A family wearing face masks passes through Union Station in Los Angeles, California, January 5, 2022. Los Angeles recently ended its mask mandate, as have many other states and cities.
Robyn Beck / AFP via Getty Images
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A family wearing face masks passes through Union Station in Los Angeles, California, January 5, 2022. Los Angeles recently ended its mask mandate, as have many other states and cities.
Robyn Beck / AFP via Getty Images
Friday changes in masking instructions from the Centers for Disease Control and Prevention to as many states and cities across the US are beginning – or already have – to ease mask-wearing duties.
According to new CDC figures, about 70% of the US population lives in a place where they no longer exist need Wear a mask to protect yourself and others. Their calculation is based on three variables: the rate of new cases, the number of new hospital admissions, and hospital capacity.
But infectious disease experts surveyed by NPR say they have not yet removed their masks. Many people still plan to wear them because they live in a part of the country where the coronavirus is still spreading widely – at least for the time being.
When do they feel comfortable dining, teaching, and grocery shopping without a mask? They shared their personal risk calculations with NPR.
Looking for low community transmission – but how low?
Dr David Dowdy, an epidemiologist at Johns Hopkins University, said: “He and other experts still consider local infection rates as they weigh their individual precautions.
Dowdy said he’s vaccinated and healthy and feels well protected when he’s hospitalized, but he’s still trying to avoid contracting COVID.
“I just don’t want to lose my job. I don’t want to spread it to my family and make them miss work and school,” he said. “And so from that perspective, cases are really more important than hospitalizations.”
Dr. Robert Wachter said he’s waiting for the daily case rate in his community to drop to 10 cases per 100,000 people a day.
“There’s nothing magical about the number 10,” says Wachter, dean of the faculty of medicine at the University of California, San Francisco. “If other people like 15 or 20, that’s fine.” He is looking for a number that “implies lower viral load in the community.”
In California, where Wachter lives, the current rate is 24 out of 100,000 people every day and is decreasing. And he started to make the exception to face coverings when there was a big enough benefit to him, including eating at an in-house restaurant.
The number of new cases per capita is also moving Dr Ali Khan, dean of the school of public health at the University of Nebraska, in deciding whether to wear a mask or not.
Khan wants to see about 5 to 10 cases per 100,000 people a day before not wearing a mask. “My wish is to never have people wearing masks forever – that’s really so that the level of transmission in the community is low enough that we can be safe,” he said. “I don’t have a high-risk condition, so I will be removing my mask in about two to three weeks as cases decrease in my community.”
A shopper wears a mask at a grocery store in Washington, DC, on February 19, 2022. Mayor Muriel Bowser announced that she will let DC’s mask-wearing powers expire at the end of the month.
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A shopper wears a mask at a grocery store in Washington, DC, on February 19, 2022. Mayor Muriel Bowser announced that she will let DC’s mask-wearing powers expire at the end of the month.
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Dr. Lisa Maragakis, senior director of infection prevention at Johns Hopkins Health System, agrees that she wants to see the case rate “in the single digits” before she feels comfortable not wearing a mask. She is tracking a daily case rate of 1 to 5 per 100,000 for a rotating 7 to 14 day average.
Wachter acknowledges that the daily COVID case rate isn’t a perfect guide to taking (or forgoing) precautions, especially as more and more people use home tests without not reported across countries. Still, he said, the drop in community transmission is a good sign that “the system isn’t too strained; that the hospitals aren’t overwhelmed; that I’ll have access to an audit. and that I have access to therapies [if needed]. ”
A trend that persists over time
However, it is not just about the number of reported cases.
Dr. Abraar Karan, an infectious disease physician at Stanford University, looks at how many tests come back positive, the so-called test positivity rate.
If there is a check positive rate less than 1% – no increase – Karan says “the chance of a resurgence or community outbreak is much lower.” The positivity of testing can be found in many government districts Community Profile dataset or on the state health department’s COVID-19 dashboard.
“Given the high prevalence of the disease in the community today, I wouldn’t remove my mask in indoor settings,” Karan said of her community.
Cases are falling in Karan who lives in California, as well as in much of the United States. If people start taking off their masks and the case count remains low, he said it’s an encouraging sign: “We could very well buy ourselves a good spring.”
The other health mavens don’t have a strict count in mind. “There will come a time when the baud rate [reaches a plateau] and it didn’t budge. At that point, I’ll make a decision,” said Dr. José Romero, Arkansas’ Health Secretary. Factors he will consider at that point include how effective the vaccine is. and whether COVID treatments are widely available.
A permanent accessory – as part of a layered risk strategy
Masking is also not an all-or-nothing option.
Even if Romero of Arkansas feels comfortable going grocery shopping without a mask on, “I’m not sure I’m going to give it up completely,” he said. Like the bottle of hand sanitizer in his backpack, he sees masks as just another measure to protect himself, especially in times of higher risk.
A diner wears a mask outside a restaurant in San Francisco, California, United States, on Wednesday, February 16, 2022. The state’s indoor mask requirement has expired.
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A diner wears a mask outside a restaurant in San Francisco, California, United States, on Wednesday, February 16, 2022. The state’s indoor mask requirement has expired.
David Paul Morris / Bloomberg via Getty Images
Masks have become an enduring accessory for Seema Lakdawala, a virologist at the University of Pittsburgh. “It’s a really good addition to the vaccine,” she explains: “If I’m wearing a mask and someone else in my environment gets infected, I’ll breathe in less virus. Even if I do get infected, the infectious disease is probably low enough that my immunity from the vaccination can create a strong enough barrier and help me recover.”
Practically speaking, “If it’s rare, maybe I’ll go into a store without a mask on,” she said, “But I’ll keep the mask in my car or in my coat pocket. And If I wanted to, I’d just pull it out and put it on.”
Considerations for people at high risk and their households
Of course, the decision about wearing a mask is personal. They will be different for certain groups, including those at high risk of severe COVIDcan’t get vaccinated or live with someone in either of the previous two categories.
Although her youngest child is now 6 years old and vaccinated, Lakdawala says it makes sense for families with young children to continue to be more vigilant about the risk of COVID. “I think if I had children under 5, I would still be very nervous about some of the environments we would go to. [to]”Lakdawala said.
For those similarly cautious during this transition, a properly fitted, high-quality N95 or KN95 mask can provides a significant amount of protection to the wearer, even if others in public are not wearing masks. However, there are still places where Maragakis thinks the mask requirements for everyone should be kept.
“We need to understand and care for the most vulnerable among us by not forcing people into situations where they have to be in close contact with people not wearing masks.”
Maragakis said requiring masks for a while longer would make sense in a number of contexts, including on public transit.
Yuki Noguchi contributed to this report.
