Update – June 10, 2021
We updated this blog post to include updated face mask guidance from the Centers for Disease Control and Prevention (CDC).
Face masks are an essential tool in our fight against COVID-19 (the coronavirus). But wearing a face mask raises many questions for people with asthma.
Do We Still Need to Wear Face Masks to Prevent the Spread of the Coronavirus?
The Centers for Disease Control and Prevention (CDC) updated their mask guidance. Anyone who is fully vaccinated against COVID-19 can safely resume activities without wearing a mask. You will still need to follow federal, state, local, tribal, or territorial laws. These jurisdictions, workplaces, and private businesses may still require that you wear masks.
You are fully vaccinated two weeks after getting your second Pfizer or Moderna shot or two weeks after getting one Johnson & Johnson shot.
If you have a condition or are taking medicines that weaken your immune system, talk with your doctor about which activities are safe to do.
If you have not received a COVID-19 shot yet, plan to get vaccinated as soon as possible.
Should I Still Wear a Face Mask?
The COVID-19 pandemic is slowing, but it is not over. You should wear a mask if:
- You are not fully vaccinated against COVID-19 (Only when it has been at least two weeks after your second Pfizer or Moderna shot or your one Johnson & Johnson shot are you fully vaccinated – until then you should wear a mask)
- You are fully vaccinated but feel more comfortable continuing to wear a mask
- You have asthma and/or allergies and would like the added protection from pollen, poor air quality, or other respiratory infections
- You have an impaired immune system
According to the CDC, the coronavirus that causes COVID-19 is airborne and spreads from person to person the coronavirus that causes COVID-19 is airborne and spreads from person to person. It can spread through droplets from your nose or mouth when you breathe, talk, sing, yell, eat, sneeze, or cough. You are most likely to catch it if you are not fully vaccinated and less than 6 feet (2 meters) from someone who is infected.
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 if you are not fully vaccinated. 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 coronavirus you take in, which can result in milder illness.
Do Children Need to Wear Face Masks?
COVID-19 vaccinations are now available in the U.S. for everyone 12 years old and older. Children in this age range should get vaccinated as soon as possible so they are protected from COVID-19.
Children should continue to wear a face mask and stay 6 feet apart if they are:
- 2 years old and older
- Too young to receive the COVID-19 shot
- Are not fully vaccinated
Children with a disability that keeps them from safely wearing a mask and children under 2 should not wear masks.
Can People With Asthma Wear Face Masks?
Yes, people with asthma can wear face masks.
The CDC recommends that you wear a mask in public where you can’t keep a proper distance from other people if you are not fully vaccinated. The WHO recommends wearing a fabric mask that allows you to breathe while talking and walking quickly.
“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.”
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. Other studies back this up as well. And a face mask made of three layers probably won’t fit tightly enough to affect your oxygen either. If your mask is uncomfortable, try a new type of mask.
Other Benefits to Wearing Face Masks
Pollen can trigger asthma. Wearing a mask can help cut down breathing in pollen. When it’s hot, be cautious while wearing face masks during hot weather. Consider going out when pollen counts are lower or during the day when temperatures are lower.
Changes in the weather can also be an asthma trigger. When it’s cold, wearing a face mask can warm and humidify the air you breathe. When it’s hot, wearing a face mask may make it harder to breathe.
Exercise is important for people with asthma. Stay active but avoid situations where you would need a mask. If you are outside on a trail or in a park, you probably wouldn’t need to wear a mask. Consider working out outside or at home instead of going to a gym or exercise class that may require a mask.
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 fits well will provide the best protection, If you feel the need to readjust or pull on your mask, it does not fit well. 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 three-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
Do not wear two disposable masks at a time or combine a KN95 mask with any other mask.
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 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 businesses or schools 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.
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 if you are not fully vaccinated, 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 still required for travel on all public transportation even if you are fully vaccinated.
As of June 10, 2021, the updated mask guidance from CDC says that masks are still 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.
What Can I Do If My Job Requires Me to Wear a Face Mask?
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 for time off to get the COVID-19 vaccine.
- 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 may be 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 mask suggestions above.
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. Getting fully vaccinated, physical distancing, staying home, and washing your hands often can also help protect you and other people from COVID-19.
Medical Review June 2021 by Mitchell Grayson, MD
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