The complete guide to wearing a face-mask in COVID-19

The two main routes of transmission of the COVID-19 virus are respiratory droplets and physical contact with contaminated surfaces. 

Respiratory droplets are generated when an infected person coughs or sneezes, and possibly also through breathing and speaking. The heavier droplets tend to fall to the ground rapidly within a 1m radius. This is why any person who is in such close contact with someone with respiratory symptoms (coughing, sneezing) is at a high risk of being exposed to potentially infective respiratory droplets.  

This also explains the need to maintain ‘physical distancing’ and keep a distance of at least at 2m between people.  

Droplets may also land on surfaces (such as doorknobs, lift buttons or counters) where the virus could remain viable and could be picked up. Therefore, the immediate environment of an infected individual can serve as a source of transmission (contact transmission). 

Face masks help reduce the spread of infection in the community by limiting the spread of infection from infected individuals who may not know they are infected, who have not yet developed symptoms or who remain asymptomatic. The wearing of masks will therefore enhance the effects of physical distancing. 

It is important to note that face covers are not a replacement for keeping physical distancing; observing cough and sneeze etiquette; maintaining meticulous hand hygiene and avoiding touching one’s face. Wearing of masks or visors is mandatory in addition to these measures, which should always be maintained. 

Face-mask rules 

• It is now legally mandatory for all individuals to wear a face mask or visor whenever they leave their house, unless exempted.  
• Where tolerated, a medical or cloth mask (or a mask together with a visor) is preferred to a visor alone. 
• The mandatory use of medical or cloth face masks and visors/face shields is conferred by the Public Health Act and several legal notices. 

It is the law that: 

• Any person shall, outside their residence, both when going to an indoor place and outdoors, wear a medical or cloth mask or visor in a proper manner covering the nose, mouth and chin. 
• It is the responsibility of employers to provide appropriate masks and/or visors for their workers and to ensure that these are worn in an appropriate manner covering nose, mouth and chin. 
• You do not need to wear a mask in private homes or private vehicles. 
• However, although not mandatory, the public health authorities strongly recommend that a face covering is worn in private homes or in private vehicles when you are in the company of persons who do not form part of your household. 

The following individuals are exempt from wearing a face mask: 

(a) children up to three (3) years of age; 

(b) persons with severe cognitive, physical, mental or respiratory impairments who have difficulties tolerating a mask as certified by a licensed medical practitioner, in which case such individuals shall at all times carry the relevant medical certificate exempting them from wearing a mask. 

(c) Persons with disability, Autism Spectrum Disorder (ASD) and Sensory Processing Disorder (SPD) may be exempt from mandatory wearing of masks on a case-by-case basis, depending on the individual’s sensitivity. 

(d) In particular, children on the autism spectrum have heightened sensory experiences and wearing a face mask over the mouth or the elastic pulling at the ears can cause distress. Increased handling and contamination in this case could make mask wearing counterproductive. Not all individuals on the spectrum have the same triggers and many resources are available (social stories for example) which can prepare children with ASD/ SPD to wear a face mask. 

If an individual can tolerate it well and wear mask or visor appropriately, it should be encouraged. Otherwise, a certificate by a licensed medical practitioner is to be kept at hand in case one is approached for enforcement reasons. 

The temporary removal of facemasks shall be permissible in the following situations: 

(a) in the case of children attending kindergarten, while in the classroom; 

(b) during high intensity physical activity; 

(c) when speaking or providing assistance to any individual who relies on lip reading to communicate; 

(d) during official public speaking provided that a physical distance of at least 2m between individuals is maintained: Provided that the delivery of lessons or lectures in schools, universities or other education establishments shall not be construed as official public speaking; 

(e) if requested to for identification purposes, including at banks, at the airport or seaport or by law enforcement officials; 

(f) to receive any medical or cosmetic treatment or service involving the face or mouth; 

(g) to take medication; 

(h) when seated at establishments where food and drink is served. 

Penalties 

Any person who breaks these rules is liable to a €100 penalty, but the penalty can be reduced to €50 if the offence is admitted and the penalty is paid before proceedings commence before the Commissioner of Justice. 

The correct procedure to wear and remove a mask 

1. Before putting on a mask, clean your hands with soap and running water or an alcohol-based hand rub (containing 70% alcohol). 
2. Cover your nose, mouth and chin with the mask.  Avoid touching the mask while wearing it. 
3. Replace the mask with a new one after prolonged use, or as soon as it becomes damp. 
4. To remove the mask: bend your head forward, remove the mask from the straps (do not touch the front of mask); discard immediately in a closed bin (or into a wipeable sealed container, wipeable plastic pouch or a disposable plastic bag in the case of cloth masks); and clean hands with soap and running water or alcohol-based hand rub. 

Appropriate use of face masks 

1. Failing to put on or remove your mask safely may lead to an increased probability of getting infected with COVID-19. 
2. Regardless of how well they work, the success of cloth or surgical masks at protecting others depends on whether people in the community wear them properly, keep them in place, and make sure the mask doesn’t get too wet. 
3. Non-medical face masks prevent viral particles from potentially being spread by the mask wearer. They do not protect the mask wearer from being infected if someone who is positive for COVID-19 transmits respiratory droplets onto the person wearing the mask. 

Cloth face masks should: 

• Fit snugly but comfortably against the side of the face. 
• Be secured with ties or elastic loops around your ears. 
• Include multiple layers (ideally a minimum of 3) of tightly woven fabric. 
• Allow for breathing without restriction. 
• Withstand laundering and machine drying without damage or change to their shape. 
• Be stored either in a non-porous sealable container (such as a lidded plastic box), a disposable plastic bag or a wipeable plastic pouch. Reusable containers/pouches should be wiped with 70-90% alcohol and left for a minute to dry after having had a used mask stored in them. 

Studies indicate that accumulated moisture, such as from breathing, can trap the virus in a mask and make it a strong source of contamination when the wearer takes it off 

• This is why it is very important that masks are removed for disposal or storage until washing/sterilisation for re-use. 
• If one is wearing a mask for many hours, it is important to have spare masks on hand so that a fresh mask can be put on whenever the previous mask becomes wet or soiled. 
• Used masks must not be stored in pockets or left lying about on surfaces but should be placed in a sealable plastic pouch or wipeable container until they can be laundered or safely disposed of.  
• Masks should never be shared. 

Wearing a face mask may create a false sense of security and may result in the neglect of other essential measures, such as hand hygiene practices and physical distancing 

The appropriate use of face masks is essential for their effectiveness and safety. Smoking should be avoided, especially when wearing a mask. 

N-95 respirators and surgical masks must continue to be prioritised for use by healthcare workers They are not recommended for use in the community. 

Cloth face masks should NOT be placed on young children under 3 years of age 

Anyone who has trouble breathing; or who is unconscious, incapacitated or otherwise unable to remove the mask without assistance. 

Masks should NOT be used during strenous work and when practicing vigorous exercise 

Masks or visors are to be worn if a sport does not involve vigorous exercise or is practiced in the vicinity of other people. 

Cloth face masks, after being removed safely, should be washed after each use in a washing machine using normal laundry detergent at 60⁰C 

Cloth facemasks can be washed numerous times. 

Do not re-use single-use disposable masks 

Some types of masks include a plastic one-way valve on the front that makes it easier to breathe. When you breathe in, the valve is closed, but when you breathe out, it opens to allow your exhalation to leave unfiltered, and that exhalation will include viruses if you have the virus and thus not protect those around you, negating the reason for using the mask in the first place. The use of these types of mask is therefore not recommended.