Note: This story was first published on 28 April 2020 and updated on 8 June 2020.
An ever growing number of governments, experts and health agencies are telling people to wear a face mask or cover their face in some form when they're out in public.
The World Health Organization (WHO) says there is limited evidence on the effectiveness of fabric face masks and coverings. But it does recommend their use in areas where the virus is still transmitting at a high rate -- particularly in settings where you may not be able to keep a physical distance from people of at least 1 metre (other health agencies recommend a distance of at least 2 metres).
All experts and agencies stress that people should not wear a medical-grade surgical mask, as these should be reserved for the people who need them most:
- healthcare workers on the frontline
- people showing symptoms of coronavirus
- people caring for someone with suspected coronavirus
But the WHO is now also recommending medical face masks for:
- people over 60
- people of any age with underlying health conditions
This is again advised in areas where the virus continues to transmit at a high rate and in situations where people can't keep distance themselves from others.
Face masks are not a substitute for washing your hands regularly and keeping your distance from other people.
But given the ongoing nature of the pandemic, you may want to make your own face mask as an additional way to protect yourself.
Who says I should wear a face mask?
The Centers for Disease Control and Prevention (CDC) in the US was the first to recommend that everyone cover their mouth and nose with a cloth in public.
They particularly advise wearing cloth coverings in places where physical distancing may be hard to practice, like the supermarket, pharmacy or on public transport.
This decision was made after recent studies showed that many people with coronavirus lack symptoms, and even those who eventually do show symptoms can spread the virus to others before displaying them.
But the agency says cloth face masks should not be worn by children under the age of 2, anyone who has trouble breathing or is unable to remove the mask without help.
The European Centre for Disease Prevention and Control is not directly advising people to wear cloth face masks in public but says they could be considered, especially in busy, closed spaces.
The WHO is now recommending people wear cloth face masks in public in areas where the virus is spreading widely, particularly in settings where keeping a physical distance may be difficult.
A report by the UK's Royal Society concluded that face masks would help reduce the spread of the virus in these situations.
Many groups of scientists have also written open letters calling for the use of face masks in public.
What's the benefit of wearing a fabric face mask?
The coronavirus is spread through droplets that are released into the air when an infected person coughs, sneezes or breathes out. It can then infect people through their eyes, nose and mouth.
Evidence on whether fabric face masks can capture these droplets and prevent the spread of infections is very limited. One small study suggested they could be used as a last resort, as they did reduce the number of bacteria and viruses a person breathes out.
But another study on health workers found they increase the risk of infection as they can get moist and may be reused.
The Royal Society report, however, concluded that cloth face masks do catch enough of the virus particles a person breathes out to help reduce the number of infections spreading in the community.
What are the concerns around face masks?
The WHO fear that wearing a face mask may make people less likely to follow other important measures, such as handwashing and physical distancing.
The agency also says it may lead to people touching their face more often - under the mask and under the eyes - because they have something unfamiliar on their face.
It also says that evidence about the benefit to the wider community isn’t clear.
But given the coronavirus continues to spread widely in some countries, the WHO are now advising that cloth face masks may provide an extra level of protection in these places.
How to make your own face mask
There are a few ways to make your own mask at home using fabric and elastic bands.
The WHO suggests a 3-layered mask may provide the most protection. These are made of:
- an inner layer of material that absorbs well, such as cotton
- a middle layer of non-woven, synthetic material, such as polypropylene
- an outer layer of non-absorbent material, such as polyester or polyester blend
The CDC suggests a few simpler ways
The sewing method
- a sewing machine
- 2 rectangles of fabric
- 2 pieces of elastic
- a needle and thread
How to do it:
- Cut out two 10inch by 6inch rectangles of fabric. Put the 2 rectangles on top of each other.
- Fold over the long sides a quarter of an inch and hem.
- Fold the double layer of fabric over half an inch along the short sides and stitch down.
- Thread a 6inch piece of elastic through the wider hem on each side of the cloth face covering. Tie the ends together to create ear loops.
- Gently pull on the elastic so the knots are tucked into the hem. Adjust so the mask fits your face.
- Stitch the elastic in place to prevent it from slipping.
The bandana method - no sewing involved
- a bandana or square cloth
- 2 pieces of elastic
How to do it:
- Fold the bandana in half.
- Fold the top third down and the bottom third up.
- Put 2 plastic bands or hair ties about 6 inches apart.
- Fold the sides to the middle.
- Secure the sides in place.
- Put the mask on, securing it around your ears.
The T-shirt method - no sewing involved
- a T-shirt
How to do it:
- Cut 7 or 8 inches of fabric from the bottom to make a rectangle.
- Cut out a smaller rectangle 6 or 7 inches long starting from one edge of the fabric. Leave a small amount of fabric at the top and bottom.
- Cut tie strings in the top and bottom pieces of fabric.
- Tie the strings around your neck, then over the top of your head.
How should I wear a face mask?
If you make your own face mask then you must know how to use it properly:
- clean your hands with soap and water or an alcohol-based hand gel
- make sure you put the mask on the right way - not upside down or back to front
- for face masks with ear loops, hold the mask by the loops and place around each ear
- for face masks with ties, bring the mask to nose level and tie the top strings on the crown of your head. Tie the bottom strings lower, so it rests on the back of your neck
- pull the bottom of the mask over your mouth and chin
- make sure your mouth and nose are securely covered and the mask fits closely while allowing enough room to breathe
- wash your hands before taking your mask off and wash your hands straight afterwards
- take your mask off from the back, either by untying it or by removing the bands from your ears
- don't share your mask with others
How do I clean my face mask?
There’s some limited evidence that cloth face masks may create problems by someone taking it off the wrong way or wearing it repeatedly without washing it, so it’s crucial to clean your face mask properly. You should:
- wash the mask daily and as soon as possible after each use, using detergent
- use a washing machine at 60C
If hot water is not available, wash the mask in soap/detergent and room-temperature water, followed by either:
- boiling the mask for 1 minute
- soaking the mask in 0.1% chlorine for 1 minute and thoroughly rinsing the mask with room temperature water .
Still follow the rules
Remember that wearing a face mask - homemade or not - is not a substitute for following the advice given by your government to reduce the spread of coronavirus. You should still:
- wash your hands regularly with warm water and soap for at least 20 seconds
- use an alcohol-based hand gel if soap and water are not available
- stay at home as much as possible
If you think you may have coronavirus, you can use our COVID-19 Symptom Mapper to check your symptoms and compare them with others around the world.
This should give you a better understanding of how the illness is affecting you and will help us to map the spread of the outbreak.