Cloth masks, really?

By Kristina Maki, RN

Kristina Maki
MNA Nurse Educator

MNA Nurse Educator

MNA Nurse

It is surreal working as a nurse right now, right?  I am struggling to keep up with all the changes to practice; they seem to be happening daily.  Who’d have thought we’d be talking about reusing N95s, much less having to discuss using cloth masks…

I hate the ideas of cloth masks.  I know that it might come down to having to use them at some point, which makes me really angry.  Truthfully, it scares me to think that our only source of protection is a simple cloth over our faces.  Here are the facts that I’ve been able to dig up about fabric masks: THEY ARE NOT SAFE!  A randomized controlled trial found that simple cloth masks provide around 3-4% filtration (source).  The cloth masks might be even more detrimental because they can provide a user with a false sense of security.  There are a lot of infection control issues.  For instance, what if your mask is made with the same fabric on the front and back- how will you know which side is dirty and which side is clean when you’re donning and doffing?

The CDC is very explicit when they describe handmade fabric masks as an absolute last resort. “Homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option.”  There is no CDC-approved fabric mask!

I hope it never comes to the point when healthcare workers have to choose between no protection, or the use of a cloth face mask.  It is still our employers’ obligation to provide us adequate protection, even in a pandemic. Keep pushing for your employer to provide you the appropriate PPE. It feels like we’re being told to jump out an airplane, without a parachute.  Please be safe, my friends.

*note:  the author is also a bedside nurse in the Twin Cities.


  1. I appreciate this information. I wonder if all the crowded churchgoers on Easter will have pastel-colored masks.

  2. This comment is from an old retired RN. I worked during the 9/11 time in fact a shift I worked was a 7p to 7a one on the night of that unforgettable day. The times that followed with continued threats, the anthrax scare during which time I was actually temporarily quarantined in an ER room with a patient who brought in a white powder that he recieved in a package and wanted it checked to see if it was dangerous. It wasn’t. Scary times then scary times now. Thanks many times over to all front line nurses,docs, RTs,rad techs,cna’s, housekeeping folks, EMT’s, etc etc for all you do. I appreciate and respect you more than ever during these trying times. A word to all medical administrators,distributors of medical supplies and anyone else who is involved in this fight but not on the front line: get your part done no matter what it takes. Support these people who are directly involved with patients AT ANY COST get the frontlines what they need pronto.

  3. Ok, if we are faced with this awful dilemma, we as nurses, can we come up with a somewhat better plan? Who knows better than us on what we are facing? We should find a plan to conserve our resources. We need to have our own think tank!

  4. Hi,
    I came to this sight to get some sort of guidelines of making face masks…. it seems I shouldn’t bother… from what you said here all the seamstresses are waisting their time.
    If it comes to a point when you would need to use a cloth mask what should it look like? What should it be made of… cotton, cotton blend, polyester?? What would be the best pattern, what is the best fabric? …
    … Would a sheet with a high thread count be better that fabric used to make a quilt??
    We want to help… but we don’t want to waist our time and sewing supplies if you aren’t going to use them.

  5. There is no way to really know what fabric is best since this is unprecedented. I would guess a tighter weave, possibly make it with a batting between 2 materials. I did see a good video from someone who is a seamstress and she was making them from a 3M furnace filter. The filter was N95 approved (?) I believe the filter part was in-between 2 pieces of fabric. It was on youtube.
    Thank you for your concern and willingness to help!

  6. I visit new families in their home. Unless the nurse uses some kind of mask, some families are refusing visits for urgent issues – high BP, baby weight loss and feeding issues, incision care. We are obviously not given masks to wear every day. What are the options?

    If the problem is filtration, then let’s figure out a standard way of increasing filtration.

    If the problem is putting on a mask with contaminated side in, then let’s make them so the inside is different. If the mask is contaminated, the nurse should be putting on a clean one anyway (which is possible with enough cloth ones).

    If nurses are taking them off wrong then lets give them some education.

    Yes, we need to push for more “real” masks. But what would you like nurses to do in the meantime? I have to see patients tomorrow. I want a mask tomorrow. My families want a mask on me tomorrow.

    You say you hope nurses don’t have to choose between cloth or nothing. Well, that’s exactly what’s happening, today.

    So I’m going to make masks today with the best available information about filters that I can find. Because something IS better than nothing.

  7. To the seamstresses out there-
    All the pictures of past pandemics we see medical professionals wearing cloth masks. Same with military operation field hospitals. But obviously this has changed with current workers in the health field. I admire your dedication and abilities- find somewhere they are appreciated.

  8. That’s what I thought when my friends said they were making masks out of fabric. I said who authorized that ? They said that they had to because there was nothing otherwise in Washington state.

