The Covid virus spreads mainly from person to person through respiratory droplets. Respiratory droplets travel into the air when you cough, sneeze, talk, shout, or sing. These droplets can then land in the mouths or noses of people who are near you or they may breathe these droplets in.
Masks are a simple barrier to help prevent your respiratory droplets from reaching others. Studies show that masks reduce the spray of droplets when worn over the nose and mouth.
You should wear a mask, even if you do not feel sick. This is because several studies have found that people with COVID-19 who never develop symptoms (asymptomatic) and those who are not yet showing symptoms (pre-symptomatic) can still spread the virus to other people. Wearing a mask helps protect those around you, in case you are infected but not showing symptoms.
Wearing a mask is especially crucial when you are indoors with persons you do not live with and are unable to keep at least 6 feet away, because COVID-19 spreads primarily among people who are in close contact with one another.
Your mask offers some protection to you
You can also get some protection using a cotton mask. The fabrics used and how your mask is constructed will most likely determine how well it protects you from inhaling the virus (such as the type of fabric, the number of layers of fabric, and how well the mask fits). Who should or should not wear a mask
Masks should be worn:
By people 2 years of age and older
Any time you are in a public setting
Any time you are traveling on a bus, train, or other form of public transportation traveling within, or out of Singapore.
When you are around people who do not live with you, including inside your home or inside someone else’s home
Inside your home if someone you live with is sick with symptoms of COVID-19 or has tested positive for COVID-19
There are specific instances when wearing a mask may not be feasible. In these instances, consider adaptations and alternatives.
The following categories of people are exempt from the requirement to wear a mask:
A child under the age of 2 years;
A person with a disability who cannot wear a mask, or cannot safely wear a mask, for reasons related to the disability;
A person for whom wearing a mask would create a risk to workplace health, safety, or job duty as determined by the workplace risk assessment
Types of masks
Some masks work better than others to help slow the spread of the virus that causes COVID-19. Note: N95 respirators should be prioritised for healthcare personnel.
Cloth masks
More effective fabrics for cloth masks are
Tightly woven fabrics, such as cotton and cotton blends
Breathable
Two or three fabric layers
Less effective fabrics for cloth masks are
Loosely woven fabrics, such as loose knit fabrics
Single layer
CDC is currently studying the effectiveness of various cloth mask materials. Refer to our Scientific Brief: Community Use of Cloth Masks to Control the Spread of SARS-CoV-2 | CDC for more information.
Medical procedure masks (sometimes referred to as Surgical Masks or Disposable Face Masks)
Medical procedure masks are single-use masks that are not made of cloth and are not designed to be washed or laundered. They are sold online and through large retail stores. These are not the same as other medical masks. You may prefer using medical procedure masks in situations where your mask is likely to get wet or dirty. As with cloth masks, make sure your medical procedure mask fits close to your face without large side gaps and completely covers your nose and mouth. Bring extra medical procedure masks with you in case you need to change out a dirty or wet mask.
Masks with exhalation valves or vents
CDC does not recommend using masks with exhalation valves or vents. The hole in the material may allow your respiratory droplets to escape and reach others. Research on the effectiveness of these types of masks is ongoing.
NIOSH-approved N95 respirators
N95 respirators are critical supplies that should be prioritized for healthcare workers and other medical first responders to prevent supply shortages.
Clear masks or cloth masks with a clear plastic panel
Clear masks or cloth masks with a clear plastic panel are an alternative type of mask for people who interact with
People who are deaf or hard of hearing
Young children or students learning to read
Students learning a new language
People with disabilities
People who need to see the proper shape of the mouth for making appropriate vowel sounds (for example, when singing)
If you use this type of mask, make sure
You can breathe easily
Excess moisture does not collect on the inside of the mask
You remove the mask before sleeping, since the plastic part could form a seal around your mouth and nose and make it hard to breathe
Other Types of Face Protection
We do not recommend using face shields or goggles as a substitute for masks. Goggles or other eye protection may be used in addition to a mask.
Do NOT put a plastic face shield (or a mask) on newborns or infants.
