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Understanding CDC’s New Masking Recommendations


By Tiffany Wiksten, MSN, RN-CIC

The Centers for Disease Control and Prevention’s (CDC) recommendations surrounding masking has generated a lot of questions since the start of the COVID-19 pandemic.

Recently, a number of questions have come our way on the CDC guidelines on mask fit and, especially double masking. I’ve outlined our responses to some of the most frequent questions below.

Why are there new recommendations for masking?

The CDC has issued new recommendations for masking to increase mask protection by improving mask fit and filtration. Wearing a mask is instrumental in preventing the spread of COVID-19. The types of masks and face coverings that are available vary by design, material, filtration and securement method.  
Additionally, each person is unique and the way a mask fits one person, may not be the same way it fits another person. There is new evidence that a mask’s performance is affected by its:

  • fit
  • air filtration
  • layers 

Well-fitted masks with multiple layers help prevent respiratory droplets from entering or exiting your mask, protecting you and those around you. 

What can I do to help ensure my mask is protecting me in public?
Choosing a mask that fits snugly against the face and has multiple layers are two important ways to increase the effectiveness of the mask. When selecting a mask, choose one with a nose wire, if available, to prevent air from leaking out along the top of the mask.  

The most effective cloth masks have multiple layers of fabric. Check the fit of your mask for air leakage around the outside edges with your hands with each breath.  

There are a few ways to improve the fit of your mask including:

  • wearing a mask fitter or brace over the outside of a mask to prevent air leakage
  • knotting and tucking the ear loops of a three-ply mask
  • wearing a disposable mask under a cloth mask   

The CDC recommends that you do not combine two disposable masks as they are not designed to fit tightly and adding a second disposable mask will not improve the fit of the first mask. Similarly, The CDC recommends not combining a N95 or KN95 mask with any other mask.   

I am a health care worker, should I wear two masks at work?
Health care organizations are responsible for deciding what types of masks must be worn as personal protective equipment (PPE) and they may also have policies about the f masks that employees are allowed to wear as source control. Organizations should determine the type of health care mask (PPE) that is appropriate for their health care workers for the anticipated level of exposure, based on the risk of exposure to:

  • blood
  • bodily fluids 
  • specific infectious agents
  • chemicals or other hazards

Healthcare workers should work with their infection preventionist and leadership team to determine the appropriate mask(s) to wear based on the potential for exposure and continuing need for source control. As recommendations continue to evolve on masking, vaccinations and all things related to the pandemic, we will keep you updated!

Tiffany Wiksten, MSN, RN-CIC, is Associate Director, Standards Interpretation in the Office of Quality and Patient Safety at The Joint Commission.