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Face mask and visor use by the general public
In situations with high infection burden in society and where it is difficult to keep a safe distance, face masks can be recommended as part of the measures to reduce the risk of transmission. Face masks may be used in addition to, but not replacing, other measures.
In the regulations, there is a national requirement for face mask use by people in quarantine who must use public transport, and recommendations for their use in connection with quarantine and isolation. Beyond these situations, the individual municipality decides whether face mask use is imposed or recommended locally.
General about measures and risk of COVID-19
The most important measures to prevent infection with the SARS-CoV-2 virus are to stay at home in case of illness, to keep at least 1 metre distance from others and to practise good hand hygiene and cough etiquette.
Close face-to-face contact involves the highest risk. Standing back to back, or behind each other as in a queue, gives less risk of infection.
When sitting or standing next to someone, there should be at least 1 metre distance from your shoulder to the other person's shoulder.
People can pass each other without a particular risk of transmission and the recommendations do not apply in these situations.
Medical face masks and cloth face coverings
We distinguish between medical face masks and cloth face coverings:
- Medical face masks are disposable face masks produced for use in the healthcare service that meet current standards.
- Cloth face coverings are homemade or manufactured cloth face coverings made of textiles or other washable materials.
Medical face masks are defined as medical devices. National and European regulations set requirements for such face masks. The requirements include degree of filtration, breathability, splash resistance, how the face mask is to be tested, and documentation required (NS-EN 14683: 2019 + AC: 2019).
Cloth face coverings are not medical devices and are not covered by formal regulations. However, the European standardisation organisation CEN has prepared an agreement document with guidance on minimum requirements, test methods and how coverings can be used (SN-CWA 17553: 2020).
The agreement specifies requirements for filtration ability and breathability, design, size and washability. There are two classes for cloth bandages based on their filtration ability, which must be at least 70 or 90 per cent of particles of around 3 µm (3 micrometres). In comparison, medical face masks type II and IIR must have a filtration capacity of at least 98 per cent.
For use outside the health service, the Norwegian Institute of Public Health recommends either medical face masks, or cloth face coverings that meet the requirements of the European agreement document for cloth face coverings (SN-CWA 17553: 2020). If there is a shortage of medical face masks, these should be reserved for the health service. The Norwegian Institute of Public Health does not recommend the use of cloth face coverings in the health service.
Use of face masks during quarantine and isolation
People in quarantine after arriving in Norway can use public transport from the point of arrival to the place of quarantine, and the same if they leave Norway during the quarantine period. People in infection quarantine may be allowed to use public transport to reach a suitable quarantine place only after an assessment by the municipal medical officer. Then people over the age of 12 years shall wear a face mask on public transport.
People who are in home isolation because they have COVID-19 (confirmed or probable) should use a medical face mask when they are closer to other household members than 2 metres, if their health condition allows it. Alternatively, household members can wear medical face masks when they are closer to the infected person than 2 metres.
Use of face masks in areas with increased risk of transmission
The government has asked municipalities with local outbreaks to consider imposing face mask use indoors in public places where it is not possible to maintain at least 1 metre distance. This includes:
- public transport
- public places like shops and shopping centres
- restaurants and bars. The rule should apply both for employees and for guests in all situations where they are not sitting at a table.
It is therefore important to familiarise yourself with the recommendations on the use of face masks that apply to the area where you are.
Groups that may be exempt
Not everyone can use a face mask, for medical or other reasons, including the following groups:
- Children under 12 years are not recommended to use face masks.
- Children under 2 years should not use face masks as they can interfere with their ability to breathe.
- People who are unconscious or have a reduced state of consciousness, or for other reasons are unable to remove the face mask themselves.
Others who for medical or other reasons may be exempt from using face masks include, for example, people who:
- have a chronic heart and / or lung disease
- have an illness or condition that causes impaired cognitive function, or where the use of a face mask would be a major mental strain
- interact with people with impaired hearing
Correct use of face masks
It is important to have clean hands when you put on and remove the mask. For the face mask to have a good effect, it is important that it fits snugly around the edges and covers the mouth and nose well. In this way, you ensure that as much of the air you breathe in and out is filtered through the face mask, and does not leak out the sides.
