As masking mandates lift and new coronavirus infections fall across the United States, there’s lots of confusion about if, and when, to wear a mask.
“This is the hardest thing of all, because it’s not just the risks and benefits to you,” said Dr. Robert Wachter, a professor and the chair of the medicine department at the University of California, San Francisco. “It’s the risks and benefits to the people around you.”
A good way to frame this issue is to ask: Who are the most vulnerable people in your immediate circle?
If you have compromised immunity, for example, or live with someone who does, it’s a good idea to continue to wear a mask and maintain social distance around strangers, especially in indoor areas with standing air where the virus may collect. Masks are also important if you’re unvaccinated or spending time with others who are unvaccinated. Covid-19 is more dangerous for people who have not been vaccinated. Masks are essential in hospitals that have many vulnerable patients.
But if you’re otherwise healthy and have received your vaccine and booster shots, your risk of getting seriously ill with Covid is extraordinarily small. It’s about in line with other risks people take every day, such as driving in a car.
Many people “are weighing the fact that they would love to go back to normal and may be willing to accept a little bit of risk in order to gain a level of simplicity that they last knew in 2019,” Dr. Wachter said. “That’s not irrational.”
There’s also always the risk that someone may develop long-Covid, even if they are vaccinated, though much about the condition remains unknown.
The Centers for Disease Control and Prevention continue to recommend wearing masks in indoor spaces if infection rates are high. However, in many cases, the decision to wear masks is a personal one.
We spoke to experts to help give you a guide to the places, and the situations, where it’s a good idea to cover your face.
Should you cover your face outside?
There’s little scientific evidence to show that face coverings offer much added protection in many outdoor spaces such as sidewalks or parks. Crowds can make things more complicated, such as at a concert or sports event.
“If you can’t feel wind on your cheeks, you’re probably not in an area of great outdoor ventilation,” said Dr. Asaf Bitton, a primary care doctor who is the executive director of Ariadne Labs, a public health innovation center at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. “If you’re really shoulder-to-shoulder with people, that might be a case of outdoor mask wearing, at least for now.”
Erin Bromage is an associate professor of biology at the University of Massachusetts Dartmouth who studies infectious diseases. He has assisted touring bands to assess Covid risk throughout the pandemic. The main place he’s seen risk of transmission in concerts is in the standing-room-only area close to the stage.
“Where the risk is mainly focused is the pits at the very, very front of the stage where people are on top of each other singing, physically exerting,” Dr. Bromage said.
He stated that outdoor concerts are generally safe. “If you’re standing on a lawn watching a show, there’s really no data to support that a mask does anything to protect you that Mother Nature’s not taking care of.”
And if the venue requires vaccines or a recent negative Covid test, you’re in even better shape.
What about indoor spaces like supermarkets and gyms?
First and foremost, follow the norms and the rules of the business you’re entering. If the sign at the door says “Mask Required,” you don’t want to make retail workers have to enforce policies over which they have no control. Their jobs are tough enough. However, everyone can wear a mask without much sacrifice.
If the business is mask-free, think about the space, the crowds, and the airflow.
Dr. Bromage proposes an analogy to cigarette smoking: If someone smoked, would the air quickly smell and taste like cigarettes? If the answer is yes, then so would the virus. You’d be smart to wear a mask. If not, it’s unlikely that you’ll get infected.
“When I walk into a space, I always do that,” Dr. Bromage said. “How high are the ceilings? Is the air moving at all? Can I create my own little buffer of space?”
Imagine a big-box store with high ceilings. “Those tend to have good ventilation and because of the high ceilings, there’s a lot of dilution,” said Linsey Marr, an engineering professor at Virginia Tech who studies the airborne transmission of viruses. “The risks are pretty low, unless you’re in a crowded line waiting to check out.”
“If it’s a smaller space and crowded space, Trader Joe’s, for example, or some New York market with tiny aisles and people are really packed in there, the risk is higher,” she continued. “You might want to wear a mask.”
A hair salon might be a small space, Dr. Bromage said, but there typically won’t be that many people inside the business, so the risk of an infected person passing through will generally be low, especially as case counts fall.
At a restaurant, one person’s cigarette smoke at the next table over wouldn’t fill the air above yours. Dr. Bromage said that smoking at your table would be a hazard, and that your dining companions are the most likely to smoke.
The gym might feel particularly frightening. While heavier breathing can release more virus particles, gyms have excellent ventilation systems. (“If gyms did not have good air circulation, they would stink,” Dr. Bromage said.) Any virus particles that might be floating around in the sweat are being sucked away by the sweat smell.
Dr. Bromage uses the cigarette analogy again. He’d run on the treadmill unmasked, but he’d put an extra treadmill between himself and another runner. But a spin class, in a small room with “people shouting, yelling, huffing puffing”? He said it was probably not yet.
What about public transport?
Public transit is exempted from local mandates. However, federal regulations still require you to wear a mask.
It’s also just a good idea — On buses and subways, there are a lot of strangers moving in and out of a tight, enclosed space.
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“That is somewhere I would probably still wear a mask,” Dr. Marr said.
A mask is a must for passengers on planes. There’s no national mandate requiring airline passengers to be vaccinated, so even if you’re vaccinated, you don’t know the status of the people around you.
Also, you don’t want to ruin your vacation or business trip by becoming infected and having to quarantine, even if your risk of becoming seriously sick remains low.
What about when my child goes back to school?
Experts in public health agree that school mask mandates shouldn’t be enforced for ever, but they disagree on when the time is right to remove them. It can be confusing for parents to make changes to existing rules.
Here are some tips to help you make the right choice for your family.
Children almost never suffer severe symptoms, whether or not they’re vaccinated. Many students have gone to school without masks during the pandemic — like in Britain, part of Europe and many U.S. states — and very few children have gotten seriously sick.
“The risk to children has always been lower than it is to adults,” said Dr. David Rubin, a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania.
The jury is still out about whether masks can hinder social development. But several studies do suggest that a mask makes communication difficult, inhibiting children’s ability to recognize one another or each other’s emotions.
“Children and their schools have had to shoulder a collective burden, largely to protect the adults in their lives,” said Dr. Rubin, who is also the director of PolicyLab at Children’s Hospital of Philadelphia.
Consider all the ways that children get along with each other as the world opens up. Although masks may prevent transmission in the classroom, children can still interact outside of school hours.
“Masks don’t work when people are wearing them in one circumstance, but later that day, they take them off,” said Dr. Bromage, who has consulted with schools about different mask policies. “All we’re doing is transferring infection from the school to after school.”
The United States is a notable exception in its devotion to pediatric face masks. The World Health Organization does not recommend them for kids under 5, and the European Centre for Disease Prevention and Control doesn’t recommend them for children under 12.
What if you get the sniffles?
Covid is not the only bug out there, and it is not the only one that can cause serious illness to vulnerable individuals. For example, flu can kill more than 30,000 Americans in a single season. The majority of those affected are older adults and immunocompromised.
“Flus and colds are probably transmitted the same way as Covid,” Dr. Marr said. “If you feel a little sick, then you could be shedding virus into the air and transmitting to other people. You should stay home or, if you must go out, wear a mask.”
What type of mask should I wear?
A well-fitting, high quality mask will protect you, experts say, even if other people aren’t covering their airways.
KN95, N95 & KF94 masks are the best protection around, just make sure they’re not counterfeit. Cloth masks offer limited protection — especially if you don’t add a filter or a second mask — and surgical masks often gape.
Here’s a Wirecutter guide to buying N95 and KN95 masks, and here’s how to spot a fake.
Source: NY Times