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The wearing of face masks during the COVID-19 pandemic has received varying recommendations from different public health agencies and governments. The topic has been a subject of debate, with various public health agencies and governments disagreeing on a protocol for wearing face masks. As of early May, 88% of the world's population lives in countries that recommend or mandate the usage of masks in public and 75+ countries have mandated the use of masks. Debates have emerged regarding whether masks should be worn even when social distancing at six feet, whether they should be worn during exercise, worn in the home to reduce viral load, and whether there are mitigating factors. Additionally, public health agencies of different countries and territories have often changed their recommendations regarding face masks over time. Face masks have been a subject of shortages, and also been made compulsory in some countries.

Types of face masks, from least to most protective, include cloth face masks, medical (non-surgical) masks, surgical masks, and filtering facepiece respirators such as N95 masks and FFP masks. Face shields and medical goggles are other types of protective equipment often used together with face masks.

Types of masks

A cloth face mask is a mask made of a common textile, usually cotton, worn over the mouth and nose. Unlike surgical masks and respirators, they are not subject to regulation, and there is currently little research or guidance on their effectiveness as a protective measure against infectious disease transmission or particulate air pollution. They were routinely used by healthcare workers starting from the late 19th century until the mid 20th century. In the 1960s they fell out of use in the developed world in favor of modern surgical masks, but their use has persisted in developing countries.

A surgical mask is 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 viruses and bacteria, keeping it from reaching the wearer's mouth and nose. Surgical masks may also help reduce exposure of the wearer's saliva and respiratory secretions to others. A surgical mask, by design, does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures. Surgical masks also do not provide complete protection from germs and other contaminants because of the loose fit between the surface of the face mask and the face. Surgical masks may be labeled as surgical, isolation, dental, or medical procedure masks. Surgical masks are made of a nonwoven fabric created using a melt blowing process.

An N95 mask is a particulate-filtering facepiece respirator that meets the N95 air filtration rating of the US National Institute for Occupational Safety and Health, meaning that it filters at least 95 percent of airborne particles, while not resistant to oil like the P95. It is the most common particulate-filtering facepiece respirator. It is an example of a mechanical filter respirator, which provides protection against particulates, but not gases or vapors. Like surgical masks, the N95 mask is made of melt-blown nonwoven polypropylene fabric. The corresponding face mask used in the European Union is the FFP2 respirator.

Recommendations

Health organizations have recommended that people cover their mouth and nose with a bent elbow or a tissue when coughing or sneezing, and dispose of any tissue immediately. Surgical masks are recommended for those who may be infected, as wearing a mask can limit the volume and travel distance of expiratory droplets dispersed when talking, sneezing, and coughing. The World Health Organization (WHO) has issued instructions on when and how to use masks.

Masks have also been recommended for use by those who are taking care of someone who may have the disease. The WHO has recommended the wearing of masks by healthy people only if they are at high risk, such as those who are caring for a person with COVID-19, though they also acknowledge that wearing masks may help people avoid touching their face. Several countries have started to encourage the use of face masks by members of the public.

As of May 2020, 88% of the world's population lived in countries where their government and leading disease experts recommended the use of masks in public places to limit the spread of COVID-19.

World Health Organization

World Health Organization advice to the public in the context of COVID-19 endorsed the use of masks only under the following conditions:

• If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection.
• Wear a mask if you are coughing or sneezing.
• Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand sanitizer or soap and water.
• If you wear a mask, then you must know how to use it and dispose of it properly.

— World Health Organization

US Centers for Disease Control and Prevention

The United States Centers for Disease Control and Prevention (CDC) recommended in April 2020 that the general public wear cloth face coverings in public settings where other social distancing measures are difficult to maintain, such as grocery stores and pharmacies, especially in areas of significant community-based transmission, due to the significance of asymptomatic and pre-symptomatic disease transmission.

In March 2020, the CDC recommended that if neither respirators nor surgical masks are available, as a last resort, it may be necessary for healthcare workers to use masks that have never been evaluated or approved by NIOSH or homemade masks, though caution should be exercised when considering this option.

