“What’s your favorite part of school so far?”
It’s the quintessential adult-to-kid question after a week or two of school, so when the orthotropics hygienist asked John this week, I was fully expecting certain 9-year-old boy answers.
Most years he might say recess, STEM class experiments, silent reading time, or seeing his friends. Sometimes he comes up with a really fun activity that his creative teacher facilitated in the first week.
This year, the infamous 2020?
He said: “Mask breaks.”
I would agree.
Where to Put Your Mask When You Need a Breath?
When required to wear a facial covering all day at school or work, human beings definitely need breaks to breathe freely without their masks.
And the masks need some time to dry out as well.
Our school is really committed to creating many “mask break” opportunities for the kids throughout the day, which is wonderful, but it begs the question:
Where should you put your mask when taking a short break?
Since my goal in this post series, starting with how to wear a mask correctly to avoid personal risk, is to protect the wearer from inviting greater harm, an important goal while taking one’s mask off and then putting it back on (“doffing” and “donning” respectively, in professional mask-speak) is to make sure the inside is not contaminated by the outside, the wearer’s hands, or anything else.
Easier said than done!
Before school started, John and I were talking about where he could put his mask when he goes out to recess.
After a lengthy academic discussion about the feasibility of using a hook in his locker, my wise fourth-grader pointed out, “But Mom, I’ll have to wear the mask to the door to outside!”
Oh dear. That’s right.
So the only options we came up with included his own pocket, pulling the mask down to his chin or neck (as I see so many doing out in public), hanging it from one ear, or wearing it like a bracelet.
After our discussion, we heard that many school kids were using lanyards to hang their masks around their necks, and that seemed like the best of all the imperfect options. (You can even find lanyards specifically marketed for holding masks.)
Why still imperfect?
A mask hanging around the neck while a child is playing outside could easily be collecting pathogens, including the very virus in question.
We don’t reduce the spread if we give our children a direct delivery system of viruses to faces.
What About the Sleeve Masks? Are They Safe?
It seems like mask breaks are easiest when using a gaiter-style mask, those “sleeves” that get pulled down to the neck when not in use.
The school gave each child a gaiter mask made of the sport-type fabric many workout shirts are made of.
The gaiter is certainly the most convenient for kids to not lose, contaminate, or turn into a slingshot.
It’s also the style I see 2 major problems with:
- It causes humans to touch their nose more than seasonal allergies do! Even my kids, who are well trained not to touch their faces with masks on as you saw in the last post, constantly adjust the gaiter style mask right at the nose.
- A study from Duke University found that gaiter-style masks actually cause an increase in droplets from a speaking human compared to no mask at all. They’re even worse than bandanas, which have been specifically banned in my state as an acceptable face covering.1
It’s likely only a matter of time before gaiters too are not allowed, so I won’t even address proper gaiter protocol other than to recommend against them.
Annnnnnd, guess what? Just after we published this post, a health influencer sent an email sharing info that the Duke University study had been misinterpreted, and in fact, gaiters should work just fine.
The additional “droplets” measured turned out to be fibers from the mask. (source) Guess who doesn’t feel any safer?
Fleece or polyester masks are made of PLASTIC, folks, and if they’re releasing fibers outwardly, you better believe they’re also releasing fibers inward, into our kids’ throats and lungs, or at best, into their mouths where they’re being swallowed.
I’ve already covered plastic risks dozens of times in the past decade, so it’s highly unfortunate that microfiber/polyester masks are the “breathable” comfortable kind, instead of cotton. All of those that I have purchased are cotton, organic when I could find them, and always frustrated that I had to have this expense at all.
I shopped only at Etsy because I wanted to support small businesses in this time when so many businesspeople are suffering or closed by force.
But here we are, in a world where our children are required to cover their faces at school. If that’s the case, while I fight it personally I will find the balance professionally and help families mitigate the risk to their kids.
Let’s talk mask breaks.
How to Take a Mask Break Properly
Mask Break C.O.D.E.
