Using Masks to Slow the Spread of COVID-19

Requirements and exceptions for wearing masks

Current mask requirements were updated under Executive Order 72 on April 29, 2021. The order includes requirements for wearing masks (face coverings) to help stop the spread of the disease:

  • All people aged 5 and older must cover both their mouth and nose with a mask, as recommended by CDC, in indoor settings with others. This does not apply to people who live in the same home.
    • In Virginia, masks are required to be worn by employees and patrons in most public settings, such as restaurants, museums, performing arts venues, and retail businesses. Specific requirements are outlined in Executive Order 72
    • CDC recommends that people who are not fully vaccinated wear a mask when they are in indoor public settings, when they are using public transportation, or when they are around people who don’t live in their household.
    • CDC recommends that people who are fully vaccinated wear a mask when they are in indoor public settings, when they gather indoors with unvaccinated people from more than one household, when they visit indoors with an unvaccinated person who is at higher risk for severe COVID-19 or with an unvaccinated person who lives with someone who is at higher risk for severe COVID-19.  
  • All people aged 5 and older must cover their mouth and nose with a mask when they are outdoors, as recommended by CDC. While it is generally safe for fully vaccinated people to be outdoors without a mask, CDC continues to recommend that everyone wear a mask in crowded settings and venues where it is harder to maintain physical distance. 
    • In Virginia, masks are required to be worn by employees and patrons in  public settings, such as restaurants, concert venues, theaters, sports venues, farmers’ markets, and retail businesses.
    • CDC recommends that people who are not fully vaccinated wear a mask when they are in a public setting or when they are around people who don’t live in their household.
    • CDC recommends that people who are fully vaccinated wear a mask when in crowded settings, such as concerts, sporting events, and graduation ceremonies. Fully vaccinated people may choose to remove their mask outdoors when alone or in small outdoor gatherings.
  • All travelers, both vaccinated and unvaccinated, aged 2 years and older in the United States, including Virginia, are required to wear face masks while on public transportation. Public transportation includes airplanes, ships, ferries, trains, subways, buses, taxis, and rideshares, as well as transportation hubs, such as airports and stations. This requirement applies to passengers, transportation conveyance operators (e.g., crew, drivers, conductors, and other workers involved in the operation of public transportation conveyances), and operators of transportation hubs. 

Masks for Children: Adults should use their best judgement in putting face masks on children ages 2-4 while inside public areas or when outdoors and within 6 feet of others who do not live with them. Masks should not be worn by children under the age of 2 years. For children aged 2 years or older, find a mask made for children, if possible. .

Fully vaccinated means 2 weeks or more have passed since getting the second dose of a two-dose vaccine (e.g., Pfizer-BioNTech or Moderna), or 2 weeks or more have passed since getting 1 dose of a single-dose vaccine (e.g., Johnson & Johnson [Janssen]). If you have a condition or are taking medications that weaken your immune system, you may NOT be fully protected even if you are fully vaccinated. Talk to your healthcare provider. Even after vaccination, you may need to continue taking all precautions.

You are also considered to be fully vaccinated if you have completed a COVID-19 vaccination series with a vaccine that has been authorized for emergency use by the World Health Organization (such as AstraZeneca/Oxford).You will not need any additional doses with an FDA-authorized COVID-19 vaccine.

Exceptions: There are a number of situations when people don’t have to wear a mask. These include:

  • While actively eating or drinking
  • While exercising or using exercise equipment
  • Anyone who has a breathing problem or health issue that would put their health at risk by wearing a mask 
  • Anyone communicating with people who are hearing impaired for which the mouth needs to be visible
  • While participating in a religious ritual
  • People who are fully vaccinated might not need to wear a mask outside unless in crowded settings

Other exceptions can be found in Section II of Executive Order 72.

