The Live Free or Die state needs to have people think not just of their own life and liberty, but the liberty and lives of others, when it comes to wearing face masks, according to a New Hampshire doctor.

“This is time for personal sacrifices to benefit the greater good,” said Dr. Michael Calderwood, the associate chief quality officer at Dartmouth-Hitchcock Medical Center in Lebanon.

Calderwood said more than 30 states are seeing a rise in the spread of COVID-19 since Memorial Day weekend. While New Hampshire’s cases continue a slow decline, he said people need to consider wearing masks when they leave the house.

Calderwood isn’t the only person suggesting mask wearing. University of New Hampshire Associate Professor of Health Management Semra Aytur said masks can drastically cut the spread of the disease and save lives. “I always wear one,” Aytur said.

Studies are showing that if widespread mask use were in place in all 50 states, tens of thousands of lives could be saved. Aytur said the more people wearing masks in the community, the less the novel coronavirus that causes COVID-19 can spread.

“If at least 50 percent of people wear a cloth face covering all the time, it reduces the spread to a reproduction number of 1,” Aytur said. “More than 50 percent could significantly impact that number.”

In epidemiology, a reproduction number is used to calculate the spread of a disease. A reproduction number of 1 (R1) would mean that the disease is stable and the infection curve is flat. An R0 would mean the disease is not spreading.

Calderwood explained that if 100 people spent time within 6-feet of an asymptomatic person with COVID-19, around 17 people would contract the illness. If everyone wore masks, only three people would become infected, he said.

A new study out of the Institute for Health Metrics and Evaluation at the University of Washington is forecasting that more than 33,000 lives could be saved by Oct. 1 if the whole country adopted wearing face masks.

The study forecasts that a total of 180,000 people in the U.S. will die from COVID-19 by Oct. 1, but those numbers drop to 146,047, with a range of 140,849 to 153,438, if at least 95 percent of people wear masks in public. In New Hampshire, according to the study, 95 percent of people wearing a mask could mean between 126 and 1,200 people’s lives are saved. There are currently more than 121,000 deaths and more than 2.3 million infections in the U.S.

Calderwood said wearing a face mask won’t necessarily protect the wearer from contracting the illness, but it will prevent a sick person from passing it along. COVID-19 has an incubation period of at least several days and up to 14 before an infected person begins to show any symptoms, so people need to be conscious that they could spread the virus before they know they are infected.

“We need to really be thinking about our neighbors,” Calderwood said.

Aytur said most people do not need surgical masks or N95 masks, and these masks should still be set aside for medical facilities. Instead, a simple cloth mask with two layers will do the job, she said, noting that she wears a homemade mask.

Though some people make cloth masks with a pocket to insert a coffee filter, it does not need to be complicated, Aytur said. The mask can be some cotton fabric, a scarf, a bandana or even a cut up T-shirt. The mask should be at least two layers, but it could be one depending on the material.

Aytur suggests people use the “sunlight test” to be sure: “It should be something thick enough by itself, or it should be able to be folded over, and you no longer see sunshine shining through it,” she said. “Then it is safe.”

Early on in the pandemic, the Centers for Disease Control and Prevention recommended against wearing face masks. This was partially out of concern there would be run on supplies, creating a shortage of personal protective equipment for medical workers. Calderwood said there was also worry that if more people wore masks in public they would touch their faces more as they adjusted the masks, creating more new infections.

There was a run on supplies and hospitals and first responders ran short of the N95 respirator masks and the typical surgical masks. Gov. Chris Sununu partnered with people like noted New Hampshire investor and businessman Dean Kamen and others to secure supplies from overseas, but regular people also pitched in to help in the early part of the pandemic.

Javi Kalback, 37, from Dover, was part of a group of volunteer sewers on the Seacoast who made reusable cloth masks for hospitals and first responders. “We ended up making almost 60,000 masks,” Kalback said.

Kalback’s group used quilters fabrics to make the masks, with two layers for protection. The sewers could turn out a mask in half an hour or less depending on the skill of the sewer, Kalback said.

The CDC changed its recommendation in April and is now encouraging people to wear masks. New Hampshire is recommending people wear masks in crowded and enclosed spaces, like grocery stores. The state is also giving away disposable masks to businesses for customers to use.

Reusable handmade masks are now becoming part of the new COVID economy. Sisters Megan Sheehan, 19, and Casey Sheehan, 18, from North Conway, started an online mask store on Etsy called MCMasksNH. They made 200 cloth masks for the store, with each mask talking about half an hour of labor. Aside from helping with college expenses, the sisters are setting aside 10 percent of their profits for the Alzheimer’s Association.

“We haven’t turned a profit yet but have decided to donate 10 percent of our first month’s revenue instead,” the sisters said in an email interview. “Our family has been directly affected by Alzheimer’s: our Nana currently has the disease and our great grandmother had it and passed many years ago.”

Aytur said wearing a mask in public should be combined with social distancing of at least 6 feet, hand washing, and avoiding large gatherings in order to prevent a second wave of COVID-19 later this summer or in the fall.

“If enough people just wore the cloth face covering, along with hand washing and physical distancing, it would really make a difference,” Aytur said.

Calderwood said there are some people who cannot wear masks because of pre-existing respiratory illnesses. It’s also difficult to get small children to wear masks and keep them on and it is not recommended for children under two. That makes mask wearing by those who are able more important, Calderwood said.

“The rest of us really need to think about what we can do to protect those members of the community,” he said.

These articles are being shared by partners in The Granite State News Collaborative. For more information visit