In recent weeks, COVID-19 has taken an alarming and disproportionate toll on the Hispanic/Latino/a/x community in Durham (as well as elsewhere in North Carolina and nationally). This is due to a variety of causes, including both pre-existing factors (health injustices, socioeconomic inequality, high-risk exploitative jobs), as well as recent COVID-specific trends (hospitals turning away Spanish-speaking patients with COVID symptoms, jobs where social distancing is impossible, employers requiring workers to report to work even if they have been exposed). In other words, Latinos in Durham are getting sick, and sometimes dying, simply from going to work.

Consistently wearing face coverings is one of the best ways to limit the spread of COVID-19, especially in settings where social distancing is impossible. The purpose of this user experience study is to determine which types of masks are best suited to the kinds of high-risk, difficult, labor-intensive jobs that many Latinos work: construction, landscaping, restaurants, and cleaning.

Cover Durham, in collaboration with El Centro Hispano and its community health workers, conducted a free mask distribution on Saturday, July 11, at La Superior supermarket in Durham. During the distribution, we recruited more than 100 possible participants for the user experience study. Of those, Cover Durham selected 25 individuals to participate, all of whom live in Durham County. The goal was to have a representative range in terms of profession, age, gender, location, and national origin. 22 participants finished the study.

Results
1. Most masks were highly rated by most participants. This suggests that many of the options are feasible from a user experience perspective.

2. Most participants liked surgical masks, but a sizable minority strongly disliked them, citing breakage and sweating.

3. Participants found it hot, tiring, and difficult to wear a mask all day at work, regardless of which mask they were wearing. They expressed the necessity of masks that stay cool, dry, well-secured, and breathable under their work conditions.

4. Participants broadly agreed with one another about good and bad features of masks.
Material: cotton or cotton blend
Cut: fitted, covering the chin so it doesn’t ride up, big enough to cover a range of faces.
Tie style: adjustable earloops or ties
Color: dark or with patterns
Nosepiece

Removable filter (although most did not actually like the filter)

5. Masks are mandatory in most workplaces, however many participants would like employers to provide masks, be stricter about communicating and requiring mask use, and encourage social distancing in the workplace.

6. Participants offered six reasons that others in their community do not wear masks:
a. Lack of responsibility/moral failure/selfishness
b. Lack of education and information

c. Physical discomfort
d. Fatalism/resignation to getting COVID-19
e. Feeling embarrassed by how it looks to others
f. Conspiracy theories/disbelief in COVID-19

7. Masks are more widely available than they were at the beginning of the pandemic. Masks are available in many stores, though they can be very expensive. It remains difficult to find masks for children.

8. Participants suggested supermarkets, work sites, apartment complexes and trailer parks, churches, restaurants, El Centro Hispano for mask distribution.

9. Participants recommend education between family members, education at worksites, and community-based information sessions by Spanish-speaking nurses or health workers. It is important to emphasize that COVID prevention is about protecting one’s family and community.

Conclusion
In light of these findings, we recommend:
1. Using the above criteria for procurement of face coverings for workers.

2. Communication campaigns that emphasize family/community protection, responsibility, and solidarity, as well as peer-to-peer education.

3. Workplaces with safety rules, such as construction sites, should make COVID rules part of general workplace rules.

4. For outdoor workers, limiting mask requirements as much as possible by focusing on the high-risk parts of the job (being in a truck with others, lifting things together, lunchtime)

5. Requiring employers to provide masks to workers.

6. Encouraging employers to apply mandatory mask requirements and require social distancing whenever possible.

Read the full study in English and in Spanish.