Masks: Where to Wear

When SVMC staff members go out in public, they notice many people wearing masks appropriately and a few who are not wearing them as directed. Some of the non-compliance, it seems, may relate to confusion about when a mask is necessary and why.

The risks can be determined by evaluating your likelihood to encounter people who are ill or those outside your household, how many people you will encounter, how close you are likely to get to others, and how long you will be near them. Here’s a helpful guide for getting it straight:

Situation	Where to Wear	Risks
Either indoors or outside at home with the family members you live with, all of whom are healthy	Don't wear	It’s just not feasible to wear a mask at all times. As long as the number of people you live with is small and consistent and the group is following distancing, masking, and handwashing guidelines, the risk is minimal. Those who live in large groups should follow the recommendations in the last line of the chart.
Either indoors or outside at home if a family member is ill with flu- or COVID-like symptoms	Both those who are ill and those in proximity to them should wear a mask.	Wearing a mask when close will help prevent the well people in the household from becoming ill. Also, keep as separate as possible, disinfect surfaces a few times a day, and wash hands frequently.
Inside with healthy people you don’t live with	Everyone should wear a mask over their mouth and nose for the entire time.	Wearing a mask in this case will help keep those who are ill, but who don’t yet know it yet, from spreading the virus. Also keep these meetings 6 feet apart and brief. Note that those who are not healthy should not visit or accept visitors.
Outside with people you don’t live with	Same as directly above.	Same as directly above.
Out for a walk or hike alone or with those you live with	Intermittent mask wearing. In this case, put on your mask in the case you are likely to come within 6 – 10 feet of others.	Time spent in proximity to someone who is shedding the virus is a significant factor is catching it. So the chances of catching it while passing someone in the street or on the trail is very small. Allow as much space as possible and put the mask on when you can’t avoid getting close to others.
Out for a walk or hike with those you do not live with	Both people should wear a mask the entire time.	While the risk of passing the virus is lower outside than inside, it’s still best to have a mask on when near people you don’t live with for any length of time, even if you are walking a little way apart.
Running in to pay for gas or pharmacy	Wear a mask over both your mouth and nose the entire time.	Even though you will not be spending long inside the gas station, you need to wear a mask. Many people would have been in and out of the space throughout the day. The aerosolized virus can hang in the air for as long as an hour. Also, you may have touched the gas pump, the gas station door, and a keypad. So take care not to touch your face and keep hand sanitizer in your car, so you can clean your hands before touching the steering wheel and shifter.
While at the grocery or hardware store	Wear a mask over both your mouth and nose the entire time.	Of all of the circumstances where masks are important, this is the most crucial. Given the number of people visiting the store and the amount of time most people take to do their weekly shopping, the grocery store and other stores are high-risk zones. Limit your trips to once a week, if possible; follow the guidelines meant to help distance shoppers; and sanitize your hands before driving.

Based on the risks—your likelihood to encounter people who are ill or those outside your household, how many people you will encounter, how close you are likely to get to others, and how long you will be near them—the greatest risk is being a healthcare worker. Which is why we wear our masks, eye protection (face shields or googles) and other protective equipment the entire time we are working.

Wearing your mask at the appropriate moments is key to minimize your risk of exposure and the risk that you will expose others. Together with limiting visits, distancing, and handwashing, good mask-wearing habits will lessen how many people become infected with COVID-19.

Donna Barron, RN, is the infection preventionist at Southwestern Vermont Medical Center.