Face shields and goggles are primarily used to protect the eyes of the person wearing it. Goggles do not cover the nose and mouth. Face shields are not as effective at protecting you or the people around you from respiratory droplets. Face shields have large gaps below and alongside the face, where your respiratory droplets may escape and reach others around you and will not protect you from respiratory droplets from others. However, wearing a mask may not be feasible in every situation for some people.
Face shields and goggles
People who interact with those who are deaf or hearing impaired may find that a face shield is better than a mask when communicating. If you must wear a face shield instead of a mask:
Choose a face shield that wraps around the sides of your face and extends below your chin or a hooded face shield. This is based on the limited available data that suggest these types of face shields are better at preventing spray of respiratory droplets.
Wash your hands after removing the face shield. Avoid touching your eyes, nose, and mouth when removing it.
Clean and disinfect reusable face shields according to the manufacturer’s instructions. If you use a disposable face shield, wear it once and throw it away according to the manufacturer’s instructions.
Mask adaptations and alternatives
We recognizes that wearing masks may not be possible in every situation or for some people. Those who cannot wear a mask are urged to prioritise virtual engagement when possible.
For in-person activities, we have provided a few examples of what you can do to make wearing a mask more feasible and how to reduce the spread of COVID-19 if you cannot wear a mask.
Situations where wearing a mask may not be possible
Make sure to maintain physical distance from others when you cannot wear a mask.
Dining
We recommends wearing a mask while dining in a restaurant, particularly indoors and when speaking with restaurant workers and servers, except when actively eating or drinking.
The risk of COVID-19 spread increases in a restaurant or bar setting as interactions within 6 feet of others increase. Masks may reduce the risk of COVID-19 spread when worn in any of these risk scenarios.
Water activities
Do not wear a mask when doing activities that may get your mask wet, like swimming at the beach or pool. A wet mask can make it difficult to breathe and may not work as well when wet.
High intensity activities
Masks should always be used in public settings, but if you are unable to wear a mask because of difficulty breathing during high intensity activities, choose a location with greater ventilation and air exchange (for instance, outdoors versus indoors) and where you can keep at least 6 feet of distance from others during the activity. If such a location is not available, opt for low-intensity activities such as walking or yoga that allow for mask wearing.
If you are able to wear a mask, remove your mask if it gets moist from sweat and replace it with a clean mask.
Opt for an activity that does not require using mouth guards or helmets. Wearing a mask with these types of protective equipment is not safe if it makes it hard to breathe.
Supervise children who are wearing a mask while playing sports.
Certain groups of people who may find it difficult to wear a mask
Some children 2 years and older, and people of any age with certain disabilities
Appropriate and consistent use of masks may be challenging for some children and for people of any age with certain disabilities, including people who have high sensitivity to materials on their faces, difficulty understanding why wearing a mask is protective (such as those with an intellectual disability), or those who have problems controlling their behaviour.
When determining if children and people with certain disabilities should wear a mask, assess their ability to:
Use a mask correctly
Avoid frequent touching of the mask and their face
Limit sucking, drooling, or having excess saliva on the mask
Remove the mask without assistance
Those caring for children and people with certain disabilities who may need assistance with wearing masks should
Ask their healthcare provider for advice about the person you are caring for wearing a mask. If they are unable to wear a mask, ask their healthcare provider about alternative ways of reducing transmission risk
Ensure proper mask size and fit
Remove their mask before sleeping, napping, when they may fall asleep (such as in a car seat or stroller), and in situations when continual supervision is not possible
Consider prioritizing wearing a mask in public settings and when around people who don’t live in your household, particularly when indoors. Masks may not be necessary when you and the person you are caring for are outside and away from others, or with other people who live in the same household. However, some localities may have mask mandates while out in public and these mandates should always be followed.
Masks should not be worn by:
Child under 2 years of age
A person with a disability who cannot wear a mask, or cannot safely wear a mask, for reasons related to the disability
A person for whom wearing a mask would create a risk to workplace health, safety, or job duty as determined by the individual workplace risk assessment.
People who are deaf or hard of hearing, and those who will interact with people who are hearing impaired
If you interact with people who rely on reading lips, you may have difficulty communicating while wearing a mask.