In March and April 2020, the CDC faced backlash over their earlier statements advising that most healthy people did not need to wear a mask. The earlier recommendations had been made to try to conserve supplies for medical professionals, but damaged the agency's credibility.

China and Asia

China has specifically recommended the use of disposable non-surgical medical masks by healthy members of the public, particularly when coming into close contact (1 metre (3 ft) or less) with other people. Hong Kong recommends wearing a surgical mask when taking public transport or in crowded places. Thailand's health officials are encouraging people to make cloth face masks at home and wash them daily. The Taiwanese, South Korean, and Japanese governments have also recommended the use of face masks in public.

When asked about the mistakes that other countries were making in the pandemic in March, the Chinese Center for Disease Control and Prevention director-general George Fu Gao said:

"The big mistake in the U.S. and Europe, in my opinion, is that people aren't wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role − you've got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others."

Rationale for wearing masks

Among the reasons cited by Chinese health officials for the wearing of masks, even by healthy individuals, are the following:

1. Asymptomatic transmission. Many people can be infected without symptoms or only with mild symptoms.
2. Impossibility of appropriate social distancing in many public places at all times.
3. Cost-benefit mismatch. If only the infected individuals wear a mask, they would possibly have a negative incentive to do so. An infected individual might get nothing positive, but only bear the costs such as inconvenience, purchasing expenses, and even prejudice.
4. There is no shortage of masks in China, which has been producing 100 million masks per day since early March.

Leading microbiologist Yuen Kwok-yung from the University of Hong Kong cites a large viral load in sputum and saliva of an infected person and asymptomatic cases as the reasons why even healthy individuals should wear a mask.

According to Stephen Griffin, a virologist at the University of Leeds, "Wearing a mask can reduce the propensity people to touch their faces, which is a major source of infection without proper hand hygiene." The precautionary principle has also been cited by the British Medical Journal as a reason some may encourage universal face mask wearing.

Asian health officials and experts have been promoting universal masking. For instance, Linfa Wang (a leading infectious disease expert who heads a joint Duke University and National University of Singapore research team) stated that masking is about "preventing the spread of disease rather than preventing getting the disease," remarking that the point is to cover the faces of people who are infected but do not know it, so it is imperative for everyone to wear one in public.

Recent studies have suggested that the required six feet of social distancing is insufficient and based on debunked studies from the 1930s or error. Researchers and science writers have suggested that masks be worn even when social distancing at six feet, should be worn during exercise, and might be worn in the home to reduce viral load.

Shortages of face masks

Early epidemic in China

As the epidemic accelerated, the mainland market in China saw a shortage of face masks due to increased public demand. In Shanghai, customers had to queue for nearly an hour to buy a pack of face masks; stocks were sold out in another in half an hour. Hoarding and price gouging drove up prices, so the market regulator said it would crack down on such acts. In January 2020, price controls were imposed on all face masks on Taobao and Tmall. Other Chinese e-commerce platforms – JD.com, Suning.com, Pinduoduo – did likewise; third-party vendors would be subject to price caps, with violators subject to sanctions.

By March China had quadrupled its production capacity (100 million masks per day).

National stocks and shortages

In 2006, 156 million masks were added to the US Strategic National Stockpile in anticipation of a flu pandemic. After they were used against the 2009 flu pandemic, neither the Obama administration nor the Trump administration renewed the stocks. By 1 April, the US's Strategic National Stockpile was nearly emptied.

In France, 2009 H1N1-related spending rose to €382 million, mainly on supplies and vaccines, which was later criticised. It was decided in 2011 to not replenish its stocks and rely more on supply from China and just-in-time logistics. In 2010, its stock included 1 billion surgical masks and 600 million FFP2 masks; in early 2020 it was 150 millions and zero, respectively. While stocks were progressively reduced, a 2013 rationale stated the aim to reduce costs of acquisition and storage, now distributing this effort to all private enterprises as an optional best practice to ensure their workers' protection. This was especially relevant to FFP2 masks, more costly to acquire and store. As the COVID-19 pandemic in France took an increasing toll on medical supplies, masks and PPE supplies ran low, causing national outrage. France needs 40 millions masks per week, according to French president Emmanuel Macron. France instructed its few remaining mask-producing factories to work 24/7 shifts, and to ramp up national production to 40 million masks per month. French lawmakers opened an inquiry on the past management of these strategic stocks. The mask shortage has been called a "scandal d'État" (State scandal).

