Wearing a face covering is a public health measure designed to capture
respiratory droplets from the wearer, who may or may not yet have
symptoms of COVID-19, to prevent onward transmission.1Three quarters of countries across the world currently recommend or
mandate their use.2 After initially advising against
face coverings, the US Centres for Disease Control and Prevention, the
World Health Organisation and the UK Government all now recommend their
use.1,3,4 Guidelines on public use of face coverings
draw on the principles of infection control to recommend how to make or
obtain, use and clean them. Such guidelines are often presented
alongside guidelines intended for healthcare facilities. In this
article, we contrast medical and sociocultural narratives for face
coverings and argue for more explicit engagement with the latter when
promoting uptake.
Masks or face coverings?
Terminology varies but can broadly be divided into medical masks (which
are regulated by manufacturing specifications and include surgical
masks), non-medical masks (which include cloth masks and other fabric
face coverings), filtering facepiece respirators (including FFP2 or N95
respirators) and face shields (usually made of Perspex). Recommendations
on what members of the public should use differs between countries and
is influenced by local norms and country-level supply of personal
protective equipment for health workers. As COVID-19 spread, China and
South Korea rapidly increased production of medical masks, whereas
Czechia and Thailand have been early proponents of using cloth masks to
conserve supplies of medical masks.2 In 1897, a
‘medical mask’ typically consisted of some layers of gauze tied with
string, and later became four-ply cotton muslin; in most modern
healthcare settings such masks are disposable and made of layers of
paper and waterproof backing. 5 In this paper we use
the term ‘face covering’ to include the full range of materials people
adapt and use to cover their mouth and nose to prevent the spread of
SARS-CoV-2. This include medical and non-medical masks, but also pieces
of clothing. We do not consider Perspex face shields in this article
because they are not currently advised for primary respiratory
protection or for source control and also not respirators as they are
recommended for use by health workers.1