Yes, You Should Wash Your Hands Before You Put On Your Coronavirus Face Mask

Dr. Darien Sutton-Ramsey explains everything you need to know

A certain world leader is “choosing” not to follow guidelines by the Centers for Disease Control and Prevention when it comes to face masks. But experts pretty much all agree that you should definitely. wear cloth masks in public, especially if you are going to be near other people.

As the United States adapts to varying degrees of social distancing measures in order to slow the spread of the novel coronavirus, and the illness it causes, COVID-19, it can be difficult to keep up with the latest on best practices, discern worthwhile advice, and keep yourself and those around you as safe and healthy as possible. By now, it’s common sense to wash your hands for a minimum of 20 seconds, stay home as much as you can, and try to stay at least 6 feet away from other people at all times. But masks, which the CDC began recommending civilians wear in the beginning of April, can be a bit more confusing. Many cities and states are requiring people to wear them in public, but isn’t there a shortage, and shouldn’t we save them for frontline health care workers so that they don’t get sick? Do masks even work if you don’t nab one of the heavy-duty N95 masks? And are there any risks that wearing masks can pose themselves?

To answer your questions, MTV News called Dr. Darien Sutton-Ramsey, an emergency physician in New York, to help break down everything you need to know about wearing your own mask, why it works, and how to keep it as clean and useful as possible. (Though there are plenty of options available online, you don’t need to buy one — if you have a piece of cotton you don’t mind sacrificing, you’re on your way to making a DIY mask.) He gets, that though wearing masks  is common for people living in various countries, the act — which he calls an “act of solidarity and altruism” — is still a novel idea for many Americans. But it’s crucial, he stresses, to keep yourself from infecting other people, even if you aren’t presenting symptoms of COVID-19. Here’s everything you need to know:

MTV News: What function do masks provide generally, whether they're medical-grade or cloth and paper masks?

Dr. Darien Sutton-Ramsey: There are two main types of masks that people know about. The surgical-style mask — the one you drape over your ears — doesn't really connect closely to your face, but it covers your mouth and your nose. It would stop your respiratory particles or droplets from going outside. That's why we stay 6 feet away from each other. We would still suggest practicing social distancing with 6 feet, but wearing a mask adds that extra layer of protection that prevents the respiratory droplets contaminating other people and surfaces.

You usually have to get fit-tested for the N95 mask. You can't have a beard, you can't have facial hair, and it needs to sit closely to your face to protect you from respiratory droplets. It's called an N95 mask because anything larger than 95 microns will not get through this filter.

The CDC really elaborates on the type of mask that you should wear, specifically ones made from cotton, because the idea is that those masks can prevent you from infecting others. With the N95 masks, the goal is to protect others from infecting you.

MTV News: How do the surgical or other cloth masks keep you from infecting others, if you are a vector for the virus?

Sutton-Ramsey: We have to go back and look at what are the chances of you having an infection without symptoms. There really haven't been great studies to elaborate on this, because we can’t test everyone who we think might have it. We're really only testing people who we basically know have it. But we also know this coronavirus is moving around the community in asymptomatic carriers who are transmitting it to those who are vulnerable, who are then getting sick and then placing stress on the healthcare system. So the goal of wearing the mask is to prevent the transmission of those asymptomatic infections.

There's been a recent study — full disclosure, my twin brother Desmond published the study — where he tested every patient who[se babies] he delivered at Columbia University for two weeks. It totaled over 200 people. And out of the 200 people he found that 33 of them had COVID-19 and of the 33 who had it, 29 were asymptomatic. That’s almost 90 percent. That just helps people understand that many people are walking around with this virus and just simply don't know.

MTV News: You mentioned that the CDC is really advocating for cotton, as opposed to other fabrics. Is there a reason why cotton is better, or can other fabrics be used if people don’t have access to it?

Sutton-Ramsey: Certainly, other fabrics can be used. The reason why we talk about cotton so much is because it's the most easily available. We don't want to be prohibitive, or make people feel as though they need to buy new materials. The idea is this is something that you can find in your house.

There's definitely other types of materials that can help; you just have to be aware of what type of material you're using. A breathable material probably won't be as effective as cotton because it theoretically would have more tiny holes in it that would allow you to release respiratory droplets that can endanger other people. The main goal is that number one, you want to secure it around your face, and number two, you want to make sure you can still breathe, obviously, while you're wearing it.

MTV News: Whenever I go outside, I often see people wearing their masks on their chin. What can people be doing better about mask hygiene?

Dr. Sutton-Ramsey: I spend so much time in the hospital where I'm operating around people who understand how to wear a mask. Sometimes I walk outside and I'm like, what is going on?!

Number one, before you put the mask on, you should always wash your hands. You're going to bring your hands close to your face, so you want to make sure that you have clean hands.

Number two, when you're putting the mask on, you can adjust it if your hands are clean, but try your best to avoid being around your mouth. That's the whole goal.

Number three, when you're wearing the mask, it should cover both of the holes in the front of your face, which include your nose and your mouth. If you're wearing the mask just over your mouth, you still can transmit respiratory droplets out of your nose and vice versa.

If you're going to walk around and not wear the mask, putting it on your chin exposes the inside of the mask to any kind of contamination that may have been on your face and therefore increases your risk of exposing yourself to the coronavirus. So if you're going to take it off, make sure that you take it off carefully: Wash your hands first, remove it from your ears, and then place it in a secure place where it cannot be contaminated. Don't wear it on your face or other parts of your body.

MTV News: People are trying to run outside more, and running with a mask is not easy. What should people know about the risks of wearing or not wearing a mask while they're working out?