In late-March/early-April 2020, as Western countries were in turn dependent on China for supplies of masks and other equipment, China was seen as making soft-power play to influence world opinion. However, a batch of masks purchased by the Netherlands was reportedly rejected as being sub-standard. The Dutch health ministry issued a recall of 600,000 face masks from a Chinese supplier on 21 March which did not fit properly and whose filters did not work as intended despite them having a quality certificate. The Chinese Ministry of Foreign Affairs responded that the customer should "double-check the instructions to make sure that you ordered, paid for and distributed the right ones. Do not use non-surgical masks for surgical purposes".

N95 and FFP masks

N95 and FFP masks were in short supply and high demand during the COVID-19 pandemic. Production of N95 masks was limited due to constraints on the supply of nonwoven polypropylene fabric (which is used as the primary filter), as well as the cessation of exports from China. China controls 50 percent of global production of masks, and facing its own coronavirus epidemic, dedicated all its production for domestic use, only allowing exports through government-allocated humanitarian assistance.

In March 2020, US President Donald Trump applied the Defense Production Act against the American company 3M, which allows the Federal Emergency Management Agency to obtain N95 respirators from 3M. White House trade adviser Peter Navarro stated that there were concerns that 3M products were not making their way to the US. 3M replied that it has not changed the prices it charges, and was unable to control the prices its dealers or retailers charge.

In early April 2020, Berlin politician Andreas Geisel alleged that a shipment of 200,000 N95 masks that it had ordered from American producer 3M's China facility were intercepted in Bangkok and diverted to the United States. Berlin police president Barbara Slowik stated that she believed "this is related to the US government's export ban." 3M said they had no knowledge of the shipment, stating "We know nothing of an order from the Berlin police for 3M masks that come from China," and the US government denied that any confiscation had taken place and said that they use appropriate channels for all their purchases. Berlin police later confirmed that the shipment was not seized by US authorities, but was said to have simply been bought at a better price, widely believed to be from a German dealer or China. This revelation outraged the Berlin opposition, whose CDU parliamentary group leader Burkard Dregger accused Geisel of "deliberately misleading Berliners" in order "to cover up its own inability to obtain protective equipment". FDP interior expert Marcel Luthe said "Big names in international politics like Berlin's senator Geisel are blaming others and telling US piracy to serve anti-American clichés." Politico Europe reported that "the Berliners are taking a page straight out of the Trump playbook and not letting facts get in the way of a good story." The Guardian also reported that "There is no solid proof Trump approved the heist".

Jared Moskowitz, head of the Florida Division of Emergency Management, accused 3M of selling N95 masks directly to foreign countries for cash, instead of the US. Moskowitz stated that 3M agreed to authorized distributors and brokers to represent they were selling the masks to Florida, but instead his team for the last several weeks "get to warehouses that are completely empty." He then said the 3M-authorized US distributors later told him the masks Florida contracted for never showed up because the company instead prioritized orders that came in later, for higher prices, from foreign countries (including Germany, Russia, and France). As a result, Moskowitz highlighted the issue on Twitter, saying he decided to “troll” 3M. Forbes reported that "roughly 280 million masks from warehouses around the US had been purchased by foreign buyers and were earmarked to leave the country, according to the broker — and that was in one day", causing massive critical shortages of masks in the US.

As more and more countries restricted the export of N95 masks, Novo Textiles in British Columbia had plans to become the number-one manufacturer in Canada. AMD Medicom in Quebec also plans to become the second Canadian manufacturer of N95 masks, with a contract to supply the Government of Canada.

The mask industry

Manufacturing

This section needs expansion. You can help by adding to it. (May 2020)

As of 2019, mainland China manufactured half the world output of masks. As Covid-19 spread, enterprises in several countries quickly started or increased the production of face masks. Cottage industries also emerged, manufacturing for localised use.

