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On February 10th, the CDC released information about double masking. It appears that they completed an experiment in January looking at effectiveness of double masking AND decreasing the gap in a surgical mask by knotting the elastic earpiece.  See pics below. 

The goal is to create a tighter fit which effectively decreases the number of aerosolized particles, it does not indicate this will filter the particles better. Net result is that a closer fit is better. The CDC does not specifically recommend that staff double mask, but they can double mask if the  second  mask helps to close the gap. Specifically, the result from the experiment recommends if double masking, use a medical disposable mask covered by a cloth mask, not two medical masks. The report also states not to double up over a KN95.

Double mask refers to a three-ply medical procedure mask covered by a three-ply cloth cotton mask. A knotted and tucked medical procedure mask is created by bringing together the corners and ear loops on each side, knotting the ears loops together where they attach to the mask, and then tucking in and flattening the resulting extra mask material to minimize the side gaps.

The CDC conducted experiments to assess two ways of improving the fit of medical procedure masks: fitting a cloth mask over a medical procedure mask and knotting the ear loops of a medical procedure mask and then tucking in and flattening the extra material close to the face. Each modification substantially improved source control and reduced wearer exposure. 

On 2/10/21, the CDC Director released a statement saying, any type of mask is better than no mask at all, however, a well-fitting mask offers the greatest performance at protecting the wearing and preventing exposure. The experiment showed that if both the source and receiver are wearing masks as described above, they are offered 95% protection as compared to no mask at all.

The CDC continues to recommend a mask with two or more layers, covering mouth and nose which fits snuggly against the nose and sides of face.  A well-fitting mask is important for greater protection.

Life After Vaccination

You do your part while at work. You are wearing PPE, having your patients wear masks when appropriate, AND getting vaccinated. You are doing your part to slow the spread, and our statistics show it is working. 

Now, continue to be diligent in your personal lives too. Remember that wearing a mask is the simplest action you can take to fight the spread of COVID-19.  Masking helps prevent the spread by containing the moist cough/exhaled particles inside the mask. Masks help protect others by providing a covering to prevent particles from reaching your nose and mouth.  Double masking or knotting and tucking as mentioned above further decreases the aerosol spray.

Face coverings are an important step in helping slow the spread of COVID-19 when combined with other everyday preventive actions, including social distancing and frequent handwashing.

We must continue to be vigilant in efforts to prevent the spread.  Many of you have been vaccinated, but we, as a country, have not obtained herd immunity yet. According to the CDC, there is not enough information currently available to say if or when the CDC will stop recommending that people wear masks and avoid close contact with others to help prevent the spread of the virus that causes COVID-19.

Experts need to understand more about the protection that COVID-19 vaccines provide in real-world conditions before making that decision. Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision. We also do not yet know whether getting a 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. The CDC will continue to update this information as they learn more.

While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to help stop this pandemic.

To protect yourself and others, follow these recommendations:

  • Wear a mask over your nose and mouth
  • Stay at least six feet away from others
  • Avoid crowds
  • Avoid poorly ventilated spaces
  • Wash your hands often

Together, COVID-19 vaccination and following the CDC’s recommendations for how to protect yourself and others will offer the best protection from getting and spreading COVID-19.

The CDC released new information regarding fully vaccinated people who then have an exposure to known laboratory confirmed COVID positive individual. 

In the updated guidance, the CDC said, previously recommended, 14-day  quarantining is not necessary for fully vaccinated people within three months of having received their last dose as long as they do not develop any symptoms. “Fully vaccinated” means that at least two weeks have passed since a person has received the second dose of a two-dose vaccine or one dose of a single-dose vaccine.

A summary of recent changes (last updated February 10, 2021):

  • Updated information on delayed, local injection-site reactions after the first mRNA vaccine dose. These reactions are neither a contraindication or precaution to the second dose.
  • Updated quarantine recommendations for vaccinated persons. Fully vaccinated persons who meet criteria will no longer be required to quarantine following an exposure to someone with COVID-19. Additional considerations for patients and residents in healthcare settings are provided. Specifically, as an exception to the above guidance no longer requiring quarantine for fully vaccinated persons, vaccinated inpatients and residents in healthcare settings should continue to quarantine following an exposure to someone with suspected or confirmed COVID-19; outpatients should be cared for using appropriate Transmission-Based Precautions. This exception is due to the unknown vaccine effectiveness in this population, the higher risk of severe disease and death, and challenges with social distancing in healthcare settings. Although not preferred, healthcare facilities could consider waiving quarantine for vaccinated patients and residents as a strategy to mitigate critical issues (e.g., lack of space, staff, or PPE to safely care for exposed patients or residents) when other options are unsuccessful or unavailable. These decisions could be made in consultation with public health officials and infection control experts.
  • Additional information and updated recommendations for testing for TB infection. TB testing can be done before or at the same time as mRNA COVID-19 vaccination, or otherwise delayed for ≥4 weeks after the completion of mRNA COVID-19 vaccination.

Resources:          COVID-19 Vaccines | CDC

                              Preventing The Spread Of COVID-19 | TN COVID-19 Hub

CDC report: Double-masking can block more than 90 percent of viral particles (nbcnews.com)

Maximizing Fit for Cloth and Medical Procedure Masks to Improve Performance and Reduce SARS-CoV-2 Transmission and Exposure, 2021 | MMWR (cdc.gov)

Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines | CDC