Update – Feb. 12, 2021
We updated this blog post to include updated face mask guidance from the Centers for Disease Control and Prevention (CDC).
Face masks have become essential tools in our fight against COVID-19 (the new coronavirus). But wearing a face mask raises many questions for people with asthma.
Why Do We Need to Wear Face Masks 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 masks?
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 (2 meters). And it may spread in other ways.
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 mask 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. None of their clients got COVID-19.
Wearing a face mask may also make COVID-19 symptoms less severe if you do get it. Several studies show that face masks may reduce the amount of particles of the new coronavirus you take in, which can result in milder illness.
Should People With Asthma Wear Face Masks?
The CDC and the World Health Organization (WHO) both recommend that you wear a mask 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 mask may not be best for everyone. According to the CDC, these people should not wear face masks:
- 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 mask.
“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 mask 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 face mask made of three layers probably won’t fit tightly enough to affect your oxygen either. A face mask may just be uncomfortable.
If you can’t wear a mask 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 or curbside pickup 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.
Changes in the weather can be an asthma trigger. When it’s cold, you may need to wear a scarf or ski mask over your face mask to stay warm.
Pollen can also trigger asthma. When it’s hot, be cautious while wearing face masks 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 Should I Wear?
There are many options for cloth face masks. You can buy disposable or reusable face masks 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 somewhat effective.
Finding a mask that is comfortable and provides the best protection is important. The CDC recommends:
- Masks with multiple layers of fabric
- Masks that fit snugly against the sides of your face without any gaps
- Masks that cover your nose, mouth, and chin
- Masks with inner filter pockets
- Masks with a metal strip or nose guard to keep air from leaking out
- Using a mask fitter or brace over a disposable or cloth mask to prevent air leaking out of the sides and top
- Wearing one disposable mask underneath a cloth mask (The second mask should push the edges of the inner mask against your face)
- Knot and tuck ear loops of a 3-ply mask (See video below)
- Children two years and older wear a mask that is made for children to ensure a snug without any gaps
Do not choose masks that:
- Are made of fabric that makes it hard to breathe, such as vinyl
- Have exhalation valves or vents which allow virus particles to escape, unless the inside of the valve/vent is covered by fabric
- Are intended for health care workers, including N95 respirators
Do not wear two disposable masks at a time or combine a KN95 mask with any other mask.
Face shields should be worn with masks. Do not wear a face shield alone at this time since we don’t know if they are effective.
The WHO recommends masks that have 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 face mask 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. Make sure your face mask blocks the light but still allows you to breathe through it.
Some types of face coverings are not effective at preventing the spread of the new coronavirus. Bandannas cannot fit tightly enough against your face. The CDC suggests wearing a neck gaiter with two layers or folding it in half to make two layers. 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 type of masks are most appropriate in their environment.
If you have a latex allergy, be careful with elastic ear loops. Choose face masks with fabric ear loops or that tie behind your head.
Here is a video that teaches you how to make a no-sew face mask from a T-shirt. This would be a good homemade face mask to wear over a disposable mask.
How you wear, remove, and clean your face mask is important. It should fully cover your mouth, nose, chin, and beard. Make sure there are no gaps between the face mask and your skin.
Follow these steps when putting on and removing a face mask:
- Wash your hands or use hand sanitizer before putting on a face mask.
- Avoid touching the face mask while using it.
- If your face mask gets damp, replace it with a clean one.
- Remove the mask by the ear loops or ties, trying to not touch the parts of the mask that touch your face.
- Wash your hands or use hand sanitizer.
- Wash fabric face masks in hot, soapy water right away. Throw away disposable masks immediately.
Continue to practice physical distancing even if you wear a face mask. A face mask 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.
Do I Have to Wear Face Masks on Public Transportation?
Masks are now required for travel on all public transportation.
As of Feb. 2, 2021, the updated mask guidance from CDC says that masks are required on planes, buses, trains, and other forms of public transportation. This includes traveling into, within, or out of the United States and in U.S. transportation hubs such as airports and stations.
AAFA's Chief Mission Officer, Melanie Carver, talked about face masks on “The Itch Podcast.” During the episode, she shared:
- Best practices for handling a face mask
- What to look for when buying or making a face mask
- How to clean your face mask
- If people with asthma can wear a face mask
What Can I Do If My Job Requires Me to Wear a Face Mask?
As you return to work, you may be required to wear a mask as part of your job. But if you have trouble breathing while wearing a face mask, 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 masks in different fabrics or styles to find something more breathable.
- 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 mask 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.
If your company requires a face mask, 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 mask is only part of the strategy to prevent the spread of COVID-19. If you can’t wear a face mask due to asthma, physical distancing, staying home and washing your hands often can also help protect you and other people from COVID-19.
Medical Review February 2021.
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