Distribution

This section needs expansion. You can help by adding to it. (May 2020)

Some clinical stockpiles have proved inadequate in scale, and markets have expanded as non-medical consumers started obeying mandated mask-wearing or determined that masks might help or encourage them. Worldwide demand for face masks has resulted in masks shipping around the globe as a result of commercial transactions or of donations.

Culture

Attitudes

In East Asian societies, a primary reason for mask-wearing is to protect others from oneself. It is seen as a collective responsibility to reduce the transmission of the virus. The broad assumption behind the act is that anyone, including seemingly healthy people, can be a carrier of the coronavirus. A face mask is thus seen as a symbol of solidarity. Elsewhere, the need for mask-wearing is often seen in an individual's perspective where masks only serve to protect oneself.

Cultural norms and social pressure may also impede mask-wearing in public. According to the Hong Kong doctor and infectious disease expert Joseph Tsang, the promotion of universal masking may resolve perceptions against mask-wearing, because mask-wearing is intimidating if few people wear masks due to cultural barriers, but if all people wear masks it shows a message that people are in this together.

In the western world, the public usage of masks still often carries a large stigma, as it is seen as a sign of sickness. This stigmatization is a large obstacle to overcome, because people may feel too ashamed to wear a mask in public and therefore opt to not wear one. Secondly, it is heavily racialized as an Asian phenomenon. However, there is also a divide within the western world, as seen in the Czech Republic and Slovakia where mass mobilization has occurred to reinforce the solidarity in mask-wearing since March 2020.

On social media, there has been an effort with the #masks4all campaign to encourage people to use masks. Mask-wearing has been called a prosocial behavior in which one protects others within their community.

Fashion

Face masks have had an impact on fashion, with the masks themselves becoming a fashion statements, haute couture brands having pivoted to address both public health and aesthetic needs.