How masks can help protect all of us

Protect others. Many people with COVID-19 have no signs or symptoms and can pass the virus to others without knowing it. When we talk, sneeze, sing, cough, or breathe, tiny droplets that contain the virus can be carried into the air. Infections occur mainly through exposure to these droplets when a person is in close contact with someone who has COVID-19.

These droplets can sometimes remain in the air for minutes to hours. In closed spaces with poor ventilation (not a lot of fresh air coming in), there is evidence that people with COVID-19 seem to have infected others who were more than 6 feet away. Wearing a mask helps stop droplets from going into the air or landing on surfaces.

If you are sick with COVID-19 or think you may have COVID-19, wear a mask when you need to be around other people or animals, even in your own home.

Protect yourself. Masks help reduce breathing in droplets that contain the virus. Masks with multiple layers of cloth with higher thread counts will protect you better than single layers of cloth with lower thread counts. You should always wear a mask when caring for someone who has COVID-19 to help keep you from getting sick. For better fit and extra protection, you can wear two masks: a disposable mask underneath and a cloth mask on top. You can also wear a cloth mask with a fitter or a brace for a better fit. 

Better fit and protection is especially recommended for these situations:

Wearing Masks After Receiving Vaccinations. After you are fully vaccinated (with one dose or two doses), it is important to continue using all the tools available to protect yourself and others. This includes wearing a mask in certain situations, avoiding crowds, and washing your hands often. There is still more to learn about the COVID-19 vaccine, including how long protection lasts, and if getting the COVID-19 vaccine will prevent you from spreading the virus that causes COVID-19 to other people, even if you don’t get sick yourself. It is important to remember that no vaccine is 100% effective. There are also not yet enough people fully vaccinated in the community, so everyone must continue prevention measures to keep their community healthy and safe. See here for more information on activities that fully vaccinated people can take part in. 

Support business and the economy by wearing a mask. Anything that can slow the spread of COVID-19 is good for business. The sooner we can slow the spread of COVID-19, the sooner we can get this pandemic behind us and get back to “normal.” Studies have shown that wearing a mask can significantly reduce COVID-19 transmission. One study showed that even a 15% increase in mask wearing by the public could prevent the need for lock downs and save the U.S. economy over 1 trillion dollars. Places with widespread use of masks have seen large decreases in new COVID-19 cases.

Tips for selecting, wearing and making masks

VDH recommends the use of masks to prevent the spread of COVID-19 and supports current CDC recommendations for what to look for when selecting a mask.

  • Fits snugly but comfortably against the side of the face
  • Completely covers the nose and mouth
  • Includes two or more layers of fabric
  • Is secured with ties or ear loops
  • Has a nose wire 
  • Blocks light when held up to a bright light source
  • Allows for breathing without restriction
  • Can be washed and machine dried without damage or change to shape

Cover your mouth AND nose with your mask. COVID-19 is spread primarily through droplets from your nose and mouth. Covering your nose and mouth helps to prevent the spread of the virus to others. It is possible to be infected with COVID-19 if you breathe in the virus through your nose. Do not put the mask around your neck, on your forehead, under or only on your nose, or on your chin.

Use a Mask that Fits Your Face. People come in all shapes and sizes and that includes our heads and faces. If your mask keeps falling down below your nose, you should look for a smaller mask or make knots in the ear loops so that it fits more snuggly. You want to avoid having to keep touching your mask to get it back in place.

Double Masking or Wearing a “Double Mask”. One way to make sure your mask fits better and provides extra protection is to wear two masks: a disposable mask underneath and a cloth mask on top. A cloth mask can also be worn with a fitter or a brace for a better fit. Do not wear two disposable masks together to create a “double mask”. If you use a KN95 mask, you should also wear it alone and not with other masks. A recent CDC report showed that wearing a cloth mask over a medical procedure mask provided more protection to the person wearing the masks and more protection to others (source control).