- Clean surface. When you need to take your mask off, set it on a clean surface. This might mean having a clean container with you or a new paper bag. OR you can hang it if possible.
- Outside down. If you’re setting your mask down, place the outside of the mask facing down so that the inside doesn’t touch anything. If hanging on a lanyard, fold the outsides together.
- Dry time. Moisture is an issue; we don’t want to create an environment for bacteria or fungi to grow and then put it back on our faces! Mask breaks are a great time for the mask to dry out. (Don’t use a plastic bag or closed container to store your mask unless it will be washed before wearing again.)
- Ear loops only to hang. Hanging the mask up on a hook where neither the inside nor outside of the mask can touch anything else would be a great option, (but tricky in schools).
Here’s how we hang our masks in the vehicle:
This can all be boiled down to:
The inside of a mask shouldn’t touch the outside of the mask or anything else!
Other Mask Break Notes
In the interest of doing my research but yet staying balanced, here are some recommendations from MDs and mask experts I consulted.
However, I don’t think all of these are feasible for normal humans living normal lives, especially kids at school! But you’ve been informed…
- Technically after putting the mask back on (“donning” your mask), the surface that it touched should be cleaned.
- Pulling your mask down to your chin is not a good idea, because masks can get folded in half and contaminate the inside with the outside. If you’re going to try this maneuver anyway or if you have a gaiter mask, at least work hard to keep only the inner surface touching your skin and adjust the mask only using ear loops or the sides of your gaiter by the ears, not the part that touches your nose. As I’ve watched my little boys use gaiters, I know this is TOUGH. The sleeve masks fold up quickly around the neck if they’re tight on the child’s face, and it’s even more difficult not to touch the nose area than it is with earloop masks. Try to encourage your kids to use a natural hand sanitizer before pulling their gaiter masks up by the center.
- If your mask falls on the ground, you need a new one until yours can be washed.
- Don’t ask others to hand you your mask – they won’t do it right! And you don’t know where their hands have been.
Note that I’m not just worried about spreading coronavirus here, but general germ theory protocol.
If you wouldn’t put something in your mouth that had been on the ground, you shouldn’t put it on your face.
Some folks are all about exposure to soil and germs, so they’d eat the proverbial dropped Oreo even after 5 seconds. If you’re cool with that, then don’t worry as much about your mask touching other objects.
Everyone needs to have their own level of acceptance with what you want to bring to your face, but I think it’s important to be informed and cognizant about all this.
Why Keeping the Outside of Your Mask Clean Matters
When masks were first becoming an expectation or recommendation in early summer, my husband and I were talking about our perception of their efficacy.
I knew even at that time that we’d all be touching our faces more, and I said something to the effect of “viruses crawling from your cheek to your nose! That’s how you get sick when you touch your face!”
He challenged me on my facts, and lo and behold, he was right.
Viruses can’t crawl. They can’t move at all.
A virus is totally dependent on a host cell or something else (Achoo! Droplet transmission!) to have any mobility. They canNOT crawl from your cheek to your nose to make you sick.2
However, we still know that not touching your face is important, because the closer a virus gets to your orifices, the easier it is for the next errant face itch — even with your non-infected elbow — to drag the little bugger to your nose or eyes where it can wreak its havoc in your cells.
Similarly, if the outside of your mask gets pathogens (viruses, bacteria, or fungi) or toxins (like dust mites, pesticides, or cleaning solutions for starters) on it, it’s just all the easier for a quick transfer to the inside to occur.
Your nose is just one itchy moment away from being the recipient of a germ delivery.
I choose to treat the outside of my mask as sacred as the inside, as “off-limits” as picking my nose in a crowded grocery store would be.
And again, I’m not in favor of universal masking, particularly for kids. I think the certain risks outweigh the potential benefits (more on that in the last post in the series).
I’m also not terrified of catching COVID-19 and will take what will come to me, but I have an aversion to causing myself harm and knowingly bringing problems into my home (or into my nasal passageway).
So if I have to wear a mask, and if my children have to wear masks for a temporary time, we’re going to do it with as much education and knowledge as possible. Without stressing out, because I’m all about balance!
