Yes, surgical masks offer better protection against COVID-19 than cloth masks

As COVID-19 cases rise again in the United States with the emergence of the omicron variant, people are focusing on things they can do to best protect themselves against COVID-19. Public health officials say the best protection is getting vaccinated and a booster shot.

Recent news headlines have also suggested that another step people can take to protect themselves is ditching their cloth masks for surgical masks.

THE QUESTION

Do surgical masks offer better protection against COVID-19 than cloth masks?

THE SOURCES

• Studies (here, here and here) on the effectiveness of different types of masks
• Centers for Disease Control and Prevention
• U.S. Food and Drug Administration
• World Health Organization
• National Institute for Occupational Safety and Health
• Oklahoma State Department of Health
• Dr. Ashwin Balagopal, infectious disease expert at Johns Hopkins Medicine

THE ANSWER

Yes, surgical masks offer better protection against COVID-19 than cloth masks.

WHAT WE FOUND

The Centers for Disease Control and Prevention (CDC) recommends the wearing of face masks to limit the spread of COVID-19. But the U.S. public health agency doesn’t specifically recommend one type of mask over another. 

Meanwhile, the U.S. Food and Drug Administration (FDA) describes a surgical mask as "a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment." 

"If worn properly, a surgical mask is meant to help block large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria), keeping it from reaching your mouth and nose. Surgical masks may also help reduce exposure of your saliva and respiratory secretions to others," the FDA writes.

The World Health Organization recommends surgical masks for certain groups of people who are at higher risk of being hospitalized or dying from COVID-19. That includes people 60 and older and anyone with an underlying health condition.

Multiple studies have found that surgical masks offer better protection against airborne particles than cloth masks.

One study conducted by researchers from Yale University, Stanford University and Bangladesh found the “filtration efficiency” of surgical masks was about 95% compared to 37% for cloth masks. Another study by researchers at the University of Colorado concluded that the filtration efficiency of surgical masks ranged from 42-88%, higher than the 16-23% efficiency range of cloth masks. A study by Duke University researchers also found surgical masks were better at limiting the transmission of droplets than cloth masks.

The latter two studies also concluded that N95 masks, which the FDA classifies as respirators, were the most effective at filtering particles and limiting droplet transmission. N95 masks filter at least 95% of airborne particles, according to the FDA.

What’s the difference between a surgical mask and a respirator like an N95 mask? Surgical masks don’t provide reliable protection from aerosolized particles and therefore are not respiratory protective devices, according to the FDA. Furthermore, surgical masks are cleared by the FDA, while N95 masks are approved by the National Institute for Occupational Safety and Health and must meet a higher standard for protection. You can find a list of approved N95 masks here.

That elevated standard is why Dr. Ashwin Balagopal, an infectious disease expert at Johns Hopkins Medicine, recommends people wear an N95 mask instead of a cloth mask.

“I’m concerned that [cloth masks] don’t protect as well,” he said.

Balagopal also encouraged people to wear KN95 masks if they can’t get their hands on N95 masks. The difference between the two masks is where they are certified, according to the Oklahoma State Department of Health. While N95 masks are certified in the U.S., KN95 masks are certified in China.

KN95 masks are “the most widely available respirators that meet an international standard,” according to the CDC. However, the agency warns against counterfeits – saying 60% of KN95 masks in the U.S. are counterfeit and do not meet U.S. standards.  

The CDC says basic N95 masks can be used for personal use, but that N95 masks with “surgical” labels should be prioritized for health care workers. 

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