What People With Asthma Need to Know About Face Masks and Coverings During the COVID-19 Pandemic

As we all return to work, school and public places, face coverings and masks have become essential tools in our fight against COVID-19 (the new coronavirus). But wearing a face covering raises many questions for people with asthma.

Why Do We Need to Wear Face Masks or Coverings During the COVID-19 Pandemic?

Physical distancing (also known as social distancing) helps slow the spread of COVID-19. So why do we need to wear face coverings?

Studies have shown many people have COVID-19 and don’t show symptoms. Or they may have the virus a few days before they show symptoms. The purpose of wearing a face covering is to keep you from spreading COVID-19 to other people. This is especially important in places where you will be close to people, like while shopping, in a waiting room or on public transportation. In Missouri, two hair stylists had COVID-19 and served 139 clients. Both the stylists and the salon clients wore face masks or coverings. None of their clients got COVID-19.

Wearing a face mask or covering may also make COVID-19 symptoms less severe if you do get it. Several studies show that face masks or coverings may reduce the amount of particles of the new coronavirus you take in, which can result in milder illness.

According to the Centers for Disease Control and Prevention (CDC), COVID-19 spreads from person to person. It can spread through droplets from your nose or mouth when you are close to someone, less than 6 feet. And it may spread in other ways, but there is still a lot we don’t know about this new virus.

Should People With Asthma Wear Face Coverings or Masks?

The CDC and the World Health Organization (WHO) both recommend that you wear masks or fabric face coverings in public where you can’t keep a proper distance from other people. The WHO recommends wearing a fabric mask that allows you to breathe while talking and walking quickly.

A face covering may not be best for everyone. According to the CDC, these people should not wear face coverings:

• Children under age 2
• Anyone who has trouble breathing
• Anyone who is unconscious, unable to help themselves or can’t remove the mask on their own
  
  

Some people with asthma may experience discomfort or have trouble breathing while wearing a face covering.

“For people with very mild asthma or well-controlled asthma, it’s probably not going to be an issue,” said Dr. David Stukus, member of the Medical Scientific Council for the Asthma and Allergy Foundation of America (AAFA). “For people who have very severe disease and have frequent exacerbations, ER visits, hospitalizations, require lots of medications and frequent symptoms, it might cause more issues for those folks.”

We all need to work together to slow the spread of the new coronavirus. If you’re having trouble wearing a mask, try a different fabric or fit. Wearing some kind of breathable face covering is better than nothing. According to the WHO, medical masks when worn the right way do not cause you to breathe in more carbon dioxide or reduce your oxygen levels. And a homemade face covering made of three layers probably won’t fit tightly enough to affect your oxygen either. A face mask or covering may just be uncomfortable. Try coverings made from fabrics like 100% cotton T-shirt material.

If you can’t wear a mask or face covering because of severe asthma or breathing distress, protect yourself from COVID-19 in other ways:

• Stay home as much as possible.
• Ask others to run errands or shop for you, or use delivery services if possible.
• When in public, keep a distance from others (physical distancing, about 6 feet).
• Avoid or limit close contact with people who are sick, and wash your hands often.
• Avoid crowds as much as possible.
• Avoid travel that is not necessary.
• Clean and disinfect your home and car regularly, especially items you touch often.
  
  

Hot, humid weather and pollen can be asthma triggers. If you have asthma, you may need to be cautious while wearing face coverings during hot weather or when the pollen is high. Consider going out when pollen counts are lower or during the day when temperatures are lower.

Exercise is important for people with asthma. But wearing a mask while exercising may make it harder to breathe. Continue to try to stay active, but avoid situations where you would need a mask. If you are outside on a trail or in a park with few people, you probably wouldn’t need to wear a mask. Consider working out at home instead of going to a gym or exercise class.

What Kind of Face Mask or Covering Should I Wear?

There are many options for cloth face coverings. You can buy disposable or reusable face masks or coverings at many major retail stores or online, or you can make your own. Fabric made from 100% cotton, such as heavy-duty quilt fabric or a knit T-shirt, can be effective.