I’m not throwing fits about getting rid of masks, yet, but that will come if this goes on too long or we start seeing some of the predicted mask sickness or vehicle accidents caused by mask-wearing drivers, for example.
What My Boys are Doing for Mask Breaks
We do go to an in-person school that is requiring masks all day for all ages, a risk we accepted with full knowledge (see more about how we made that decision and why I think it’s the right one for my 3 boys while we homeschool our daughter in this video on Facebook).
My kids are hanging their masks by both loops on lanyards around their neck while out to recess or eating lunch, which in my opinion is preferable to pulling it to the chin or jamming it in a pocket.
Technically the mask experts would say that it’s basically now become a net to catch all the pathogens in the air, just in time to deliver them to your face.
They each have a paper bag in their backpacks with a backup mask in case something happens to the first one (or we forget some morning, probably a 67% chance of that happening in the next few weeks!!).
For now, I’m allowing the gaiter for my fourth grader, but our 5-year-old is only using earloop masks after observing him using a gaiter for a short period of time last weekend.
Bottom Line: We Choose the Best of the Imperfect Options for Mask Breaks
There’s really no perfectly safe way to wear masks in community settings without disposing of a surgical mask every time you take it off, which is such an environmental hazard I can’t bring myself to recommend it!
Even among doctors, there’s little agreement.
You’ll see in my first post in this series that eight MDs agreed on a proper “how to wear a mask” protocol.
How to Wear a Face Mask Correctly with Mask C.O.D.E.
Use this memory tool to teach kids (and adults!) how to wear a mask safely and correctly.
Check out the full post for more details and a free pdf download!
And that’s where the agreement ended.
Dr. Matthew admitted that although the suggestions on my mask-wearing list are correct ideally, even she doesn’t follow them all in reality.
When we discussed mask break ideas, which I had doctor input on but is NOT as universally approved, she said it’s probably no big deal if a mask hits the ground, because, “It turns out that COVID has a fairly low risk of being spread by fomites (meaning touching the ground or some other object) so maybe we don’t have to worry so much about that. Honestly, I just stuff it my purse and get on with life. We have enough stress and enough things to worry about.”
On the other hand, Dr. Kilbane said that we know viruses suspended in droplets fall to the ground, so she specifically complimented my note about not putting a mask back on that has touched the ground. “The 5-second rule doesn’t apply to masks during COVID times,” she said.
Dr. Song and I conceded that we’re all just making this up with the best knowledge we have because no one reallllly knows enough about this particular virus OR how masks work in day-to-day use to be certain about how to keep oneself or others safe.
And plenty of doctors and mask experts are against universal masking as well.
It’s not a pretty political or health scene.
But everyone agrees that if one must wear a mask, washing cloth masks on a regular basis is very important! Let’s talk about that in the next post in the series!
- Fischer, E., Fischer, M., Grass, D., Henrion, I., Warren, W. & Westman, E. (2020). Low-cost measurement of face mask efficacy for filtering expelled droplets during speech. Science Advances, 6(36). Retrieved from https://advances.sciencemag.org/content/6/36/eabd3083
- Bowron, C. (2020, March 6). A COVID-19 primer: How viruses work and spread. Retrieved from https://www.minnpost.com/health/2020/03/a-covid-19-primer-how-viruses-work-and-spread/
- Song, E. (2020, June 30). Flying with Kids During a Pandemic [Blog Post]. Retrieved from https://healthykidshappykids.com/2020/06/30/flying-with-kids-during-a-pandemic/
- Centers for Disease Control. (2020, August 7). How to Wear Masks. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-wear-cloth-face-coverings.html
- Centers for Disease Control. (2019, March 5). Interim Guidance for the Use of Masks to Control Seasonal Influenza Virus Transmission. Retrieved from https://www.cdc.gov/flu/professionals/infectioncontrol/maskguidance.htm
- Centers for Disease Control. (2020, August 7). Considerations for Wearing Masks. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html#surgical-masks