Since the start of the pandemic, the cloth mask has evolved from homespun craft project to fashion accessory. But if you're traveling by air, your favorite fabric mask may not make the cut. A handful of international airlines are nixing cloth face coverings aboard their aircraft in favor of surgical-type masks (aka medical or procedure masks) and N95, KN95, and FFP2 respirators.
Finnair is the latest carrier to institute such a ban. Could US domestic carriers follow suit? Here's what experts say about masking up in the skies.
Do-You-Have-The-Right-Mask-Face-Masks-for-Airline-Travel-GettyImages-1294976830 stated. "Fabric masks are slightly less efficient at protecting people from infection than surgical masks."
Air France, Germany's Lufthansa Group, and Santiago, Chile-based LATAM Airlines Group previously enacted similar policies.
Lufthansa said its masking policy complies with a resolution adopted by German Chancellor Angela Merkel and the nation's 16 states in January requiring medical masks on public transportation. The action was initially prompted by worries that the Alpha variant could spread and stoke the COVID-19 pandemic. Now it's the Delta variant that's cause for concern.
The cloth mask ban by carriers like Lufthansa is partly cultural, Petra Illig, MD, secretary of the International Airline Medical Association, and an aerospace medicine specialist in Anchorage, Alaska, tells Health. "In some of these countries, they just want to reduce the risk as much as possible," she says.
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Are cloth masks protective?
Yes, cloth masks do reduce community exposure to the virus, reports the US Centers for Disease Control and Prevention (CDC). They substantially block exhaled respiratory particles, and they can also reduce a masked person's inhalation of these droplets, the CDC points out.
The issue with fabric face coverings is the level of protection, Dr. Illig says.
With cloth masks, not only do the types of materials used and number of layers differ from mask to mask, but how they fit can vary widely as well. "In the cloth mask world, there's just no standardization," she says.
A February 2021 review in Morbidity and Mortality Weekly Report (MMWR) describes the results of a CDC experiment designed to simulate a person's coughing. A cloth mask blocked 51.4% of the aerosols emitted during a cough, while a medical procedure mask blocked 56.1%. But "double masking"—wearing a cloth mask over a medical procedure mask—blocked 85.4% of cough particles.
David O. Freedman, MD, professor emeritus of infectious diseases at the University of Alabama at Birmingham, says, ideally, a cloth mask should have an absorbent middle layer of synthetic material, such as spun polypropylene, and it should fit tightly around the nose and mouth. In reality, he says, cloth masks run the gamut.
The airlines that are trying to tighten up masking requirements can obviously identify a respirator or surgical mask when they see it, he says, whereas it's impossible to assess the quality of a cloth mask someone is wearing. "If you say cloth is OK, you're going to get a lot of people with crappy cloth masks," he tells Health.
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What exactly are the airlines saying about masks?
To be clear, the ban on cloth masks is by no means universal. Plenty of international airlines allow some wiggle room in the type of mask you wear. Aer Lingus says face coverings may be "reusable cloth masks or disposable masks." Emirates allows cloth or medical masks.
While a handful of carriers have announced an outright ban on fabric masks, others describe the specific types or features that won't pass muster. Air Canada, for example, does not accept face coverings "made with mesh or lace fabric."
That makes sense. After all, the reason for masking up is to reduce the emission of virus-containing droplets and aerosols into the air (so-called source control) and to stave off the inhalation of these respiratory particles (for personal protection), says CDC.
What type of mask does the CDC consider acceptable?
In the US, face masks are still required at airports and on commercial aircraft, per the Transportation Security Administration (TSA). Children under age two and travelers with certain disabilities may be exempted.
What qualifies as a proper mask? According to CDC, if it's a cloth mask, it must be made of two or more tightly woven, breathable layers of fabric. Masks with slits, punctures, or exhalation valves are not acceptable. Neither are scarves, ski masks, balaclavas, bandanas, or turtlenecks pulled up over a person's nose and mouth. Fabric that's loosely woven, like a knit, doesn't get the job done either, per CDC guidance.
Will domestic airlines institute a cloth mask ban?
US carriers aren't likely to wage war over the type of masks people wear in the sky. At least that's Dr. Freedman's hunch. "There's no way to know for sure, but my intuition would be, with all the controversy about masking, et cetera, that they're probably not going to try to push it," he says.
US airlines have enough of a battle on their hands with people who "just plain and simple don't want to wear a mask," says Dr. Illig.
President Joe Biden recently authorized the TSA to double fines on people who refuse to mask up. First-time offenders face penalties of $500-$1000. A second offense can exact a penalty of $1,000-$3000, per the TSA.
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A word about airplane air
Many people have the perception that cabin air is nasty. But Dr. Illig says the air on commercial carriers is actually very clean; it's purified via HEPA filters. "Most public buildings replace the air about one-and-a-half to two-and-a-half times an hour, and in airplanes, it's about 10 to 12 times an hour," she says.
Dr. Freedman offers a slightly different ventilation statistic: The average office building with air conditioning probably has five or six air changes an hour, he says, while some modern airplanes can reach 20 or 30 air changes per hour.
But what these metrics fail to account for, he says, are the times when people are piled up against one another in the aisle as they board or deboard, when the plane is sitting at the gate with its engines off, or when the plane pushes back from the gate and it takes some time for the AC to kick in. There's also a question of what happens when you're sitting on a plane with someone who's sick and coughing, he says.
So what type of mask should you wear on a plane?
Ideally, a tightly fitting N95 mask is best, says Dr. Freedman, who concedes that it can be quite uncomfortable to wear one of these masks if your trip lasts more than a couple of hours. Some of the US-made N95 masks and most of the KN95 masks come with ear loops instead of bands at the back of the head, which may be less irritating, he says.
But Dr. Illig says you don't necessarily need to wear an N95 mask unless you choose to do so. A disposal surgical mask with a metal nose piece will suffice, she says, preferably one with bands that go around the back of the head for a better fit. Double masking is also a good option.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
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