Sutton-Ramsey: When you're running around, you're breathing at a faster rate, and you're increasing your chance of exposing other people. But to be quite honest, if you're going to run, you have to weigh the risks and the benefits, given that running is great for your personal immune system and your endorphins.

If you're going for a run and the mask is stopping you from being able to breathe properly, I'd probably be OK with taking it off if your path is not within 6 feet of other people. But make sure that you store it in an appropriate place and that you put it back on appropriately when you're done running.

MTV News: A lot of Black people especially are worried that wearing a mask will put them in a different kind of danger, and that people who racially profile them might target them for harassment. We've seen instances in which Black people were followed or reported for simply following guidelines, which is heartbreaking and really frustrating, especially given that the onus is still on people of color, and that telling other people not to be racist is seen as somehow less effective. Is there any advice that you could speak to about that?

Sutton-Ramsey: As a Black man myself, when I'm wearing a mask in public, I also am on guard. I'm terrified and I'm fearful for my life, more than I am fighting the pandemic inside of a hospital. That's the sad reality, but as people of color, we are more at risk from being targeted for crimes or even just suspected of doing a crime, compared to our white peers.

When I wear a mask, I wear one that is very visible and obviously a mask because I don't want to increase the risk of someone seeing it and thinking that it may be for some other purpose. It's unfortunate, but we have to do it in order to protect our own lives.

MTV News: Governor Andrew Cuomo (D-NY) recently followed other areas in issuing an order that masks are now mandated in New York. But not everybody has the resources to buy a mask, or even has a bandana and hair ties lying around. So what can they do?

Sutton-Ramsey: I don't like wearing my special [N95] mask in the street when I'm off work. I feel like it's inappropriate, and I want to send a message that you can be creative with covering your face. There's some really creative ways to make a mask; I would personally look on YouTube.

It's also important to know that certain things kill this virus, like soap and water and UV light. So if you're wanting to reuse a mask and you don't have time to wash it and dry it, leaving it on the windowsill for sunlight can help eliminate some of the virus. Sometimes I'll use rubbing alcohol and a spray bottle, and mist my products to make sure that I'm doing my best to decrease the risk of retransmitting an infection to myself. You have to get into whatever your groove is, but I think everyone has something in their home that can work.

MTV News: A lot of people are also wearing gloves as a precautionary measure. Is there anything the public misunderstands about that?

Sutton-Ramsey: I'm so happy you brought that up because the second thing that I usually see after I watch someone who inappropriately uses their mask is, I watch them turn on their phone with their gloves on. I don't know why that makes me so angry, but it does.

I'm naturally habitualized to using a glove for a momentary experience. Gloves, to me, are gross. I am using a glove to touch something novel or foreign, something that I don't deem as sanitary. And then I'm properly taking the glove off. Oftentimes, I Purell my hands with gloves on, and then I take the gloves off to decrease the risk of transmitting something to myself. So when I see people walking around with gloves, I just wish I could stop them and explain that gloves are for a momentary experience.

Often, if you're wearing gloves, you have a false sense of security and you end up touching more things. When you're not wearing gloves or anything at all on your hands, you're usually more cognizant; you don't touch things and you wash your hands. Gloves just make people believe that they're sanitary. But all I see, as a doctor, is someone who is grosser.

MTV News: Now that we’ve been living with social distancing measures for a few weeks at least, are there any other things that people can start to implement for their own safety and the safety of others, beyond keeping 6 feet apart and staying inside as much as possible?

Sutton-Ramsey: As a physician, I'm at the front line and I can tell you that admission rates are becoming stabilized, if not decreasing, as our emergency rooms are having less and less volume. And this is across the board.

But people are afraid to go to ERs. If you have an emergency and you think you need a medical provider, do not wait. Appendixes still can rupture. I'm afraid that people are staying home with their emergencies and we're going to have a shadow of the curve that we're trying to flatten, which are all these medical problems that people tried to treat at home. Emergency rooms are still active and if you have a problem, they will actively work to protect you against COVID-19.

We should also start to talk to businesses and companies about how working from home is possible; we've seen people do it. We also have to realize that certain activities like going to the movies and large restaurants and events simply will not happen anywhere in the near future. We will get back to normal. It just will be a new normal.

MTV News: Adjusting to the new normal can be really stressful, and we're all being asked to do so very quickly. What advice would you have just from a practical perspective?

Sutton-Ramsey: It's really hard, and I am trying to figure it out myself as well. This is new territory for all of us. I realized yesterday that I will probably never be in an ER without a mask on ever again. I will never be able to show my patients my face regardless of what happens. There will never be a time where we can just eliminate masks, because of the risk that a new case of COVID-19 can present itself in the ER even if we have a normal life outside, you know?

All I can do is empathize, because it's also hard to navigate this world where some of us are naturally emotional, touchy people like I am. I don't know how to handle it, but I think we all need to work together to figure out.

MTV News: Has there been anything that you've been doing to connect with patients, because you can't show your face to them?

Sutton-Ramsey: I'm usually very close with my staff and I think we're all becoming more detached. Even though we're working together, no one is seeing each other's face for a long time. It's very weird to have that experience. But a nurse took our photos and made ID badges, so on the outside of my PPE is a photo of myself with my name so that patients see what I really look like. That's one of the things that I've done recently that I think helped patients acknowledge, ‘Oh, you're a real person.’

I make an effort to show patients my photo close up, and then they look at my eyes and they see it's the same person. We have to obviously be aware that we're dealing with a pandemic, but I really think that we can't lose the care we provide, the love and empathy we show to patients.

This interview has been edited for length.


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