Mask use and policies by country and territory

• Argentina: After appearance of three asymptomatic cases, the capital Buenos Aires introduced compulsory masking since April 14. Wearing a mask was made obligatory for everyone on public transit and everyone who contacts with the public in their position. Violators can face a fine. Authorities also prohibited the sale of N95 face masks to non-medical workers, suggesting the general public to use home-made masks instead.
• Austria: Everyone entering a supermarket, a grocery store, or a drug store or using public transportation must wear a face mask, mandatory since April 14.
• Bahamas: On April 19, the prime minister announced that wearing a mask or covering one's face with clothing is mandatory in public. Employers must provide their employees who are serving the general public with masks.
• Bahrain: The Kingdom made wearing face masks in public areas compulsory for citizens and residents as well as shop workers.
• Benin: From April 8, Benin's authorities began enforcing the mandatory wearing of face masks to halt the coronavirus.
• Bosnia and Herzegovina: Wearing a face mask is compulsory.
• Bulgaria: Bulgaria's government passed an order imposing an obligation to wear face masks on March 30. The order was cancelled the next day and changed into a recommendation, due to legal complaints.
• Cambodia: Many Cambodians started wearing face masks soon after the outbreak began in Wuhan. Businesses started to require customers to wear masks.
• Cameroon: On April 6, mayor of Douala announced that wearing a mask will be mandatory to slow the spread of coronavirus.
• Canada: Since April 6, health officials recommend wearing non-medical masks in situations where physical distancing from others is difficult (like buying groceries, or public transit).
• Chile: From April 8, Chilean Health Minister announced wearing a mask is mandatory in public transit.
• China: Healthy individuals are advised to wear disposable medical masks in public places. Some local governments require wearing masks when going outside. Shanghai makes wearing masks mandatory in public places.
• Colombia: In response to the most recent recommendations of the WHO, Colombia changed its policy on the use of masks and made it mandatory throughout the country for the use of public transport during the coronavirus emergency.
• Cuba: On March 11, the government urged citizens to make their own masks, while the textile industry was drafted to fabricate them. People were advised to carry several cloth masks with them, depending on how many hours they plan to spend in public areas. Later, wearing a mask was made mandatory.
• Czech Republic: Forbidden to go out in public without wearing a mask, or covering one's nose and mouth.
• Dominican Republic: Since April 16, the use of face mask is mandatory in all public spaces and in the workplace.
• DR Congo: Since April 20, wearing masks in the capital of Kinshasa is mandatory.
• Ecuador: On April 8, the Emergency Operations Committee (COE) decided to make face masks obligatory in public spaces.
• Ethiopia: The Council of Ministers approved a regulation that outlaws handshakes, and obligates the use of face masks in public places.
• France: On March 3, the government issued a degree announcing requisition of stocks of FFP2 and anti-splash masks until May 31, 2020.
• Gabon: On April 10, the Gabonese government announced individuals in all parts of the country are required to wear masks in public to limit the spread of COVID-19.
• Germany: On March 31, city-county Jena, Thuringia, was the first large German city to introduce an obligation to wear masks, or makeshift masks including scarves, in supermarkets, public transport, and buildings with public traffic, from April 6, very successfully. On April 2, the Robert Koch Institute, the federal epidemic authority, changed its previous recommendation that only people with symptoms should wear masks to also include people without symptoms. County Nordhausen, Thuringia, followed the example of Jena, since April 13, several other cities later. German chancellor Merkel and state governors first gave "strong advice" to wear face masks in public from April 20, Saxony made it mandatory from that day, Saxony-Anhalt followed from April 23 and (the rest of) Thurinigia from April 24, finally the governors agreed to make it mandatory, so most other states followed from April 27, except Schleswig-Holstein, from April 29, and Berlin, where shops were excluded first, they were included from April 29.
• Guinea: Guinean President Alpha Conde decided to make wearing masks compulsory.
• Honduras: From April 7, Honduras President announced all citizens will now be required to cover their mouths when they are outside.
• Hong Kong: Members of the public are recommended to wear a surgical mask when taking public transport or staying in crowded places.
• India: From April 9, masking is compulsory in the state of Odisha. When leaving their home, people must cover their mouth and nose with masks or multilayered cloth (like handkerchief, dupatta, towel, etc.).
• Indonesia: Citizens were ordered to wear face masks when they leave the house.
• Israel: All residents are asked to wear face masks when in public.
• Italy: Regions of Lombardy and Tuscany made wearing a face mask compulsory before going out in early April.
• Ivory Coast: From April, 26 masks have become compulsory to enter shopping malls or supermarkets in the Southern suburb of Abidjan, Marcory.
• Japan: Masks have been widely used by healthy individuals despite absence of official advice to do so. On March 1, prime minister Shinzo Abe enacted a policy in Hokkaido instructing manufacturers to sell face masks directly to the government, which would then deliver them to residents.
• Kenya: Wearing a face mask is compulsory. The government has Kenyans to strictly observe social distancing, which has been proved to one of the most efficient ways of preventing infection risks.
• Liberia: From April 21, it is now compulsory to wear a face mask or covering in public.
• Lithuania: Wearing a face mask or any other means of covering one's nose and mouth in public places is compulsory since 10 April 2020.