 

Knot and Tuck Ear Loops. Another way to have better fit and extra protection when wearing a 3-ply mask is to knot and tuck ear loops where they join the edge of the mask. Fold and tuck the unneeded material under the edges. Watch a video on how to do this here

 

Masks are only one part of the solution. Masks are only helpful when they are worn correctly and used with other recommendations. Don’t get a false sense of security from wearing a mask. You should still follow physical distancing rules (limiting contact and staying 6 feet away from other people), wash your hands often, avoid touching your face, and cover your coughs and sneezes.

What if I don’t have a mask? Simple steps for making a mask with everyday items from your home can be found here. Instructions for creating a clear view mask can be found here

Wearing a mask that has two or more layers of washable, breathable fabric is currently recommended to prevent the spread of the disease. If you are wearing a gaiter, make sure it has two layers, or fold it to make two layers.

Face shields are not a substitute for a mask. Face shields are primarily used to protect the eyes of the person wearing them and may be used in addition to wearing a mask.

Scarves and other cold weather headwear are not a substitute for a mask. Items like scarves, ski masks and balaclavas used for warmth are usually made of loosely knit fabrics that are not suitable for use as masks to prevent COVID-19 transmission. They can be worn over a mask.

Wash your hands or use alcohol-based hand sanitizer (with at least 60% alcohol) before putting on a mask. Cover your mouth and nose with the mask. Make sure there are no gaps between your face and the mask. Be aware that if you touch your face or adjust your mask after you have touched other objects, you can easily spread germs to your face. If you do touch your face or mask, you should wash your hands or use hand sanitizer right away.

Be careful when taking off your mask. Remove it from behind the ears and try not to touch the front of the mask or your face. Once you remove the mask, you should throw it in the trash (if it’s disposable) right away or put it in the laundry. Be careful not to touch your eyes, nose, and mouth when removing, and wash your hands right away.

 

Please do not buy N95 respirator masks or other medical face masks, unless required for your job. They are in short supply and are needed by the medical staff and first responders who are caring for sick people.

If you are using a KN95 mask, make sure it meets CDC requirements and is not a fake. About 60% of KN95 masks in the United States are fake and DO NOT meet requirements. You should also not wear a KN95 mask if it is hard to breath or if you have certain types of facial hair. You should not wear a KN95 mask with other masks (double masking); wear KN95 masks alone only. 

Masks with one-way exhalation valves or vents are not recommended. The purpose of masks is to keep respiratory droplets belonging to the person wearing the mask from reaching others. Masks with one-way valves or vents allow exhaled air to go out through holes in the material. This can allow exhaled respiratory droplets to reach others and could spread the COVID-19 virus. Therefore, VDH does not recommend using masks if they have an exhalation valve or vent. 

For people who have intellectual or developmental disabilities, mental health conditions, such as anxiety, or other sensory sensitivities, it may feel scary or challenging to wear a mask. Talk with your healthcare provider for advice on how to wear a mask. It may also be helpful to practice wearing a mask at home for short time periods and taking breaks if you feel anxious. Practicing at home first may help you adjust to wearing a mask in public settings. Taking slow, deep breaths may also help reduce anxiety or stress from wearing a mask. 

What to do if people are not wearing masks:  To file an online complaint about Executive Order 72 related only to masks and capacity requirements, click here. You may also call or talk to the business owner about your concerns if you see staff or customers who are not wearing masks in indoor public settings. Please do not call the police or your local health department. For your own safety, do not confront these people or start an argument. Try to stay 6 feet away from people who are not wearing masks.

It is a good time to be kind!  Please do not shame or yell at people who are not wearing masks. Others may have breathing problems or health issues you do not know about. People who cannot wear a mask are not required to show proof of their medical condition nor are they required to name their medical condition. 

If you are sick, stay home and separate yourself from others in your home. Wear a mask over your nose and mouth if you must be around other people, even at home. If you need medical care, call ahead and tell them you have or may have COVID-19. For more information, see VDH’s If You’re Sick site.

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Page Last Updated: May 4, 2021