masks can filter small infectious droplets and particles (less than 10 microns), while masks with multiple layers and higher thread count can filter almost 50% of fine particles that are less than 1 micron.

If you’re opting for a cloth mask, it’s important that it fits properly over your nose and mouth without any gaps around the sides of your face. Try holding it up to a bright light source to check if it has multiple layers of tightly-woven fabric. If the cloth mask doesn’t block light, or it has exhalation valves, it cannot provide protection against COVID-19.

According to a 2021 study published in PeerJ, repeated washing and drying practices can gradually reduce the filtering efficiency of cloth masks. Researchers found that cloth face mask efficiency dropped by 20% after the fourth wash cycle. 

“Many cloth masks do not provide a significant seal nor do they filter out viral particles,” Hsu said. Given the surge of the Omicron variant, it may be best to opt for a mask that can better protect you.

Surgical Masks

Surgical masks, also known as disposable or medical procedure masks, are made of non-woven fabrics with different layers. You are not supposed to wear more than one surgical mask at a time because it can ruin the fit over your face.

“Surgical masks have been shown to provide increased protection versus cloth masks,” Iahn Gonsenhauser, MD, chief quality and patient safety officer at The Ohio State University Wexner Medical Center, told Verywell. Unlike cloth masks, stretching a surgical mask was not found to change its pore size.

A 2021 study published in Science found that surgical masks were more effective than cloth masks in reducing symptomatic COVID-19 infections on a community level, especially among people aged 60 years and older.

KN95 or N95 Masks

N95 masks are respirators that can filter up to 95% of particles in the air. These masks specifically meet the standards of the National Institute for Occupational Safety and Health (NIOSH) for air filtration. KN95 masks are respirators that also provide up to 95% air filtration, but they meet China-specific standards.

“While they may appear similar, N95 masks are a completely different device to a surgical or isolation mask,” Gonsenhauser said. “The material and construction, as well as the fit to the face, are different in almost every way. An N95 is considered a respirator, unlike a standard mask.”

A typical surgical mask is more like a sneeze-guard where droplets are trapped by the physical barrier, but very small particles can travel around the open sides of the mask. N95 masks, when properly fit, do not allow airflow around the sides of the mask, effectively filtering air through the mask and blocking much smaller particles, he explained.

A 2020 study published in Science Advances evaluated 14 different face masks or mask alternatives to analyze the transmission of respiratory droplets during regular speech. The researchers found that less than 0.1% of droplets were transmitted through a fitted N95 mask while the wearer was speaking.

“There is not currently a recommendation to move to N95 masks,” Gonsenhauser said. “However, by definition, an N95 mask provides better protection from aerosols and airborne pathogens to the wearer. But evidence has not been provided that shows this results in better outcomes for the general population.”

Keep in mind that you can only use one N95 or KN95 mask at a time and should not combine it with other masks.

“Given higher infectiousness of the Omicron variant, we need a more efficient filter because fewer viral particles can result in infection than with prior variants,” Sten H. Vermund, MD, PhD, infectious disease epidemiologist and dean of the Yale School of Public Health, told Verywell. “Highly vulnerable individuals—like the unvaccinated or immunosuppressed—may opt for N95.”

Which Mask Should You Use?

Each type has its pros and cons depending on the situation, so it’s important to do a risk assessment when determining which mask to use, Hsu said. 

“The need for added protection with the KN95 or N95 is evident in those high-risk situations that are crowded or indoors, such as being on an airplane,” he added. “But these tighter-fitting masks can also result in discomfort when worn for long periods of time. In lower-risk situations where there is a greater distance between you and others, a surgical mask may provide adequate protection.”

On social media, there is a circulating graphic taken from an article from The Wall Street Journal which compares the estimated amount of time it takes to transmit an infectious dose of COVID-19. The data used in the graphic was published in the spring of 2021, which means it doesn’t take the Omicron variant into account just yet. Experts said the chart might not be exactly accurate.

“This graphic likely underestimates the value of cloth and surgical masks,” Vermund said. The chart said it takes only one hour for an infectious person with a surgical mask to infect someone without COVID-19 who is also wearing a surgical mask. Still, Hsu emphasized that the idea behind it is correct: both people are more protected if they’re wearing higher-quality masks.

“Now that there are greater numbers of N95 or KN95 available for the public, and especially during the Omicron surge, I recommend these as a way to reduce the risk of becoming infected as they are designed to provide a tight seal by reducing air leakage and the mask filters out viral particles,” Hsu said.

How to Improve Mask Effectiveness

There are several steps you can take to improve your mask’s fit and filtration.

Wear Double Masks

Wearing a disposable mask underneath a cloth mask that has multiple layers of fabric is a good way to increase your protection.

“If you wear a three-ply surgical mask and make it fit snugly with a two- to three-ply cloth mask over it, you might achieve the same [protection] as with a KN95,” Vermund said. “Double masking adds multi-ply protection and likely helps with tighter fit of the mask up against the skin.”

Knot the Ear Loops

Knot the ear loops of a surgical mask at that point where they meet the mask and tuck in the extra material to improve its effectiveness.

The CDC made the following video guide to demonstrate how it is done correctly.

Use Mask Fitters

“Make sure your mask is comfortable and creates a tight seal,” Gonsenhauser said. “If it does not, consider using a mask fitter.”

Using mask fitters over a surgical mask, such as a brace or nylon hosiery sleeve, may enhance its effectiveness by ensuring that it is well-fitted to the contours of the face.

Trim Facial Hair

Careful fit around the facial skin is important, so those with thick beards should consider trimming their facial hair to improve mask fit, Vermund said.

Beards can make mask fitting difficult. If you choose not to double mask or use mask fitters, you can trim your facial hair or shave it altogether.

Purchase Masks From Reputable Sources

According to the CDC, about 60% of KN95 respirators in the United States are counterfeit or fake. They do not meet the requirements of the NIOSH, which means they cannot guarantee that the mask will provide the expected level of protection. The CDC recommends checking the NIOSH Certified Equipment List to identify if your respirator is NIOSH-approved.

“Retailers had some counterfeit or substandard products slip through a few months back, but the supply chains have been strengthened now, so purchasing masks from known retail sources will ensure reasonable quality,” Vermund said.

Remember that wearing well-fitting face masks is just one part of the fight against the COVID-19 pandemic. You should take other preventative measures to protect yourself and the people around you.

“The most important precaution you can take is vaccination, followed by being thoughtful about the environments you expose yourself to, staying home when ill, and wearing well-fitting masks in any environment of increased exposure or transmission risk,” Gonsenhauser said.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.