The WHO recommends three layers:

• An outer water-resistant layer (such as polyester or polyester blend)
• A middle layer of non-woven fabric (such as polypropylene)
• An inner layer of cotton
  
  

Try different styles and fabrics to see what works for you. To tell if a homemade face covering will be effective, hold your mask up to a light. If you can easily see the light through your mask, it may not provide enough protection. The WHO recommends wearing a fabric mask or covering that has three layers. Make sure your face covering blocks the light but still allows you to breathe through it.

Some types of face masks or coverings are not effective at preventing the spread of the new coronavirus. Studies show bandannas and neck fleeces (also called gaiters or buffs) do not work well at blocking droplets from your mouth and nose. If you have a mask with a vent or valve, check the inside of the mask. If you see fabric inside that covers the valve or vent, then the mask is OK to wear. If you see the vent or valve from the inside of the mask, you should not wear the mask because droplets from your mouth and nose can pass through the valve as you exhale.

Keep in mind that some schools or businesses may mandate which types of face coverings or masks are most appropriate in their environment.

If you have a latex allergy, be careful with elastic ear loops. Choose face coverings with fabric ear loops or that tie behind your head.

Here is a video that teaches you how to make a no-sew face covering from a T-shirt.

Watch on YouTube

How you wear, remove and clean your face covering is important. It should fully cover your mouth, nose, chin and beard. Make sure there are no gaps between the face covering or mask and your skin.

Follow these steps when putting on and removing a face covering or mask:

1. Wash your hands or use hand sanitizer before putting on a face covering or mask.
2. Avoid touching the face covering or mask while using it.
3. If your face covering or mask gets damp, replace it with a clean one.
4. Remove the mask by the ear loops or ties, trying to not touch the parts of the mask that touch your face.
5. Wash your hands or use hand sanitizer.
6. Wash fabric face coverings in hot, soapy water right away. Throw away disposable masks immediately.
   
   

Continue to practice physical distancing even if you wear a face covering. A face covering will not give you 100% protection from COVID-19. But it will help you and others reduce the chance of spreading it, especially if you aren’t showing symptoms.

AAFA's Chief Mission Officer, Melanie Carver, talked about face masks and coverings on “The Itch Podcast.” During the episode, she shared:

• Best practices for handling a face mask or covering
• What to look for when buying or making a face mask or covering
• How to clean your face mask or covering
• If people with asthma can wear a face mask or covering

LISTEN NOW

What Can I Do If My Job Requires Me to Wear a Face Covering or Mask?

As you return to work, you may be required to wear a mask or face covering as part of your job. But if you have trouble breathing while wearing a face covering, what are your options?

The first step is to work with your employer. Talk about ways you can work while still helping prevent the spread of COVID-19.

Here are some ways you may be able to work with your employer:

• Ask to serve in a role away from the public or other employees.
• Ask if you can work a different shift or from home.
• Try different types of face coverings in different fabrics or styles to find something more breathable. Or try wearing a face shield.
• If you are part of a union, work with your union representative to ask for reasonable accommodations.
• Ask if you can take more frequent breaks if you feel a face covering is affecting your breathing.
• Stay home if you start having asthma or COVID-19 symptoms.
  
  

People with asthma are covered under the Americans with Disabilities Act (ADA). Under this act, people with disabilities can ask for reasonable accommodations so they can work. If your work requests won’t create a hardship for your employer, you can ask for accommodations.

But the ADA also says if an accommodation could cause harm to other people, then a business does not need to provide the accommodation. If a person with asthma is coughing and not wearing a mask, they might be exposing other people to COVID-19. So in this case, the employer could require the person with asthma to stay home or wear a face mask/covering.

If your company requires a face mask or covering, try to find one that works for you. Refer to the suggestions above (such as a face shield, which your employer would need to provide).

Don’t be afraid to talk to your supervisor or human resources representative. They may also have some creative ideas to help you do your job while managing your asthma.

Remember, wearing a face covering is only part of the strategy to prevent the spread of COVID-19. If you can’t wear a face covering due to asthma, physical distancing, staying home and washing your hands often can also help protect you and other people from COVID-19.