Double Masking: For Improved Protection Against COVID-19 | Daily News

Double Masking: For Improved Protection Against COVID-19

Masking is one of the imperative prevention measures recommended by the World Health Organization (WHO) and all other health agencies and experts to slow the transmission of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) or the coronavirus disease (COVID-19).

The leading cause of COVID-19 is nosocomial transmission which can mainly occur in places such as hospitals, public and private gatherings, schools, offices, universities, supermarkets, and public transportation systems. Practising social distancing and washing your hands regularly using hand sanitisers with over 60 percent alcohol content and soap and water are the other vital safety practices.

Among those prevention strategies, wearing a face mask is considered a key safety step to keep yourself safe from this airborne virus until the vaccine is fully available to the public in Sri Lanka. Face masks help stop airborne respiratory droplets and particles that can transmit COVID-19 from the people infected with the virus. A face mask acts as an active barrier blocking the virus from getting into the mouth and nose. Wearing face masks can protect older people and also people with severe pre-existing conditions such as diabetes, obesity, heart and lung diseases, weak immunity systems and cancer. The appropriate way to wear a face mask is to cover your face from the bridge of your nose to below your chin, securing enough to stay in place without tight fitting. Mask should not hinder you from talking or irritating you so that you are tempted to touch it over and over or pull it down. Touching your mask could result in touching your face and making it less effective.

Commonly considered face masks include N95, KN95, surgical masks, bandanas, and cloth masks. Minimum two-ply, or preferably a three-ply mask, is recommended to protect against COVID-19. It has been reported that the cotton cloth masks with multiple layers and higher thread counts have shown much better performance as compared to single layers of cloth masks with lower thread counts.

A recent study (Brooks J. T. et al. 2021) conducted by the United States Centers for Disease Control and Prevention (CDC) has found that double masking or wearing two face masks instead of one can effectively increase the filtration and fit the contours of the face better. The virus-containing respiratory droplets are mainly spread and airborne when an infected person talks, sneezes, and coughs. Importantly, wearing double masks can significantly enhance filtration as it has twice the layers of barriers that the SARS-CoV-2 respiratory droplets have to pass through before reaching your mouth and nose. The double masking is to wear a cloth mask on top of a surgical mask or a knot and tuck medical procedure mask. A cloth mask can be made either from synthetic or natural fabrics.

According to the above CDC study conducted with dummies, the double mask blocked approximately 85 percent of the aerosol particles generated by a simulated cough as compared to 56 percent and 51 percent for surgical and cloth masks. The breathing simulator experiment showed that when the infected person or the source was wearing the double mask and the recipient was unmasked, the aerosol exposure of the recipient was reduced by 82 percent. On the other hand, when the recipient wore a double mask and the source was unmasked, the aerosol exposure decreased by 83 percent. However, when both the source and receiver were wearing double masks, the aerosol exposure of the receiver was reduced by 96.4 percent.

Double Masking: Things to Consider

Here are some essential tips for wearing two masks safely and effectively.

Use proper mask combination:

Cloth mask and surgical mask

Avoid wearing the following mask combinations:

Two surgical masks

Two cloth masks

KN95 and any other mask

N95 and any other mask

Ensure your double mask fits snugly over your nose, mouth, and chin

Double mask should allow you to talk freely

Ensure you can breathe and see properly

Test your double mask at home and walk about for some time before using it outdoors

Wear a double mask when you cannot maintain social distancing:

Travelling by public transportation


Social gatherings

Working place

Visiting the doctor or a patient

Over the last few months, numerous rapidly transmissible COVID-19 variants, including the delta variant (B.1.617.2), have emerged worldwide. Hence, taking necessary preventive measures against the COVID-19 virus and its different variants is of significant consideration than ever. Therefore, wearing a double mask can be more effective at preventing you from exposing yourself to the SARS-CoV-2 respiratory droplets made by coughing and breathing. Moreover, other preventive practices, including regular handwashing and physical distancing, are equally important to protect you from the highly contagious viral variants.

(The writer is a Senior Lecturer at the Biosystems Technology Department, Technology University, Sri Jayewardenepura University)