Wearing a mask is nothing new for folks like Katie Passaretti, MD, an Atrium Health’s medical director for infection prevention, and an epidemiologist and infectious disease specialist for nearly 10 years. But over the past several months, many people have peppered her with a Hamlet-like question:
To mask, or not to mask?
Dr. Passaretti acknowledges that all masks aren’t created equal, and medical professionals are still learning about connections between mask usage and preventing the spread of COVID-19. But she says one thing is perfectly clear: “In general, whenever you’re near other individuals who you don’t live with, you should be wearing a mask.”
“Certainly, the closer you are the more important it is,” Dr. Passaretti says. “In crowded areas it’s even more important because you’re in closer contact with individuals that could potentially give you COVID. Anytime you’re in public next to someone you don’t live with, you don’t know if they have it.”
She says young and healthy individuals should be consistent in wearing masks outdoors, too, protecting themselves as much as others in the community. Comfort is a factor, but so is effectiveness. “Recent data shows that very thin masks or gaiters don’t provide as much protection as well-constructed cloth masks,” she says. “Disposable masks are fine as well to provide protection to you and people around you.”
Walking and Running
What about people who are outdoors for exercise, walking or running, and wearing a mask even though no one is in sight? Is that really necessary?
“If you can establish good distancing, it’s OK if you don’t wear one while exercising,” Dr. Passaretti says. “I run without a mask and if someone comes close, I cross the road. Take those measures. You don’t want to be in close proximity to other exercisers.”
She says very brief, passing contact with other people outside carries a low risk, as does passing through the air the other people just occupied. ““You never say never, but the risk of COVID is highest with prolonged close contact,” Dr. Passaretti says, “So quickly passing someone or following far behind someone is lower risk.”
Droplets disperse more quickly outside, opposed to in small rooms with poor ventilation. But individuals at higher risk might choose to wear masks at all times to provide themselves an extra element of protection. There’s also something to be said about repetitive behavior and establishing the habit of wearing a mask whenever you’re outside the house.
"While the chance of transmission is lower outside, it’s still possible that COVID could spread and you’re the unlucky one in that scenario next to a super sick person and you don’t have a mask on,” Dr. Passaretti says. “We don’t want to make any kind of absolutes regarding this.”
Dining Out and Gathering
Trying to remain social while maintaining social distance has been one of the biggest adjustments during the pandemic. Bars and nightclubs with dozens or hundreds of people jammed together are prohibited. The same goes for packed theaters, arenas and stadiums. Even indoor dining has been curtailed if not forbidden.
But what about sitting down for a meal outside?
“That’s definitely tricky,” Dr. Passaretti says. “Scope out the restaurant for how crowded it is. It’s all about lowering your risk and eating outside is better than inside. If the tables are spaced out, obviously it’s better. See if the people cleaning the tables and bringing the food are wearing masks appropriately, not under their chins or noses but taking protections seriously. Keeping the group you are dining with limited is important, too, since you’ll be taking your mask off to eat your meal.”
She’s concerned that some people believe being outdoors automatically negates the need for masks, whether at backyard parties, sporting events, or other gatherings.
Let there be no misconceptions about wearing masks outside. She recommends their use “any time people – kids and adults – are in any type of meeting, activity, or group setting, even if you are outside.” People should develop the habit of wearing masks … or at least carrying one and being ready to put it on. Unless she’s running, Dr. Passaretti typically wears a mask from the moment she exits her car until she returns.
A new mindset is crucial for the new normal.
"I anticipate things like mask-wearing and distancing will continue for a while,” Dr. Passaretti says. “It’s important to be prepared. You never know the situation you might end up in, even if you just intend to take a walk”.
“Be prepared by having a mask and wearing it properly, over your nose and mouth.”
Atrium Health is committed to help slow the spread of COVID-19 and has partnered with many of the state's largest employers and other local businesses to donate 2 million “2-ply” cloth face masks to the community. To receive a free mask, visit AtriumHealth.org/FreeMasks to find a pickup location near you.
