PHOTOS: SHUTTERSTOCK

With infection rates of COVID-19 at an all-time high because of the highly transmissible omicron variant, Pittsburgh hospitals are reporting a growing number of COVID-related admissions, and a whopping 1 in 50 Allegheny County residents have tested positive for the virus.

The Allegheny County Health Department has stressed the importance of vaccination and proper masking time and time again, citing evidence that wearing a mask can help drastically slow virus spread, especially in indoor or public settings.

But not all masks are created equal. As the Centers for Disease Control and Prevention consider changes to their masking recommendations, a slew of questions have surfaced: Are cloth masks OK? Should I double mask? What’s the difference between N95 and KN95s? Where can I get a good mask without breaking the bank? 

This guide will answer all your questions as we continue to navigate a pandemic with an ever-changing virus that requires ever-changing guidance to keep ourselves — and each other — safe.

Best protection: N95s or KN95s
The CDC recently said that it’s considering updating its mask guidance to recommend the public use KN95 or N95 masks — highly protective particulate respirators that, at the start of the pandemic, were recommended only for healthcare personnel and those in similarly high-risk or industrial environments. 

These masks are considered the gold standard for personal protection, as they provide better filtration and are proven to be more effective at protecting against all coronavirus variants, even omicron. 

They’re designed to be thrown away after each use, but the CDC has developed contingency strategies for what it calls “expected shortage” and “known shortage” situations.  These masks can be reworn “with limited use,” as long as they aren’t visibly dirty, they still fit and they haven’t been damaged with holes or tears. You shouldn’t reuse them any more than five times.

The key difference between these masks and surgical masks, for example, is that they’re more tight-fitting; the edges of the respirator form a tight seal around the nose and mouth, preventing particles from getting in around the edges of the mask. 

The material they’re made of also filters out more particles. This makes it so that the air that goes through the material and not around the mask is filtered better. N95s are regulated by the National Institute for Occupational Safety and Health, or NIOSH, which is part of the CDC.

Pre-pandemic, these respirators were used mainly at industrial or construction sites that would expose workers to dust and small particles, but some types of N95 masks have also been used by healthcare providers during procedures to protect from the transfer of microorganisms, body fluids or particulate material, according to the Food and Drug Administration.

So what’s the difference between an N95 and a KN95? The simple answer is where the masks come from. 

N95s are the standard in the U.S., while KN95s are the standard in China and other parts of Asia. So while NIOSH regulates N95s, the Chinese government regulates KN95s. Both masks are effective at filtering out 95% of very small particles, and the CDC authorized KN95 masks as a suitable alternative to N95s at the start of the pandemic, even though some healthcare providers have noted discrepancies in quality. 

Nonetheless, the differences between N95 and KN95 respirators are largely negligible for the average person. If you’re not a healthcare worker and you’re looking for the best mask to wear to Target or Giant Eagle, either an N95 or KN95 will do, as long as you’re wearing it properly.

One thing to watch out for, though, is counterfeit respirators. The CDC warned that there are some products out there that are being falsely marketed and sold as NIOSH-approved masks when in reality, they might not be capable of providing adequate protection. Signs that an N95 respirator might be counterfeit include: 

• No markings at all on the filtering facepiece respirator
• No approval (TC) number on the filtering facepiece or headband
• No NIOSH markings 
• NIOSH spelled incorrectly 
• Presence of decorative fabric or add-ons, like sequins 
• Claims for the approval for children (NIOSH does not approve any respirators for kids)
• Filtering facepiece respirator has ear loops instead of headbands (for N95s; some KN95s have ear loops instead)

Counterfeit masks are especially a problem with KN95s. The CDC estimates that up to 60% of KN95 respirators in the U.S. are counterfeit and do not meet the necessary requirements to protect wearers. This webpage from the CDC highlights some considerations you should take into account when buying an international respirator, and a few tips on how to spot the fakes.

For example, any KN95 masks that claim to be CDC or NIOSH certified are likely fake, because neither the CDC nor NIOSH approves any protection device certified to international standards. 

Now, the tricky part: buying the masks. 

N95s and KN95s alike can be more expensive than a box of surgical masks or a pack of cloth masks, making them inaccessible to some of the populations who need them most. Project N95, a nonprofit aimed at providing reputable masks for a more affordable price, offers a box of 50 N95 masks for $30, and a box of 20 of a different style N95 for $26.

