Although the US Center for Disease control initially warned against face mask usage by non-medical personnel, since April guidelines have recommended mask usage when in a social setting, especially when social distancing may be a challenge or when indoors.  There are no national non-medical face mask guidelines.  Legislation and enforcement has been left to the state, county, and local level.  

United States Face Mask Policy Non-Medical Personnel

- A face covering must be worn in most indoor settings. Individuals are expected to wear a face covering before entering the premises and must keep it on until they leave, unless there is a reasonable excuse for removing it.  
- Premises where face coverings are required are encouraged to take reasonable steps to promote compliance with the law. 
- The police can take measures if members of the public do not comply without a valid exemption. 
- The police and Transport for London offers have enforcement powers including issuing fines of £100 (halving to £50 if paid within 14 days).

England Face Covering Policies

Face mask should be worn: 
- When outside of your home
- On public transport, taxis, and private hire cars
- Walking to or at markets
- For essential workers at all workplace premises

It is compulsory to wear a face mask outside in Singapore. 
- First-time offenders can be fined up to S$300, and repeat offenders can face higher fines or prosecution in court. 
- Face masks can only be removed when engaging in strenuous exercise outdoors, such as running and jogging.



Singapore Face Covering Policies 

University of Michigan - Ann Arbor

University of California, Davis

- Masks/respirators (N95, etc)
- long-sleeved gowns
- goggles 
- disposable round caps
- latex gloves 
- show covers
-ventilators

Personal Protective Equipment (PPE)

- N95: best-known respirator against the virus in the form of a mask
-  Surgical masks: used by healthcare professionals in the absence of N95 masks
- Surgical Masks with FPR: surgical masks fitted with 9-10 air-conditioning filters
- Pneumask: Stanford designed face-mask with a snorkel-like design
- PAPR Mask:  powered air-purifying respirator attached to surgical masks


Face Masks

In low-contagion areas, healthcare workers used surgical masks, latex gowns, gloves, and disposable round caps. In high-contagion areas, healthcare workers used N95 masks, long-sleeved gowns, goggles, disposable round caps, latex gloves, and show covers.

PPE in the Tongji Hospital in Wuhan, China

- medRxiv
- Journal of the European Academy of Dermatology and Venereology (JEADV)
- WHO

References for Personal Protective Equipment (PPE) by Journal

Self-contamination during repeated donning and doffing or breakdown of materials due to extended wear are the greatest risks of reusing PPE.

Reuse of PPE presents higher risk for contracting COVID-19

Medical staff who must constantly use skin disinfectants and personal protective equipment (PPE) during the COVID-19 pandemic develop skin injury and disease that lowers their performance and quality of life. Experts from The Chinese Society of Dermatology have recommended measures to prevent and treat these conditions.


PPE skin injury/disease prevention and treatment 

With the demand for protective personal equipment constantly increasing due to COVID-19, there are compromises being made, aiming to reduce negative ramifications.
- Healthcare workers required to personally acquired their own PPE.  Often sacrifices quality of protection and increases risk of contagion.
-  Reusing of PPE presents higher risk for contracting COVID-19.  Quality degrades over time and reduces effectiveness of protection.

Negative Consequences of PPE Shortage

Face Mask Policies by Country 

High-efficiency particulate air (HEPA)-based air-conditioning filters are a problem while still usable. HEPA masks filter particles larger than 0.3 microns through the device, however the danger of inhaling glass fibers in the mask which could cause throat/facial irritation exists. Therefore, N95 masks are still the most adequate masks for the task.

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