To mask or double-mask? That is the question some Americans are asking as more infectious variants of COVID-19 are reported in the United States.

While a face covering over one’s mouth and nose is a proven spread-prevention method, new strains of the coronavirus appear to be even more contagious and developing ways around vaccines being distributed worldwide. Dr. Anthony Fauci, a chief medical advisor to the President Biden administration and an infectious disease expert, said in a recent briefing using two face masks at once furthers the popular strategy to prevent sharing COVID-19 in whatever form it may be. North Carolina leaders, like Governor Roy Cooper and state health secretary Dr. Mandy Cohen, have embraced the method at recent visits to vaccination clinics.

Dr. Becky Smith, the medical director of infection prevention and control at Duke University Hospital, recently spoke on the topic during a panel about the emergence of new variants. She said while there may be new guidance from federal officials in the coming days or weeks, it’s unlikely health care workers will begin using the double-masking technique.

“We know after 11 months in the healthcare setting that our very robust infection control bundle works,” Smith said. “We’re doing things like symptom screening, everyone is universally masking and using a medical-grade mask and then we have a robust testing program to test patients on admission.”

Smith also said the vaccination of many frontline health care workers in Phase 1 of distribution does provides an extra level of protection.

“With all of those things together,” she said, “the addition of a second mask may be less important than it might be in a community setting, where we don’t have these strict control measures in place.”

North Carolina’s Department of Health and Human Services reported one of the new COVID-19 variants in the state in January. Smith said while there are several guidelines in place meant to protect public health, it’s hard to know who around you is symptomatic when away from your household.

“The double-masking idea really is more layers of mask in front of your mouth, the source of how you transmit COVID-19, equals more protection,” she explained. “There are not actually any well-controlled studies that compare double-masking to single-masking. But there’s some logical sense that an additional layer of protection would reduce transmission.”

“I do kind of predict there will be some forthcoming guidance from the CDC on this,” Smith added. “But for now, in the healthcare side, we’re not mandating our healthcare workers wear this given that robust infection prevention bundle. If you’re in the community setting, it might make sense to add this layer of protection. It’s pretty easy to do and medical masks are widely available at this point.”

North Carolina has several requirements for face coverings enacted when people visit or work in businesses, which Governor Roy Cooper amended in November. Additionally, President Joe Biden signed an executive order in January requiring Americans to wear masks when traveling on planes, trains and public transportation.

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