Consider wearing a clear mask or a cloth mask with a clear panel
If you are not able to get a clear mask, consider using written communication, closed captioning, or decreasing background noise to make communication possible while wearing a mask that blocks lips
People with certain underlying medical conditions
Most people with underlying medical conditions can and should wear masks.
If you have respiratory conditions and are concerned about wearing a mask safely, discuss with your healthcare provider the benefits and potential risks of wearing a mask.
If you have asthma, you can wear a mask. Discuss with your healthcare provider if you have any concerns about wearing a mask.
Outdoor workers
If you work in a setting where masks could increase the risk of heat-related illness or cause safety concerns (for example, straps getting caught in machinery):
Discuss with an occupational safety and health professional what mask would be suitable.
Prioritise wearing masks indoors and when in close contact with other people, like during group travel or shift meetings. Some localities may require wearing masks in public while outdoors, and these requirements should be followed.
In cold weather, wear masks under winter gear such as scarves and ski masks. If masks become wet from breathing or snow, replace them with dry ones. Keep one or more backups for this purpose.
What to do if you find wearing a mask uncomfortable?
It may help to practice wearing a mask at home for short periods to get used to the feeling and try different styles and fabrics recommended above.
Try relaxation techniques such as breathing in and out deeply or listening to soothing music while wearing a face mask, which can help to keep you calm.
Mask use and carbon dioxide
Wearing a mask does not raise the carbon dioxide (CO2) level in the air you breathe
A cloth mask does not provide an airtight fit across the face. The CO2 completely escapes into the air through the cloth mask when you breathe out or talk. CO2 molecules are small enough to easily pass through any cloth mask material. In contrast, the respiratory droplets that carry the virus that causes COVID-19 are much larger than CO2, so they cannot pass as easily through a properly designed and properly worn cloth mask.
If you wear glasses, find a mask that fits closely over your nose or has a nose wire to help reduce fogging. Consider using an antifogging spray that is made for eyeglasses.
People with beards
Certain types of facial hair, like beards, can make mask fitting difficult. People with beards can
Shave their beards.
Trim their beards close to the face.
Use a mask fitter or brace.
Wear one disposable mask underneath a cloth mask that has multiple layers of fabric. The second mask should push the edges of the inner mask snugly against the face and beard.
References
Brooks JT, Beezhold DH, Noti JD, et al. Maximizing Fit for Cloth and Medical Procedure Masks to Improve Performance and Reduce SARS-CoV-2 Transmission and Exposure, 2021. MMWR Morb Mortal Wkly Rep. 2021;70. Published online 2021 February 10. doi:10.15585/mmwr.mm7007e1
Brooks JT, Butler JC. Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2external icon. Published online 2021 February 10. doi:10.1001/jama.2021.1505
Mueller AV, Eden MJ, Oakes JM, Bellini C, Fernandez LA. Quantitative Method for Comparative Assessment of Particle Removal Efficiency of Fabric Masks as Alternatives to Standard Surgical Masks for PPEexternal icon. Matter. 2020;3(3):950-962. doi:10.1016/j.matt.2020.07.006
Lustig SR, Biswakarma JJH, Rana D, et al. Effectiveness of Common Fabrics to Block Aqueous Aerosols of Virus-like Nanoparticlesexternal icon. ACS Nano. 2020;14(6):7651-7658. doi:10.1021/acsnano.0c03972
Sousa-Pinto B, Fonte AP, Lopes AA, et al. Face masks for community use: An awareness call to the differences in materialsexternal icon. Respirology. 2020;25(8):894-895. doi:10.1111/resp.13891
Chughtai AA, Seale H, Macintyre CR. Effectiveness of Cloth Masks for Protection Against Severe Acute Respiratory Syndrome Coronavirus 2. Emerg Infect Dis. 2020;26(10):e200948. doi:10.3201/eid2610.200948