• Luxembourg: From April 20, wearing a mask is mandatory in places where it is not possible to keep enough distance to others such as supermarkets or on public transport.
• Malaysia: Masks have been widely used by healthy individuals despite absence of official advice to do so. On March 17, Malaysia banned exports of medical and surgical masks, to meet local demand. In April, the government was set to distribute 24.62 million masks, four for each household, while advising people to only use them if they have symptoms.
• Mexico: From April 17, all Mexico City Metro passengers must wear masks while inside stations and on trains, Mayor Claudia Sheinbaum announced on April 15.
• Mongolia: Wearing a mask is now mandatory while riding public transportation in Ulaanbaatar. Public officials and news broadcasters had even adopted to wearing masks through press conferences and news broadcasts.
• Morocco: Wearing a face mask is compulsory.
• Mozambique: The Mozambican government announced on April 8 that wearing face masks is now compulsory on all forms of passenger transport, and wherever groups of people are gathered.
• North Macedonia: As of April 22, citizens of Kumanovo, Tetovo, and Prilep must wear protective masks and gloves outside their homes, at public places, outdoor and indoor areas, markets, and shops announced the government.
• Pakistan: The Balochistan government on April 18 told citizens to wear face masks when going outside. According to provincial government spokesperson Liaquat Shahwani, citizens have been urged to wear masks or to cover their faces with any cloth in the wake of the COVID-19 outbreak.
• Panama: Panama has made it obligatory to wear a face mask whenever going outside, while also recommending the manufacture of a homemade cloth face mask to those who cannot purchase face masks.
• Peru: From April 7, the Peruvian government started distributing free masks after decreeing their mandatory use in the streets to chase away the new coronavirus, said President Martin Vizcarra.
• Philippines: From 2 April, the government required all those living in areas under enhanced community quarantine to wear face masks.
• Poland: Since April 16, covering lips and nose is compulsory before leaving one's house (e.g., by a disposable mask, cloth mask, or scarf).
• Russia: Khabarovsk has made the wearing of face masks obligatory to fight the spike in respiratory diseases and prevent the spread of the coronavirus.
• Rwanda: On April 20, Cabinet Minister of Health Daniel Ngamije said the latest guidelines require everyone to wear a mask in public, and at home during the lockdown and thereafter.
• Scotland: On April 28, the First Minister for Scotland Nicola Sturgeon advised the voluntary use of cloth face masks in enclosed spaces such as shops and public transport (but not generally in public), while noting their limitation.
• Singapore: Masks have been widely used by healthy individuals despite initial absence of official advice to do so. General mask-wearing was no longer discouraged from April 3, and made mandatory outside of one's residence from April 14.
• Spain: Wearing masks are required while on public transportation, which includes taxis, trains and buses. The government is giving masks to most people riding public transportation, even if they have a mask on.
• Slovakia: Forbidden to go out in public without wearing a mask or covering one's nose and mouth.
• Slovenia: From March 29, wearing a face mask, even one made at home, or equivalents such as scarves that cover the mouth and nose is mandatory along with protective gloves; the decree stipulates that masks and gloves need to be worn in indoor public spaces.
• South Africa: On 10 April, Minister of Health recommended that the general public use cloth face masks when going out in public (in addition to hand-washing and social distancing). After May 1, covering one's nose and mouth will be mandatory in public (with a cloth mask, scarf, T-shirt, etc.).
• South Korea: Masks have been widely used by healthy individuals despite absence of official advice to do so. The government implemented a policy of centralized procurement and rationing of face masks, purchasing 80 percent of national production since early March.
• Sweden: Sweden has not yet issued a policy recommending face masks. On 6th of may the Folkhälsomyndigheten reported that it is looking into it, and will be back with an answer mid may.
• Taiwan: On January 21, the government announced a temporary ban on the export of face masks. On 6 February, the government instituted a mask rationing system. Taiwan has been producing ten million masks per day since mid-March. On April 1, passengers on trains and intercity buses were required to wear face masks, unmasked riders facing a fine.
• Turkey: Residents will be required to wear masks at markets, as Turkish president announced.
• Ukraine: Since April 6, wearing a face mask is required by the government in public places. In Kyiv, public places were clarified to include parks and streets.
• United States: On April 6, the CDC recommended the wearing of non-medical cloth face coverings when in public places. Since April 17, residents of New York, must wear masks in public; New Jersey and Maryland issued similar requirements for their residents.
• Uzbekistan: Officials made protective masks mandatory in all major cities in order to prevent the spread of coronavirus. Officials on March 22 said citizens not wearing masks in public in major cities would be fined $22 for the first offense and $67 for repeat offenses.
• Venezuela: The government ordered the country’s citizens to wear face masks in public in response to the arrival of the novel coronavirus.
• Vietnam: Since March 16, everyone must wear a face mask when going to public places (such as grocery stores, transportation hubs, and public transport).
• Zambia: The government made it mandatory to wear face masks to minimise the spread in the country.

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• Responses to the 2019–20 coronavirus pandemic
• National responses to the 2019–20 coronavirus pandemic
• Medical masks