Debunking common face mask misconceptions

By wearing a face covering, you can help others in your family and community

Wearing a face mask or face covering in public is critical to preventing the spread of COVID-19. Infectious diseases expert Eddie Stenehjem, MD, and Kristin Dascomb, MD, medical director of Infection Prevention, and Cherie Frame, RN, director of Infection Prevention at Intermountain Healthcare review some of the most common myths about face masks and debunk misinformation circulating about the effectiveness of face coverings.

MYTH: I feel fine. I don’t need a mask.

FACT: The CDC reports that more than 40% of virus transmissions happen before people feel sick. A pre-symptomatic person can spread the virus for up to 48 hours before symptoms arise.

MYTH: I don’t need to wear a mask if I physically distance. 

FACT: To be crystal clear, it’s not either a mask or remain 6 feet apart from others. It’s both. Wearing a mask and physically distancing at least 6 feet apart is for everyone’s protection, including yours.

MYTH: There’s no scientific evidence that masks work.

FACT: “There was a recent article released in The Lancet,” says Eddie Stenehjem, MD, an infectious disease physician at Intermountain. “The Lancet is a really large medical journal out of the United Kingdom. It's incredibly well-respected and on the same level as New England Journal of Medicine here in the U.S. They just published a review article, to show the benefits of actually wearing a surgical mask or an N95 mask.

While we don't have a ton of data on homemade cotton face coverings yet,  we can extrapolate from the surgical mask data showing that yes, indeed wearing a surgical mask does help. It does decrease transmission and decreases the risk of you getting an infection. There is clear scientific evidence that masking helps in the time of viral transmission.”

MYTH: Wearing a mask causes you to inhale too much carbon dioxide, which can make you sick. 

FACT: Wearing a cloth mask will not cause dizziness, lightheadedness, and headaches (also known as hypercapnia or carbon dioxide toxicity). Carbon dioxide passes through the mask, it does not build up inside the mask.  If you feel dizzy or get a headache, you may be dehydrated since wearing a mask doesn’t make it as easy to drink water. We recommend keeping yourself very hydrated.

MYTH: The only mask worth wearing is a N95 respirator.

FACT: Multi-layer cloth masks (homemade coverings) are proven to reduce the risk of spreading droplets that may carry the virus, especially combined with frequent hand washing and physical distancing. N95 supplies should be reserved for healthcare workers.

MYTH: Homemade cloth face coverings aren't effective and shouldn’t be worn in public.

FACT: Homemade cloth face coverings can prevent COVID-19 from spreading. To be effective, masks must cover the mouth and nose, wrap around the sides of the wearer’s face and secured under the chin. Studies show that many people with coronavirus lack symptoms, and those who eventually develop symptoms can give the virus to others before those symptoms show. That’s why the CDC recommends wearing cloth face coverings in all public settings, especially where physical distancing is difficult, such as grocery stores, salons, etc.

MYTH: Masks only help if someone has symptoms.

FACT: You may have COVID-19 without knowing, since symptoms can take 2-14 days to develop, and wearing a mask will help you from spreading the virus. And if someone else is not masked and spreads infected droplets into the air, your mask serves as a barrier that limits the likelihood that you will become infected.

MYTH: Masks need to be replaced daily.

FACT: Homemade cloth face coverings can be reused if washed. You can launder in washing machines as long as they are able to retain their shape. To hand wash, knead your face covering for several minutes in hot water using detergent or soap, then rinse well with fresh water and hang to air-dry.

MYTH: Masks should only be worn in large gatherings.

FACT: If you leave home, wear a mask. You should wear a mask in public places like grocery stores, pharmacies, restaurants, healthcare offices, public transportation, essential businesses, hairdressers, etc. You don’t need to wear a mask when you’re outside and physically distancing from others (walking at a park, hiking, etc.) because there's enough air to dilute the virus decreasing the opportunity for transmission.

MYTH: Wearing a mask will weaken my immune system.

FACT: This is not true. Wearing a face mask does greatly reduce the spread of infectious droplets from entering your mouth or nose when you’re around individuals who may be sick, but it doesn’t prevent all microbes from entering your body. If surgeons had weakened immune systems after wearing masks for hours, none of them would live past 50.

MYTH: Wearing a mask can result in getting pneumonia.

FACT: There is no evidence of masks leading to fungal or bacterial infections of the upper or lower airway, as happens in pneumonia.

MYTH: I won’t be able to breathe when I wear a mask.

FACT: We’ve been wearing masks in healthcare for decades. Surgeons who wear a mask for long periods of time – sometimes 10 or 12 hours – do not pass out in the operating room, nor do they become poisoned from CO2. The feeling many get of being unable to breathe in a mask isn’t related to oxygen intake. If you have problems with anxiety while wearing a mask, we recommend practicing for short periods and slowly increasing the duration. The more you wear a mask, the less you notice it.

MYTH: The virus is so small, there’s no way a cotton mask will screen it out.

FACT: The virus is suspended in droplets from the respiratory tract that become airborne when an infected person coughs, sneezes, talks, or wipes bodily fluids on a surface. These droplets are larger than the virus, and the cloth mask is able to stop the majority of them from being inhaled by your nose and mouth.

MYTH: COVID-19 isn’t real or not that bad. It would be better for us to all catch it and move on (i.e., gaining herd immunity).

FACT: Herd immunity means that enough people have recovered from the virus and developed immunity so that it doesn’t spread anymore, but this strategy would have a high death toll. A disease that can permanently damage or kill someone should not be ignored. Until we have a vaccination, there is risk for many individuals.

MYTH: COVID-19 cases are going up, but deaths are low, so we need to stop freaking out.

FACT: Cases and deaths do not elevate at the same rate. We see about a week’s difference of cases being found to hospitalization as well as another 1-2 weeks before the number of deaths rises. This will change if hospitals are overwhelmed and not able to provide the intensive care needed to keep some of the infected people alive. Wearing masks is crucial to keeping infection rates low.

MYTH: A mandate requiring masks is unconstitutional.

FACT: Under the U.S. Constitution's 10th Amendment, state governments have the authority to regulate public health and safety and to take emergency action. Wearing a mask shows that you are concerned for the health of others. Wearing a mask not only helps you, it protects everyone around you.

MYTH: Outbreaks are fake news. Media is only reporting them at beaches and churches, not from protests or riots.

FACT:  There is difficulty in knowing where an individual actually gets COVID-19. When a person is tested, the health department will ask about everywhere the person has been in the last 2 weeks and compare this to what other people with the disease are saying. When you wear a mask and stay at least 6 feet apart, there will be less transmission.

MYTH: Masks are about keeping you afraid.

FACT: “As an infectious diseases physician, I recommend having respect for this virus as well as those around you. If you have respect for others, you will be willing to wear a mask,” says Kristin Dascomb, MD, an infectious disease expert at Intermountain Healthcare. Infected people can transmit the virus to others before showing symptoms. With a mask in place, the risk of transmission is extremely low. Don’t be afraid when wearing your mask. Feel proud that you kept yourself, your family, and your community safe.