Additional Guidance on the Use of Face Masks

September 16, 2020

To reduce the spread of COVID-19, the CDC recommends that people wear masks in public 

settings when around people outside of their household, especially when other social distancing 

measures are difficult to maintain.

The use of masks to control the spread of COVID-19: 

• Anyone visiting or working in a tribal gaming operation is encouraged to wear a mask. 

• Gaming operations should:

o Recommend and reinforce the use of masks among staff and customers.

o Frequently remind individuals not to touch the mask and to wash their hands 

frequently. 

o Provide information to staff and customers on proper use, removal, and washing 

of masks.

Evidence for Effectiveness of Masks

According to the CDC, masks are recommended as a simple barrier to help prevent respiratory 

droplets from traveling into the air and onto other people when the person wearing the mask 

coughs, sneezes, talks, or raises their voice. This is called source control. This recommendation 

is based on what is known about the role respiratory droplets play in the spread of the virus that 

causes COVID-19, paired with emerging evidence from clinical and laboratory studies that show 

masks reduce the spray of droplets when worn over the nose and mouth. COVID-19 spreads 

mainly among people who are in close contact with one another (within about 6 feet), so the use 

of masks is particularly important in settings where people are close to each other or where social 

distancing is difficult to maintain.

Why it is important to wear a mask

Masks may help prevent people who have COVID-19 from spreading the virus to others. 

Wearing a mask will help protect people around you, including those at higher risk of severe 

illness from COVID-19 and workers who frequently come into close contact with other people. 

Masks are most likely to reduce the spread of COVID-19 when they are widely used by people 

in public settings. The spread of COVID-19 can be reduced when masks are used along with 

other preventive measures, including social distancing, frequent handwashing, and cleaning and 

disinfecting frequently touched surfaces.

The term “mask,” as used in this document, does not mean surgical masks or respirators. 

Currently, those critical supplies should be reserved for healthcare workers and other first 

responders. Masks are not personal protective equipment (PPE). They are not appropriate 

substitutes for PPE such as respirators (like N95 respirators) or medical facemasks (like surgical 
masks) in workplaces where respirators or facemasks are recommended or required to protect the 

wearer. (https://www.osha.gov/SLTC/covid-19/covid-19-faq.html) 

Masks with Exhalation Valves or Vents, Face Shields and Surgical Masks

According to the CDC, the following information is available: 

Masks with Exhalation Valves or Vents. The purpose of a mask is to keep respiratory droplets 

from reaching others and to aid with source control. However, masks with one-way valves or 

vents allow air to be exhaled through a hole in the material, which can result in expelled 

respiratory droplets that can reach others. This type of mask does not prevent the person wearing 

the mask from transmitting COVID-19 to others. Therefore, CDC does not recommend using 

masks for source control if they have an exhalation valve or vent.

Face Shields. A face shield is primarily used for eye protection for the person wearing it. At this 

time, it is not known what level of protection a face shield provides to people nearby from the 

spray of respiratory droplets from the wearer. There is currently not enough evidence to support 

the effectiveness of face shields for source control. Therefore, CDC does not currently 

recommend use of face shields as a substitute for masks.

Surgical Masks. The term mask as used in this document does not mean surgical masks or 

respirators. Currently, those are critical supplies that should continue to be reserved for 

healthcare workers and other medical first responders, as recommended by current CDC 

guidance. Masks also are not appropriate substitutes for surgical masks or respirators in 

workplaces where surgical masks or respirators are recommended or required and available.

Key Points

• CDC recommends that people wear masks in public settings and when around people that

don’t live in your household, especially when other social distancing measures are 

difficult to maintain.

• Masks may help prevent people who have COVID-19 from spreading the virus to others.

• Masks are most likely to reduce the spread of COVID-19 when they are widely used by 

people in public settings.

• Masks should NOT be worn by children under the age of 2 or anyone who has trouble 

breathing, is unconscious, incapacitated, or otherwise unable to remove the mask without 

assistance.

• Masks with exhalation valves or vents should NOT be worn to help prevent the person 

wearing the mask from spreading COVID-19 to others (source control).

For more information about masks provided by the CDC please visit: 

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

For more information on tribal resources offered by the CDC, please visit: 

https://www.cdc.gov/coronavirus/2019-ncov/community/tribal/index.html