Hao W, Xu G, Wang Y. Factors influencing the filtration performance of homemade face masksexternal icon. J Occup Environ Hyg. 2021;1-11. Published online ahead of print 2021 Jan 21. doi:10.1080/15459624.2020.1868482
Gandhi M, Beyrer C, Goosby E. Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearerexternal icon. J Gen Intern Med. 2020;35(10):3063-3066. doi:10.1007/s11606-020-06067-8
Zhao M, Liao L, Xiao W, et al. Household Materials Selection for Homemade Cloth Face Coverings and Their Filtration Efficiency Enhancement with Triboelectric Chargingexternal icon. Nano Lett. 2020;20(7):5544-5552. doi:10.1021/acs.nanolett.0c02211
Kimball A, Hatfield KM, Arons M, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility — King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(13):377-381. Published 2020 Apr 3. doi:10.15585/mmwr.mm6913e1
Byambasuren O, Cardona M, Bell K, Clark J, McLaws ML, Glasziou P. Estimating the extent of asymptomatic COVID-19 and its potential for community transmission: Systematic review and meta-analysisexternal icon. J Assoc Med Microbiol Infect Dis Can. 2020;5(4)223-234. doi:10.3138/jammi-2020-0030
Johansson MA, Quandelacy TM, Kada S, et al. SARS-CoV-2 Transmission From People Without COVID-19 Symptomsexternal icon. JAMA Netw Open. 2021;4(1):e2035057. Published 2021 Jan 4. doi:10.1001/jamanetworkopen.2020.35057
Abkarian M, Mendez S, Xue N, Yang F, Stone HA. Speech can produce jet-like transport relevant to asymptomatic spreading of virusexternal icon. Proc Natl Acad Sci U S A. 2020;117(41):25237-25245. doi:10.1073/pnas.2012156117
Hamner L, Dubbel P, Capron I, et al. High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice — Skagit County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19):606-610. Published 2020 May 15. doi:10.15585/mmwr.mm6919e6
Alsved M, Matamis A, Bohlin R, et al. Exhaled respiratory particles during singing and talkingexternal icon. Aerosol Sci Technol. 2020;54(11):1245-1248. doi:10.1080/02786826.2020.1812502
Bahl P, de Silva C, Bhattacharjee S, et al. Droplets and Aerosols Generated by Singing and the Risk of Coronavirus Disease 2019 for Choirsexternal icon. Clin Infect Dis. 2020;ciaa1241. Published online ahead of print 2020 Sep 18. doi:10.1093/cid/ciaa1241
Davies A, Thompson KA, Giri K, Kafatos G, Walker J, Bennett A. Testing the efficacy of homemade masks: would they protect in an influenza pandemic?external icon. Disaster Med Public Health Prep. 2013;7(4):413-418. doi:10.1017/dmp.2013.43
Leung NHL, Chu DKW, Shiu EYC, et al. Respiratory virus shedding in exhaled breath and efficacy of face masksexternal icon. Nat Med. 2020;26(5):676-680. doi:10.1038/s41591-020-0843-2
Konda A, Prakash A, Moss GA, Schmoldt M, Grant GD, Guha S. Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masksexternal icon. ACS Nano. 2020;14(5):6339-6347. doi:10.1021/acsnano.0c03252
Aydin O, Emon B, Cheng S, Hong L, Chamorro LP, Saif MTA. Performance of fabrics for home-made masks against the spread of COVID-19 through droplets: A quantitative mechanistic studyexternal icon. Extreme Mech Lett. 2020;40:100924. doi:10.1016/j.eml.2020.100924
Ma QX, Shan H, Zhang HL, Li GM, Yang RM, Chen JM. Potential utilities of mask-wearing and instant hand hygiene for fighting SARS-CoV-2external icon. J Med Virol. 2020;92(9):1567-1571. doi:10.1002/jmv.25805
Gandhi M, Marr LC. Uniting Infectious Disease and Physical Science Principles on the Importance of Face Masks for COVID-19external icon. Med. 2021;2(1):29-32. doi: 10.1016/j.medj.2020.12.008
Pan J, Harb C, Leng W, Marr LC. Inward and outward effectiveness of cloth masks, a surgical mask, and a face shieldexternal icon. MedRxiv. 2020; Posted 2020 November 20. doi:10.1101/2020.11.18.20233353
Lindsley WG, Blachere FM, Law BF, Beezhold DH, Noti JD. Efficacy of face masks, neck gaiters and face shields for reducing the expulsion of simulated cough-generated aerosolsexternal icon. Aerosol Sci Technol. 2021; doi:10.1080/02786826.2020.1862409