Ins and outs of rule — and exceptions
If you’re heading out of the house Pennsylvania, don’t forget to take your face mask.
On Wednesday, Gov. Tom Wolf announced that masks must be worn by everyone who ventures into a public space, a move aimed at helping stop the spread of COVID-19. The new order expanded an existing one that required mask-wearing in businesses.
“This mask-wearing order is essential to stopping the recent increase in COVID-19 cases we have seen in Pennsylvania,” Wolf said in announcing the new order. “Those hot spots can be traced to situations where Pennsylvanians were not wearing masks or practicing social distancing — two practices that must be adhered to if we want to maintain the freedoms we have in place under our reopening.”
While mask-wearing has become a bit of a political flash point, health and government officials have made clear that masks are a key part of the coronavirus battle.
Even President Donald J. Trump, who in the past has mocked others for wearing masks, said this week that they should be worn. Although rarely caught on camera masked, he admitted that he wears one when in groups of people, saying he thinks he looks like the Lone Ranger with it on.
Here’s what you need to know about the new mandate and what experts say about face masks.
The mandate
The order signed Wednesday by state Secretary of Health Dr. Rachel Levine outlines the situations when a mask must be worn and includes limited exceptions to the face-covering requirement.
Individuals are required to wear face coverings if they are:
• Outdoors and unable to consistently maintain a social distance of 6 feet from individuals who are not members of their household.
• In any indoor location where members of the public are generally permitted.
• Waiting for, riding on, driving or operating public transportation or while in a taxi, private car service or ride-sharing vehicle.
• Obtaining health care services in settings that include, but are not limited to, a hospital, a pharmacy, medical clinic, dental office, veterinary clinic or blood bank.
• Engaged in work, whether at the workplace or at an off-site location, when interacting with any member of the public; working in any space visited by members of the public; working in any space where food is prepared or packaged for sale or distribution; working in or walking through common areas; or in any room where people, except for members of their household, are present when unable to physically distance.
There are some exceptions to the face-covering requirements:
• Those who cannot wear a mask due to a medical condition, including those with respiratory issues that impede breathing, mental health condition or disability.
• Those for whom wearing a mask while working would create an unsafe condition in which to operate equipment or execute a task as determined by local, state or federal regulators or safety guidelines.
• Those who are under 2 years of age.
• Those who would be unable to remove a mask without assistance.
• Those who are communicating or seeking to communicate with someone who is hearing-impaired or has another disability, where the ability to see the mouth is essential for communication.
Enforcement issues
Like Wolf’s mandate for most businesses to shut down, enforcement of the face mask order will be mainly left up to local jurisdictions.
Berks County District Attorney John T. Adams said Thursday that it will not be a priority.
In a message Adams sent to local police chiefs and shared with the Reading Eagle, the DA said he does not expect simple complaints about mask-wearing to be enforced.
“I have requested that law enforcement not be dispatched by the 9-1-1 center to respond to these type of complaints,” he wrote.
Adams added that the matter will, like the business shutdown, be one of voluntary compliance.
“I do not want to see your respective police officers getting into conflicts with your constituents over this most recent order,” he wrote.
Adams did say police will respond to some mask-related situations, such as someone being asked to leave a business because they are not wearing a mask. Those types of situations could result in a trespassing fine or arrest.
Cloth face coverings
The U.S. Centers for Disease Control and Prevention COVID-19 guidelines said cloth face masks should be worn when people are in public.
Cloth masks aren’t personal protective equipment like an N95 surgical mask, they don’t necessarily protect the wearing from infection. Instead they are meant to protect others from being infected by the wearer — known as source control.
“COVID-19 spreads mainly from person to person through respiratory droplets produced when an infected person coughs, sneezes, talks or raises their voice,” the CDC website states. “These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.”
Dr. Amy Price, a senior research scientist at Stanford University’s Anesthesia Informatics and Media Laboratory, said in a June 19 interview with the Stanford Medicine News Center that stopping the droplets is key to slowing the spread of COVID-19.
“Many people argue that cloth masks can’t be effective because they can’t filter out viral particles, which are extremely tiny,” she said. “But most of these particles leave the mouth and nose in much larger droplets that become smaller through evaporation as they move away from the body. Trapping droplets with the mask means not nearly as many viral particles escape.”
The CDC says face masks should be worn so that they cover both a person’s mouth and nose. The masks should fit snugly and the wearer should avoid touching it once it is on.
The CDC recommends cloth face masks be washed after each use. That can be done with normal laundry in a washing machine with detergent and a warm water setting or by hand.
To wash a mask by hand, create a bleach solution by mixing five tablespoons of household bleach per gallon of water. Soak the mask in the solution for five minutes, then rinse thoroughly with cool or room temperature water.
The mask can be dried in a dryer or air-dried in direct sunlight.
In order for cloth face masks to be effective, the CDC says, they need to be widely used by the public. That is in part because up to 40% of people infected with COVID-19 will not show symptoms, according to estimates from public health experts.
The CDC website, www. cdc.gov, includes directions for how to make homemade cloth face masks.
Scientific evidence
Several studies have been done on the effectiveness of face masks in fight the COVID-19 pandemic.
• A study published June 16 in Health Affairs found that the COVID-19 growth rate after face masks were mandated in 15 states and Washington D.C. slowed.
• Research by a team led by a Texas A&M University professor and published in the Proceedings of the National Academy of Sciences found that the use of face masks greatly reduced the spread of COVID-19.
The study found that use of face masks reduced the number of COVID-19 infections by more than 78,000 in Italy from April 6 to May 9 and by more than 66,000 in New York City from April 17 to May 9.
“Our results clearly show that airborne transmission via respiratory aerosols represents the dominant route for the spread of COVID-19,” said Renyi Zhang, Texas A&M distinguished professor of atmospheric sciences. “By analyzing the pandemic trends without face-covering using the statistical method and by projecting the trend, we calculated that over 66,000 infections were prevented by using a face mask in little over a month in New York City.
“We conclude that wearing a face mask in public corresponds to the most effective means to prevent interhuman transmission. This inexpensive practice, in conjunction with social distancing and other procedures, is the most likely opportunity to stop the COVID-19 pandemic.”
• A study published last month looked at 198 countries, finding COVID-19 death rates were lower in nations where cultural norms and government policies encouraged face masks.
• A study published in April that can be found on the U.S. National Library of Medicine website, www.nlm. nih.gov, concluded that having people who feel well wear face masks could be beneficial when dealing with COVID-19. The study included 19 randomized, controlled trials in community and health care settings.
The study found that in community settings maskwearing was effective with and without corresponding hand-washing. Both together were most effective.
While cloth masks were not effective for medical personal working with COVID-19 patients, they did protect others when worn by a sick patient.
• A World Health Organization-funded study published June 1 found that “face mask use could result in a large reduction in risk of infection.”
• A 2013 study of the efficacy of homemade masks in protecting against an influenza pandemic showed homemade mask, while performing much worse than surgical masks, did significantly reduce the number of microorganisms expelled while coughing.
“Our findings suggest that a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection.”