Amazon sells a 10-pack of KN95s for $21.90 at the time of publishing, and a pack of two N95s for $5.98, but if you’re buying from Amazon, take special care; Amazon came under fire last month for permitting the sale of counterfeit masks.

Good protection: surgical masks
While N95s and KN95s offer the best protection, surgical masks will also keep you relatively safe while you’re waiting for your respirators to ship, or if you can’t quite get your hands on a pack just yet.

These loose-fitting masks are worn by healthcare workers and, despite not forming the tight seal one can expect out of N95 or KN95 respirators, are fluid resistant and protect against larger respiratory droplets from coughs and sneezes. 

Most surgical masks are regulated by the FDA, and may be labeled as surgical, isolation, dental or medical procedure masks. 

They’re made in different thicknesses, too, which affects how well the mask protects you against COVID-19 infection. The general rule of thumb is the thicker the better, but make sure you can still breathe through the mask, of course.

While these masks do protect you fairly well, they also effectively prevent the wearer from spreading infectious droplets to others, according to Johns Hopkins Medical Center. 

While the weakness of this type of mask is that it lacks the tight seal, a September 2021 study published in Oxford Academic’s Clinical Infectious Disease journal found that surgical masks reduce viral shedding in aerosols from COVID-19 patients by 48% to 77%. 

In other words, they work.

They’re also much less expensive than particulate respirators like N95s and KN95s, and they’re more widely available, too. You can walk into just about any drugstore, grocery store, department store or pharmacy and find a box.

The New York Times recommends the DemeTech DemeMask Surgical Mask, which is FDA-cleared and blocks 98% of particles when worn with a good seal. (You might have to knot the ear loops to achieve the best seal.) Similarly, it attests to the Medline ASTM Level 1 mask, which has been touted as both versatile and affordable at $10 for a pack of 50.

Better than nothing: fabric masks
Early on in the pandemic, homemade cloth masks were all the rage. But now, as the virus — and our knowledge about it — evolves, we’ve learned that they don’t always offer the best protection against COVID-19. But still, wearing anything is better than wearing nothing, so if you’ve only got the cloth mask from March 2020, don’t give it up. Just keep a few things in mind.

According to NPR, researchers say that the type of fabric is an important factor in how effective cloth masks are. A tight-weave 100% cotton fabric is a good bet because the natural fibers in cotton tend to have a more three-dimensional structure that can create more roadblocks to stop particles. 

The tighter the weave, researchers found, the better the protection — although no material tested could compare to the protection offered by N95s.

If you aren’t sure if your weave is tight enough, hold your fabric up to the light. If you can see the outline of individual fibers, that fabric might not make a very good mask, since it won’t be able to filter out as many aerosols. 

To maximize its protective capabilities, any cloth mask should have multiple layers of fabric and fit snugly without restricting breathing, according to the FDA. 

Like surgical masks, cloth masks protect others from the wearer. These masks trap respiratory droplets that are released when the wearer talks, coughs or sneezes, while also acting as a barrier to protect the wearer from inhaling droplets released by others, according to the Mayo Clinic.

You could also double mask, wearing a disposable mask underneath your cloth mask. This way, the cloth mask pushes the edges of the disposable mask more tightly against your face and creates a better seal. This double-mask method might be especially effective for people who have beards that might otherwise obstruct the fit of a single mask.

You should be sure to wash your cloth mask after every use, too. You can wash it with soap and warm water in the sink and then hang it to dry, or toss it in the laundry with the rest of your clothes. Most cloth masks are machine-washable. 

Some cloth masks come with insertable paper filters, which add an extra layer. If your mask has these, great! Just make sure you take it out before you toss it in the wash.

As with all masks, it’s important that you wear them to cover both your nose and your mouth, and it’s important that you just wear them, period. Allegheny County Health Department officials have said the omicron variant is contributing to a high level of community transmission, even in places where vaccine rates are high. 

“Wear the best quality mask you have and consider double masking by wearing a surgical mask covered by a cloth mask, two surgical masks, or a KN95 mask,” said Health Department Director Debra Bogen at a Dec. 28 press briefing. “Masks greatly reduce the transmission of the virus.”

In the week spanning Jan. 2-8, Allegheny County reported 23,459 new cases, 47 new deaths and 451 hospitalizations. On Jan. 12 alone, the department reported 4,262 new infections and one new death.