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As CDC considers updating COVID-19 mask guidance, what is the difference between cloth and N95 masks?

Doctors from some of Atlanta's top healthcare systems discuss the differences.

ATLANTA — Throughout most of the COVID-19 pandemic, medical experts have said any mask is better than no mask. But now the CDC is considering an update to its mask guidance and potentially recommending that people wear N-95 masks instead of cloth masks. 

"When we look at the cloth mask it actually provides the least amount of filtration against these all-important particles at about 26.5 percent, because cotton by its characteristics is very breathable and that is why it is comfortable to wear," said Dr. Jayne Morgan, Executive Director of the Covid Task Force at Piedmont Healthcare. 

She added research has shown nylon masks can block out 60 to 70 percent of particles.

Dr. Danny Branstetter, medical director of infectious disease and infection prevention with Wellstar Health System, said with N-95 masks the difference is in the name.

"The biggest difference is the filtering material. So the 95 is to indicate that it filters out 95 percent of particulate matter," he said.

One way to see the difference is by attempting to blow out a candle. With many cloth masks, it is possible to blow out a candle, representing the particulate matter that could travel through the mask. 

With a well-fitting N-95 mask the task appears impossible or very challenging at best.

The key to wearing N-95 masks though is that they must be well-fitting, meaning it is being worn correctly and you have a good seal. That is according to Morgan who added you should look for certain features in the mask you purchase.

"If you have headbands on your mask as opposed to ear loops that is better," she said. "If you have a nose clip that you can seal around your nose as opposed to one that doesn't that is better. If you can close the gaps around your face that would be better than one in which you cannot."

While the N-95 masks might be a good option for adults, Branstetter believes they aren't the best option for children.

"A well-fitted N-95 mask or 95-grade mask is really hard to wear for long periods of time for anyone," he said. "An hour is really kind of pushing it if it is well fitted. For school and out and about in the community probably not something that is really feasible."

In an e-mail Wednesday to 11Alive, Dr. Marybeth Sexton with Emory School of Medicine stressed the need for people to simply wear a well-fitting mask, whether N-95 or not, while also getting vaccinated.

"COVID is not spreading rapidly because we're not all wearing N95s; it's spreading because 30 plus percent of the population is still not vaccinated and a lot of people aren't wearing any mask at all," she wrote. "The degree to which the Omicron variant is contagious likely does make it less forgiving of mask 'errors' or poor fit, so it's important for people to focus on a high-quality, well-fitting masks that they can tolerate wearing without frequently adjusting the mask, touching their face, breaking the seal, taking it off. The need for high quality likely means a cloth mask alone is not ideal, but the need for good fit and tolerability may mean an N95 isn't ideal for everyone either."

Sexton went on to recommend people first experiment if they haven't already with several well-fitting and high-quality masks. They should then choose, she said, the mask that fits their face and they will be able to wear.

Cloth masks can be an attractive option as they are affordable from the standpoint that when they are dirty you can wash them with your laundry and then wear them again. 

Morgan said N-95 masks though are designed to be disposable.

"If it has been 2 to 3 days you really need to think about changing it. These are disposable. If it is visibly soiled, if you have touched the inside if you have been in an environment where people may have had COVID, you've got to think of all of these things and certainly understand that finances and economy are a concern, but if you're able to we absolutely want you to change these masks out as often as possible."

Branstetter offered similar advice and said, "If you can see through it, not good. Or if it is soiled or visibly has holes in it or you're not getting a good seal, that tight fit then you should replace it."

Sexton wrote, "If people do choose an N95, they should stop using it and change to a new mask if it is damaged, if it won't hold its shape, if it won't seal to their face, or if it gets harder to breathe through."

11Alive's TEGNA sister station WBNS previously verified that in some cases you can decontaminate your mask using a paper bag. By placing your mask inside the bag for 24 to 48 hours and placing it in a dry location it can decontaminate the mask by separating it from any contaminated individuals or surfaces. 

To verify you're purchasing a legitimate N-95 mask, you can also check for a logo on the mask or packaging from the National Institute for Occupational Safety and Health. Online, the CDC has also posted listings of masks approved by the NIOSH as being N-95 quality.

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