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Face mask guidance for over-60s has changed - WHO advises medical masks

Face mask guidance for over-60s has changed - WHO advises medical grade masks
(Image credit: Getty)

Revised face mask guidance from the World Health Organization (WHO) states that people aged over 60, or those with an underlying health condition such as diabetes, lung disease, cancer or cardiovascular disease, should wear a medical grade face mask in situations where social distancing is not possible and virus transmission is active

The updated guidance signals a more defined stance from WHO on face mask use to help control the spread of COVID-19. The move comes after renewed calls for further scientific research into the effectiveness of face masks – a common coronavirus question leveled at healthcare professionals. 

In new guidance outlined during a June 5 briefing, WHO Director General Dr Tedros Adhanom Ghebreyesus said: “In areas with community transmission, we advise that people aged 60 years or over, or those with underlying conditions, should wear a medical mask in situations where physical distancing is not possible.”

What is a medical mask?

(Image credit: Getty)

Medical masks (surgical masks) are made from a minimum of three layers of synthetic non-woven materials, and designed with filtration layers in the middle. Medical masks are available in different levels of thickness, with two levels of filtration, and different levels of fluid-resistance. They reduce the transmission of droplets formed when breathing and coughing from you to those around you. They also help prevent transmission of the virus to you.

There are changes to WHO’s recommendations for face mask use for the general public too. Dr Maria Van Kerkhove, WHO Technical Lead COVID-19 advised: “For the general public, if you are sick, of course you should be at home. But if you are unwell, you should wear a medical mask and the people who are caring for you should also wear a medical mask.”

Dr Ghebreyesus added: “In light of evolving evidence, WHO advises that governments should encourage the general public to wear masks where there is widespread transmission and physical distancing is difficult, such as on public transport, in shops, or in other confined or crowded environments.

How to wear a medical face mask: WHO advice

However, not everyone needs a medical mask

Don’t interpret the revised WHO face mask guidance as a need to stock up on medical grade face masks, because not everyone needs them. Depending on the person and the situation, cloth face coverings still provide an adequate level of protection when combined with proper hand hygiene and social distancing.

In fact, the type of face mask required is very context-specific, as Dr Kerkhove explains: “What is new in the guidance is that we provide specific examples of situations in community transmission where physical distancing cannot be achieved or cannot be maintained, that a non-medical mask, a fabric mask, should be used.

“We have evidence now that if this is done properly it can provide a barrier… for potentially infectious droplets.”

To recap:

  • If you have COVID-19 or symptoms suggestive of the coronavirus, or you are caring for someone who is infected, wear a medical grade face mask.
  • If you are not sick but are working, living or traveling in areas where there is active transmission and you can’t maintain social distancing, wear a fabric face mask UNLESS you are aged 60 or over or have an underlying health condition - in those cases, wear a medical grade face mask.

An illustration showing social distancing during the coronavirus pandemic

(Image credit: Getty)

Face masks alone will not protect you from COVID-19

During the media briefing, WHO Director General Dr Ghebreyesus stressed that face masks alone cannot protect people from COVID-19. “Masks are not a replacement for physical distancing, hand hygiene and other public health measures. Masks are only of benefit as part of a comprehensive approach in the fight against COVID-19.

“Masks can also create a false sense of security,” he continued, “leading people to neglect measures such as hand hygiene and physical distancing.”

This tallies with guidance from the CDC and from the Mayo Clinic, with advice stressing the importance of staying at least one meter apart from others outside of your household, and washing your hands regularly for 40-60 seconds with soap and water. If you’re outside and unable to access a sink, cleanse your hands with an alcohol-based hand rub for 20-30 seconds.

Face mask materials, according to new WHO research

Each month we see more research surfacing about the effectiveness of homemade face masks vs surgical masks, and whether certain types of materials are better than others when it comes to personal face masks. 

Addressing this, WHO’s renewed face mask guidance states that fabric face masks should consist of at least three layers of different materials. 

COVID-19 Technical Lead Dr Kerkhove expanded on the guidelines: “That comes from new research that we requested from our partners to be able to say how many layers, what types of material, and there’s a lot of detail in here [guidelines] about filtration efficiency.”

The guidelines state that a fabric face mask should:

  • Ideally be made of three layers of fabric
  • The outer layer should be a water-resistant fabric
  • The inner layer should be water absorbent
  • The middle layer should act as a filter

The denser the weave, the better the material. An easy easy way to tell if the material is thick enough to be effective is to hold it up to the light – if you can see light through it, try and find a thicker material. Good choices for outer and inner layers include cotton (the higher the thread count, the better, denim, silk and flannel weave. 

Layer a coffee filter, toilet paper or other material that's safe to breathe as your removable (disposable) filter layer in the middle of the mask, and consider wearing a cut-off of nylon or pantyhose as the outer layer. The latter is based on scientific research into face mask materials conducted at Northeastern University.

If you’d like to make your own face covering, we talk you through everything you need to know, including different materials to use, in our homemade face masks 101. We also look at face mask extenders and how they can make wearing a mask more comfortable. No time to make your own cloth face covering? Then read our guide on where to buy reusable fabric face masks, before learning key fabric mask care tips, including how often you should wash your face mask.

Latest updates on coronavirus symptoms

Last month the CDC updated its list of coronavirus symptoms, which can vary from mild to severe depending on the individual. Symptoms can appear anywhere between 2-14 days after exposure to the coronavirus, and not everyone will display all of the symptoms. Some people may not display symptoms at all (asymptomatic).

The updated list of symptoms include a new cough, fatigue, shortness of breath or difficulty breathing, muscle or body aches, headache, new loss of taste or smell, sore throat, GI symptoms (diarrhea, nausea or vomiting), congestion or runny nose, chills or fever. If you don’t own a thermometer for fever monitoring, take a look at our guide to the best digital thermometers for babies and adults.

There is a small amount of crossover in terms of coronavirus symptoms vs seasonal allergies, especially the GI symptoms, headaches and runny nose, but fever is the key difference between the two: seasonal allergies don’t normally cause an elevated body temperature.