To Mask or Not to Mask?

April 22, 2022?

Well fitted (N95) masks, coupled with avoidance of indoor spaces are a proven method to prevent the spread of COVID-19 as well as other airborne infectious diseases. While it may be early to end mask mandates, anyone who is in an area with a higher rate of infections, wants to be indoors with large number of people, or is concerned about the risk to themselves or a loved one if they do get sick, should continue to mask up.

We have seen a dramatic fall in cases of COVID-19 as a result of our use of masks, vaccinations and boosters, and social distancing (especially avoiding large gatherings indoors). The overall number of new COVID-19 cases in the U.S. has dropped from the Omicron peak of more than 800,000 per day last January to approximately 30,000 new cases/day now. Similarly, the number of daily deaths has dropped from a peak of 2,500 per day in early February to an average daily count of approximately 400 now. We have seen a new even more highly transmissible Omicron BA.2 variant as the main source of new infections, but fortunately this variant appears to be less lethal, especially in people who are vaccinated and boosted. But this variant is causing a significant increase in cases in selected areas of the country, where people should remain vigilant to prevent a rising death toll (chiefly the NorthEast, South Dakota, and select counties in other states).?

In all areas of the country where the incidence of new cases remains low, people who are at low risk if they are exposed to COVID-19 can now safely enjoy mask-free normal outdoor activities. Although mask mandates are being lifted, some people at higher risk should still consider masks and continuing with careful social distancing as an essential tool to avoid exposing themselves and others to COVID-19. To prevent a resurgence of cases, it continues to be important to avoid large indoor gatherings, even in places where there are relatively fewer cases, and especially for those at higher risk of serious illness.?

People who should consider continuing to wear a mask indoors or in crowded spaces include those who are at high risk of serious illness:

• Anyone more than 65 yrs old, severely obese, or with other underlying significant medical conditions, such as asthma or COPD, heart or kidney failure, diabetes, cancer or if they are immunocompromised.?
• Anyone who is unvaccinated and / or hasn't received the booster more than 4 months after vaccination.
• Anyone living in a county that has an above average rate of COVID-19. You can look up your community rate of COVID-19 at the CDC county checker: https://www.cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html?

People who are not themselves at a higher risk of serious illness if they become infected should also consider masking if they are in close contact with others who are at higher risk.

Why wear a mask indoors? Indoor group meetings, especially in locations with poor air circulation, are much more likely to lead to exposure, and the risk of exposure goes up in proportion to the size of the group. So avoid large indoor gatherings, and wear a mask when indoors with others. This is particularly important if you are in a higher risk group, or if you live with or come in contact with others who are at higher risk.?

It's also important to realize that masks vary in effectiveness, and the best protection for you and those you love comes from wearing a properly fitted N95 mask. These masks were previously in short supply, but now are widely available.??

Finally, it should go without saying that everyone should get vaccinated and boosted, even if they have had COVID-19. We now have massive experience with the COVID-19 vaccines, and they have proven to be not only highly effective, but also remarkably free of significant side effects compared to the benefits they deliver. People at high risk of exposure or at high risk of serious illness if they are exposed should also receive a second booster shot, 4 months or more after their first booster.?