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Early on in the pandemic, the U.S. Centers for Disease Control and Prevention and the World Health Organization told the public not to wear N95 respirators, a type of mask that is made from high-tech synthetic fibers and provides a high level of protection against virus-laden airborne particles called aerosols. That was because there was then a shortage of such masks—and health care workers desperately needed them. At the same time, both agencies said there was little risk of aerosol transmission of SARS-CoV-2. They recommended cloth masks or other homemade face coverings that can stop some relatively large virus-carrying droplets even as it became clear that SARS-CoV-2 commonly spreads through aerosols—and as the supply of better-quality masks increased.

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Still, however, the “CDC continues to recommend that N95 respirators should be prioritized for protection against COVID-19 in healthcare settings,” wrote CDC spokesperson Jade Fulce in an e-mail to Scientific American last week. “Essential workers and workers who routinely wore respirators before the pandemic should continue wearing N95 respirators,” she continued. “As N95s become more available they can be worn in non-healthcare settings, however, cloth masks are an acceptable and recommended option for masking.”

The agency announced in May that supplies of approved respirator masks had “increased significantly.” When asked why it only updated it guidance on N95 use by the public in September, Fulce replied that the “CDC regularly reviews and updates its guidance as more information becomes available.”

Scientific American spoke with several experts on aerosol transmission—some of whom have tested various masks available on the market—and they agree that health authorities should strongly recommend people wear well-fitted, high-filtration masks.

“A year ago we could say that we were concerned about shortages for health care workers, so we were telling people to make your cloth mask, and any mask is better than no mask,” says Linsey Marr, an environmental engineer and aerosol science expert at Virginia Tech. But given what scientists know now—especially with the virus’s highly transmissible Delta variant spreading and people spending more time indoors in schools, for example—“I think the CDC should be recommending high-performance masks for everyone when they’re in these risky indoor situations,” she says.
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