  9. Masks are being stolen and diverted from hospitals. A majority of the plants that produce them are overseas and have nationalized the factories and the medical products inside of them.
    I don’t know that these will help at all, but I guess I’d rather help a little bit than not at all.

    I’ve been sewing the mask pattern that was released by clinicians at Unity Point Health in Washington state. Their pattern is not meant to be a replacement for PPE, but a backup in a worst case scenario situation. Which honestly, here we are.

    Does anyone know if there any hospitals/clinics in Minnesota or the Midwest accepting cloth mask donations? Otherwise I’ll just send them to Washington where they have an intake process for them.

    This pattern has a pocket for a makeshift HEPA filter to be placed inside of.
    Video link:
    Website with pdf pattern download:

    This is such a slow going process, it really seems like emptying an ocean with a med cup. What else can I be doing to help support our nurses and other health care staff right now? Where should I be donating? Who should I be calling?
    I can’t sit here and do nothing.

    And as far as the false sense of security goes, here’s a somewhat analogous situation that some people have seemed to be able to grasp a little more concretely.

  10. I believe that it is irresponsible to suggest that cloth masks when used and made properly are useless ! It is better to do something than nothing!!!!! Is it better to sneeze right into the air than to use a tissue or sneeze into your elbow. Is it better to wash with lots of water than not to wash at all if there is no soap? I could go on and on. We have to use common sense!!! Cloth will stop droplets from coming in contact with your skin, mucous membranes! Otherwise why do we use those skinny , non fitted blue masks at all??????

  11. Fact – A surgical mask is meant to protect the environment from the wearer.

    Fact – HCWs have contracted COVID19 wearing surgical masks.

    Fact – There is no evidence that routine use of surgical or cloth masks by healthy individuals prevents COVID 19.

    Fact – HCWs need to know the facts. The public relies on HCWs to provide the facts.

    Fact – MNA is fighting to keep HCWs from becoming patients.

  12. These studies suggest that fabric masks may be useful for staff *as a backup in the case of shortages or to slightly mitigate transmission within general public. Research is obviously limited and small sample sizes.
    If Washington is asking for them, I will send them. Are there better mask relief efforts to donate to?

    Articles for consideration:

    Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections Among the General Population – PubMed

    Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic? – PubMed

  13. In a very real sense, what happens to our health-care workers will be the metric of how we respond to this unfolding crisis. If we don’t do all we can to protect them, they will quickly transition from providers to patients, further stressing already overburdened facilities.

    Governments must support private-sector manufacturers in providing N95s and other equipment to front-line health-care providers and other essential workers. In terms of minimizing illness and death, this will be more important than any border closing, airport screening, or quarantine. Support MNA in its efforts to do this.

    National Nurses United sent a petition to the US Congress with a quarter of a million signatures demanding that Congress ensure that nurses and health care workers are immediately given the protections they need to avoid exposure to COVID-19. Support NNU’s efforts to do this.

    Nurses need to protest the lack of personal protective equipment for frontline health-care workers during this COVID19 crisis. Support MNA’s efforts to do this.

    Nurses must join MNA in educating the public. We must
    slow the spread. Inform the public of the meaning of the Governor’s stay-at-home order. Support MNA’s efforts in educating the public and legislative action.

    The N95 fits tighter and protects the wearer from inhaling infectious droplets in environment. These should not be on store shelves. Support the manufacturers such as 3M in their efforts to ramp up production. Nurses must support MNA and NNU in these efforts.

    Nurses can support the Center for Infectious Disease Research and Policy and provide the fact that CDC does recommend the N95 which filters 95% of airborne particles. Make sure hospitals are doing the same as you to educate public and support the HCWs versus just accepting alternatives.

  14. Diane Scott, thank you. I think that was the answer I was looking for.

  15. The guy that makes the pillows mike from the My pillow factory is making masks he is a mn guy, I think, hit him up !!

  16. I’m guessing you never needed to deliver a baby in the woods which, as a volunteer EMT, I did. I spent zero time complaining about what I didn’t have (which was pretty much anything sterile) and made do with what I did have.
    No, cloth masks are not CDC recommended and will not be used for surgery or for covid-19 patients, but if you have someone who is immuno-compromised and you don’t know whether you are asymptomatic, a cloth mask is better than nothing.
    This is a pandemic, people.
    Yes, pressing hospitals to provide PPE is necessary, but Mr. Trump and his sidekick Kushner just impounded 3M masks intended for Massachusetts hospitals. Maybe you can’t actually get as many as you need, no matter how hard you try.
    As one of the hundreds of people across the country who is sewing cloth masks (with two different fabrics per MN guidelines) for hours each day, I’m somewhat put off by your complaints.
    I am doing everything I can to honor and help health care workers (having been one on the frontlines), but sometimes perfection has to give way to necessity.
    I hope you have not scared the living daylights out of nurses who may need to use my masks because they are all that is available.

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