Face masks can become contaminated during use. The inside can be contaminated if you are infected. The outside can be contaminated with infectious pathogens from others. Therefore, you should touch used face masks as little as possible, and perform hand hygiene after touching them.
How to put on a face mask:
- Perform hand hygiene.
- Put on the face mask with the lighter coloured side nearest the face.
- Fasten the face mask with the elastic around the ears, or around the head if it has a tie.
- Press the noseband down on each side of the bridge of the nose and pull the face mask firmly down under the chin.
- If you wear glasses, wear these on top of the face mask.
- Touch the face mask as little as possible during use.
- Remove the face mask, preferably only touching the elastic / ties
- Dispose of the face mask as normal waste (keep the cloth face covering in a bag until it is washed).
- Perform hand hygiene.
See the film or download the posters:
- Correct use of medical face masks and cloth face coverings - posters with illustrations for download
- How to use a face mask - poster with text and illustrations
- Information about the use of face masks in other languages - posters and information letters in many languages
Re-use of face masks
- Medical face masks should not be re-used, but extended use can be considered in a shortage situation.
- Cloth face coverings can be re-used after washing, and should be able to withstand repeated washes at minimum 60 degrees. Use regular washing detergents, but not softeners. Do not use detergents that can be harmful to health.
The following cleaning methods are not recommended, either because there is insufficient documentation on virus inactivation or because they can reduce the textile's filtering ability:
- Freezing. The virus can survive at very low temperatures.
- Boiling. May affect the filtering ability of the textile.
- Dry cleaning. The process can leave harmful substances in the textile.
- Unused. If time passes between each time the face mask is used, viruses may be inactivated. However, laboratory studies have shown that the virus can survive from hours to days, depending on temperature, humidity in the room and material in the face mask. It is therefore not possible to advise how long the face mask must remain unused before it can be safely re-used.
- Clean cloth face coverings must be stored separately from used ones.
- In situations where a face mask must be used several times in a short time, it is recommended to use a new or clean face mask each time. If you touch the part of the face mask that filters the air with unclean hands, infectious pathogens can be transferred to / settle on the face mask and the risk of infection increases. It is especially important not to reuse face masks that have become damp or soiled.
Risk of re-using face masks
Re-using a face mask may increase the risk of you becoming infected, but also increases the risk of you infecting others, to a limited extent. If you still choose to re-use a face mask without cleaning it, the following is important:
- Wash or disinfect your hands before and after you put on and take off the face mask.
- Avoid touching the face mask, only touch the elastic / ties and the outer edges, e.g. when pressing down the noseband.
- Store the face mask in a clean, resealable bag. Do not put clean and used face masks in the same bag.
- Use the same side towards the face.
- Do not re-use face masks that may have become contaminated because you or others have touched the part that filters the air with unclean hands, i.e. with hands that have not just been washed or disinfected.
Knowledge base and reports
In June 2020, the Norwegian Institute of Public Health carried out a rapid review about knowledge about the effect of face masks. The review applied to the use of face masks among asymptomatic individuals and where the purpose was to prevent the spread of COVID-19. An Evidence to Decision (EtD)-framework was used to evaluate the knowledge and produce a recommendation. The report was updated in November 2020, see:
- Should individuals in the community without respiratory symptoms wear facemasks to reduce the spread of COVID-19? – Update 1
In August 2020, the Norwegian Institute of Public Health published a report (in Norwegian) with advice on which situations it may be relevant to recommend face masks to the general public, and the advantages and disadvantages of recommending the use of face masks in such situations.
Visors will be able to prevent large droplets that are thrown out of the mouth of people who speak or shout landing directly on the mucous membranes in the mouth and nose of people standing nearby. However, the visor does not protect against smaller droplets that can be inhaled by others nearby, or against droplets from the side.
There is insufficient evidence that visors alone provide good protection against respiratory viruses such as the new coronavirus. Therefore, we cannot recommend that the use of a visor alone can replace the use of a face mask to prevent potential transmission.