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

 

Update – Aug. 13, 2020

We updated this blog post to include information on types of face masks or coverings that aren't effective at preventing the spread of the new coronavirus.


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.”

It’s important to keep your asthma under control. Keep taking your medicines as prescribed. If you are having breathing issues that need your quick-relief inhaler (e.g., albuterol) more than two or more times per week, it’s a sign to call your doctor.


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.

face-mask-with-valve

The picture above shows examples of two types of valved masks. The mask on the top is not effective at preventing the spread of the new coronavirus because the valve is exposed on the inside. But the valve on the mask on the bottom is covered by fabric on the inside and is appropriate to wear.


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.


Itch Podcast Logo

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.

How do you stay healthy and avoid asthma symptoms during the COVID-19 pandemic? Join our community to learn more about protecting yourself from COVID-19.

JOIN NOW

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Comments (16)

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Thanks for the name of the new mask with fans @Pete I was able to find their website and get my questions answered.  Is your sister still happy with it after a few weeks+ usage?

@Pete posted:

my sister bought a mask with fans in it and it allowed her to commute without heat building up or getting sweaty. 

Welcome @Pete !  Is that an adaptation of a pre-Covid product or something new?

my sister bought a mask with fans in it and it allowed her to commute without heat building up or getting sweaty.  Although its a bit big on her face she can breathe comfortably now.  the blue masks were driving her nuts. 

@LoriC @Lois Hi! I have moderate to severe asthma controlled on medication and also work at a high volume business where I am working almost constantly. I have found two types of masks work for me (cotton cloth and nylon with an additional cotton cloth layer). Being high risk and considered essential I would prefer you and others wear a mask because it puts me, other  people who are high risk, or their families are high risk at ease. Considering you are high risk I would not want you to come out without wearing a mask not for my own safety but for yours! Because the virus is a respiratory illness it could be fatal with asthma so please consider your health! Also most places offer online shopping or shipping directly to your door so you can avoid confrontation on the matter completely. I know it is a hard time and trust me I am itching for things to go back to normal but unfortunately cases are on the rise an mask enforcing is for the safety of everyone.

The WHO recommendations for types of material for face mask coverings are ill-advised. Have you noticed how many people have pulled their masks down to uncover their noses, or even pulled them down under their chins? It is because they cannot breathe through them. One must use breathable fabrics for a homemade face mask. Fabrics such as cotton, and not polyester or polypropylene. The CDC RECOMMENDS COTTON. On jennifermaker.com, she uses tightly woven quilter’s cotton and heavy duty cotton T-shirt fabric.  Remember: if you can’t breathe through the mask, you will not wear the mask. I find the non-medical blue disposable mask unbearable, even though my asthma is well-controlled. It does not bother my husband; but then, my husband does not have asthma. I made my masks with 3 layers of cotton, as recommended by Jennifermaker.com.

Great tips Ben! Especially practicing wearing the mask at home and build up to a longer duration. I've seen this suggested particularly for special needs kids with sensory issues.

I'm finding that the fit of the mask is most important for me. It can't press on my nose and I need a mask that is more shaped and suck in against my face as I inhale.

@LoriC try talking to the stores managers before hand call . Perhaps they can open the store early for you or shop for you .  Unfortunately it’s policy and essential employees are trying to protect their  health .  Also other patrons are trying to do the same . At my job we had passengers who knew they were waiting on a pending Covid test and still got on a plane anyway without a mask . Every situation is not going to be perfect or to your liking but many are in the same boat as you . 

As an essential worker who wears there mask all day here are some tips  it’s important to  practice wearing the mask before hand . Try it at home in AC . Take small breaks by yourself in a spot where you don’t have to wear a mask . Communicate with your employer and coworkers . Don’t just assume that it’s just you that might have a problem. Keep in mind that  wearing masks all day may cause migraines like I get . So have a plan with that ready to go as well . Also try on the masks you plan to use of course . Each one is made different.

@LoriC posted:

I am unable to wear a mask due to my asthma! Some stores will not allow a person to shop if they don't wear a mask! They want to know why & if I say medical, they ask what my medical issue is and if I have proof of the medical issue!  I politely tell them that is between me and my Dr. and is against the ADA & HIPPA! They don't care and say that it is the policy!  
I would like to know if anyone else has encountered this discrimination and how you handled it!

I understand your frustration. I can't wear any masks so far (still looking for something I can tolerate)  You're right, we shouldn't have to carry around our diagnoses on our sleeve. I've given up on any expectation of privacy any more. I suppose the clerks are just trying to do their jobs and have something to tell their supervisors, and maybe feel as safe as possible themselves. They probably would accept a brief "asthma" and a display of an inhaler. Or you could try launching into a long story about asthma and its limitations and pretty soon they will back away and leave you alone. Then you'll have the last laugh! In these tough times, it's laugh or cry.

I am unable to wear a mask due to my asthma! Some stores will not allow a person to shop if they don't wear a mask! They want to know why & if I say medical, they ask what my medical issue is and if I have proof of the medical issue!  I politely tell them that is between me and my Dr. and is against the ADA & HIPPA! They don't care and say that it is the policy!  
I would like to know if anyone else has encountered this discrimination and how you handled it!

My problem with the cloth masks is they all produce lint and I do not want to breathe in lint. I have tried washing and lint rolling them but can't get out all the lint.  i tried a surgical mask type but it was not ASTM and even though it is paper, it also produces lint like fibers and I cannot wear it. Is there anywhere i can get true ASTM surgical  masks? Any other suggestions?

I just read about a steroid called Dexamethasone being touted as a possible aid in the coronavirus. What do you know about people who are on steroids already having some benefit from them. I am currently on prednisone and was wondering if that would offer any help.

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Last edited by Kathy P
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