Gov. Tom Wolf now recommends that all Pennsylvanians begin wearing homemade or paper masks when they leave their homes for life-sustaining reasons.

“Homemade masks limit the spread of infectious droplets in the air by containing coughs and sneezes. When a homemade mask can’t be acquired, a scarf or bandana can be utilized. By implementing community use of these homemade fabric or cloth masks, everyone will have a higher degree of protection from this virus,” read a statement from the Department of Health.

So, how do you make them? And how effective are they? Here’s what you need to know:

How to make a mask

There are lots of tutorials online on how to make face masks, including a number of different patterns and recommended materials.

The governor’s office recommended that people making their own masks follow a tutorial provided earlier this week by the New York Times. The Department of Health recommended the use of two pieces of 100% cotton fabric in mask construction, like that of a tea towel, cut to a size of 12 inches by 6 inches for a standard adult size. Other materials needed include a needle and thread or sewing machine, scissors, and pins or clips to keep the fabric being sewed in place. Items to make a mask should be purchased online to “avoid exposure in public places,” a statement from the Pennsylvania Department of Health said.

To create a homemade mask, Gov. Wolf’s office recommended a five-step process

  • Measure and cut two pieces of fabric in a rectangle pattern to fit snugly around the face (size 12 inches by 6 inches is standard for adults)·
  • Tightly sew both layers together on all edges
  • Cut fabric ties to fit around the ears
  • Sew the ties to the insides of the mask on the smaller edge, and repeat on both sides
  • Resew the sides to ensure a tight seal between both pieces of fabric and the earpiece

Masks, the office said, should fit snugly around the mouth and nose.

Should I wash my mask?

Gov. Wolf’s recommendation is that homemade masks “should be washed after each use,” and “should not be worn damp or when wet from spit or mucus.”

“The best way to wash homemade masks is using hot water and regular detergent,” Pennsylvania Department of Health press secretary Nate Wardle said. “The masks should then be dried completely on the hot setting as well. Using high temperatures will help kill any germs or bacteria.”

How effective are they?

According to the guidance from the Department of Health, homemade fabric masks are not considered personal protective equipment (PPE).

“However, homemade masks can be an effective complement to handwashing, social-distancing and other mitigation measures.”

In a news conference, Pennsylvania Secretary of Health Rachel Levine said homemade masks shouldn’t lull us into a sense of safety. “I think it’s really important that people might not become complacent, that they have a homemade mask on. We want people to stay home.”

“Depending on what material they are made of, they can approach the effectiveness of disposable surgical masks,” Fleece said. “[But] if you are not using the right material and practicing really good hygiene, these efforts have the potential to make things worse by providing a false sense of security.”

And, in addition to not filtering particles as well as official gear, masks may actually carry additional risk, especially if we’re reusing them. A 2015 study published in the medical journal BMJ Open also cautions against the use of cloth masks, noting that “moisture retention, reuse of cloth masks, and poor filtration may result in increased risk of infection.”

Nicole Jochym, a third-year medical school student at Cooper Medical School at Rowan University working with the Sew Face Masks Philadelphia organization, says it’s common sense that some kind of barrier between the ill and the healthy is worth trying, particularly if they’re used safely.

“If you’re in an elevator and someone coughs into your face, would you want something over their face, and would you want something over your own face as well?” Jochym said. The organization, whose Facebook group attracted about 1,500 members in the three days after its launch, is dedicated to supplying face masks to both individuals and health-care workers, by both helping people who want to sew masks and also coordinating distribution. The second part is tricky, she said, because she doesn’t want to risk exposing the community to the coronavirus in the process of distributing the masks. She is currently seeking to distribute more than 2,000 masks in total.

Is there a way to make masks a little better?

When it comes to homemade masks, the type of material can influence the mask’s effectiveness, according to a 2013 Cambridge University study. In that study, items like vacuum cleaner bags, dish towels, cotton-blend T-shirts, and antimicrobial pillowcases were found to be relatively good options for mask-making due to their ability to help stop the transmission of some virus particles from sick people. T-shirts and pillowcases, the study said, were best because of filtration capability.

Are homemade masks effective for health-care workers?

While fabric masks aren’t as effective as an N95 mask or disposable surgical masks, Levine said in a news conference that they may be “better than nothing.”

But she did say that they’re not suitable for all health-care workers. “For personnel that are directly caring for patients with COVID-19, those are not the right masks to use,” Levine said.

Ashish K. Jha, director of the Harvard Global Health Institute, said the recommendation from CDC that providers use bandanas in a pinch has been met with “derision” in the medical community. “There’s no evidence that bandanas protect doctors in the context of a potentially lethal droplet,” Jha said. “I think in general, we’ve got to protect our doctors” with medical-grade protection.

Even the CDC acknowledged that homemade masks are not considered personal protective equipment because their efficacy is unknown.

But if the shortages continue, some health-care workers may have little other option.

“If nothing changes and we continue having as hard a time as we are getting masks and other personal protective equipment, within a matter of a few weeks we will be out of equipment,” said David Fleece, chief medical information officer at Temple University Hospital. “Unless something changes on the supply side, this crowdsourced, hand-sewn mask alternative may become increasingly used.”

Are hospitals actually accepting donated masks?

It varies. Some hospitals and other health-care providers are taking donations of homemade cloth masks, but it is on a case-by-case basis, so it best to check with your local medical facility before sewing up a batch.

Philadelphia’s Office of Emergency Management, for example, announced this week that the city is in “urgent need” of equipment like surgical masks but cannot accept homemade items. Penn Medicine is also not currently accepting donated cloth masks, a spokesperson said. Jefferson Health, too, has ruled out donations of sewn masks for the time being.

Organizations like Masks for Heroes, Masks for Docs, and Deaconess Health Systems in Indiana, however, are helping connect makers with health-care providers that are accepting masks, as is Sew Face Masks Philadelphia. Those interested in making or receiving masks can check database or fill out forms to provide or receive masks via those groups’ websites.

Temple University Health System is among the Philadelphia area facilities accepting DIY mask donations, Fleece said, though plans have not yet been put into place regarding if and how they will be used. Temple Health, he added, is currently registered with Masks for Heroes and Masks for Docs to facilitate donations.

The Children’s Hospital of Philadelphia will also accept donations of homemade masks. Those interested in donating can drop masks off in the main lobby of the hospital (3401 Civic Center Blvd.) or mail them to the facility.

“If the supply of personal protective equipment continues the way it is, there is a decent chance we will have to use [them],” Fleece said.

Staff writers Jason Laughlin and Wendy Ruderman contributed to this article.