# Endemic Guidelines for Using Face Masks to Continue Protecting Yourself & Others

## Transitioning from a Pandemic to an Endemic

COVID-19 still exists, with a [significant number of cases continuing to rise](https://covid19.who.int/table) across the US and the world. However, its behavior is now predictable and cases are no longer spiking, leading many experts to treat it as an endemic. This guide covers implications of wearing masks during endemics, public safety importance, and expert tips to prevent future outbreaks.

## Important Considerations for Wearing Masks During an Endemic

Masks block respiratory droplets that spread airborne viruses like COVID-19. While many countries have lifted mask mandates, masks remain an impactful tool for protection.

### Should You Wear a Mask?

The CDC advises that children aged 2 years and older should wear a mask in public places and crowded settings. Caretakers of COVID-19 patients, people who are sick or suspect they have COVID-19, and the following vulnerable individuals are advised to wear masks:

- The elderly
- Pregnant women
- Caretakers and healthcare providers
- Travelers, especially internationally
- People with medical conditions (cancer, lung/heart disease, diabetes, immune system conditions)

### Who Should Not Wear a Mask?

- Children younger than 2 years old
- Anyone with trouble breathing
- Those unconscious or incapacitated
- People with sensory, cognitive, or behavioral problems

## Types of Masks

### What Is Recommended?

**Disposable or single-use masks** – Great everyday options; choose masks with multiple layers of non-woven material.

**Surgical or procedural masks** – Used in healthcare settings; provide excellent filtration and fluid resistance.

**N95s and other respirators** – Filter at least 95% of airborne particles; must be tightly fitted.

### What Is Not Recommended?

**Masks with vents or exhalation valves** – May allow respiratory droplets to escape.

**Clear or plastic masks** – Not recommended for regular use, but may be used as an alternative by those who are deaf/hard of hearing, students learning to read/speak, or certain individuals with disabilities.

## Situations When Wearing a Mask May Not Be Possible

### Dining
Wear a mask except when actively eating or drinking, especially indoors and when speaking with staff.

### High-intensity activities
Choose venues with good ventilation, keep 6 feet distance, and replace masks if they become wet from sweat.

### Water activities
Do not wear masks while swimming or doing water sports—wet masks are ineffective and make breathing difficult.

## Important Tips to Control Respiratory Infection Outbreaks

- Wear a face mask in public places, crowded indoor venues, and healthcare establishments
- Wash hands regularly with soap and water for at least 20 seconds
- Use an alcohol-based sanitizer with at least 60% alcohol if handwashing is not possible
- Avoid touching eyes, nose, or mouth with unwashed hands
- Keep a social distance of 6 feet or more indoors
- Avoid going out when sick
- Dispose of used tissues immediately
- Clean and disinfect household surfaces frequently
- Get vaccinated – [COVID-19 vaccines offer up to 94% protection](https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vaccine/art-20484859)
- Get tested if symptoms appear
- Minimize close contact with people showing respiratory symptoms
- Maintain proper respiratory hygiene
- Avoid sharing personal items with sick individuals
- Keep living environments clean

## Wearing Face Masks While on Public Transportation Conveyances and Hubs

As of April 18, 2022, the federal mask mandate on public transportation has been lifted, but the CDC continues to advise mask-wearing in crowded or poorly ventilated public transport. Other countries may still require masks when commuting. Check with local and international authorities when traveling.

## Importance of Health and Safety in Public Areas

Fine droplets from an infected person can [remain airborne indoors for hours](https://www.epa.gov/coronavirus/indoor-air-and-coronavirus-covid-19). To stay safe:

- Avoid the 3 Cs: closed, crowded, or close-contact spaces
- Choose outdoor gatherings over indoor ones
- If indoors, wear a mask and open windows for ventilation

Proper mask-wearing tips:
- Wash hands or sanitize before putting on and after taking off the mask
- Ensure the mask covers nose, mouth, and chin
- Store used masks in a clean bag; discard properly in a trash bin

## Proper Mask Care and Disposal

### Surgical and disposable masks
Remove by the strings, fold inward, wrap with ear loops, and discard in a yellow waste bag or wrapped in tissue/polythene bag.

For additional protection, WellBefore carries personal protective equipment such as [nitrile gloves](https://wellbefore.com/collections/nitrile-gloves), NIOSH-approved N95 masks, KN95 masks, and more.

## Frequently Asked Questions

**Tips for Families and Children**
Many virologists suggest we are [nearing the endemic stage](https://www.umassmed.edu/news/news-archives/2022/08/is-covid-19-reaching-the-endemic-stage-umass-chan-virologist-jeremy-luban-weighs-in/) of COVID-19, where the virus continues to spread but rarely causes severe symptoms due to population immunity.

**Is it safe to go out without a face mask?**
According to CDC metrics, [around 70% of Americans](https://www.npr.org/sections/health-shots/2022/02/26/1083210610/masks-mandates-safety) live in areas where masks are no longer needed, but it remains safer to wear one in public or crowded places.

**Am I required to get vaccinated?**
COVID-19 vaccines are not mandatory but are encouraged for everyone 6 months and older. Boosters are advised for those 5 years and older.

**Why are masks recommended during travel and in public transportation?**
Transportation hubs expose people to large crowds in poorly ventilated areas, increasing infection risk. Masks protect those who are unvaccinated, immunocompromised, or have no alternative transportation.

## References

- Brooks, J. T., & Butler, J. C. (2021, February 10). Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. JAMA Network.
- COVID-19 and Travel. (2022, April 15). Centers for Disease Control and Prevention.
- COVID-19 Vaccination. (2022, September 15). Centers for Disease Control and Prevention.
- COVID-19 vaccines: Get the facts. (2022, October 26). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vaccine/art-20484859
- Huang, P., & Stone, W. (2022, February 26). It’s safe to unmask in many places, says the CDC. These experts aren’t quite ready. NPR.Org. https://www.npr.org/sections/health-shots/2022/02/26/1083210610/masks-mandates-safety
- Indoor Air and Coronavirus (COVID-19). (2021, December 15). US EPA. https://www.epa.gov/coronavirus/indoor-air-and-coronavirus-covid-19
- Is COVID-19 reaching the endemic stage? UMass Chan virologist Jeremy Luban weighs in. (2022, August 17). UMass Chan Medical School. https://www.umassmed.edu/news/news-archives/2022/08/is-covid-19-reaching-the-endemic-stage-umass-chan-virologist-jeremy-luban-weighs-in/
- Respiratory Hygiene/Cough Etiquette in Healthcare Settings | CDC. (n.d.). https://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm
- Situation by Region, Country, Territory & Area. (n.d.). World Health Organization. Retrieved November 15, 2022, from https://covid19.who.int/table