We are a nation of under-doers and over-doers. Every time the government has issued COVID-19 guidance throughout the pandemic, one slice of America has ignored it, while another slice has followed it to the letter, and then some. The government says stay six feet apart? Some Americans scoffed, while others didn’t set foot inside a restaurant for a year. The CDC’s decision to let vaccinated people go unmasked is shaping up to be another such cleavage. Some freshly vaccinated fastidious types might be thinking, Wait, should I be wearing a mask indoors anyway?
For some Americans, this is no longer a choice. Buffeted by rising COVID-19 case counts resulting from the hyper-transmissible Delta variant, Los Angeles County re-implemented an indoor mask mandate a few days ago. Unlike mask guidelines elsewhere, the new rule applies to everyone, regardless of vaccination status. Other localities might soon follow.
This is disappointing, because vaccines were supposed to free us from masks. Vaccination protects against COVID-19 extremely well, and asymptomatic vaccinated people are less likely to spread the coronavirus to others. Almost everyone over the age of 12 who wants a vaccine could have received one by now for free, so vaccinated people might have little desire to protect their anti-vaccine neighbors. Yet about 40 percent of Americans, disproportionately Republicans, refuse to get vaccinated, which is causing COVID-19 cases to surge and spoiling hot vax summer.
So if you don’t live in L.A., should you keep donning a mask in Trader Joe’s? Or taking sips of a cocktail between mask-yanks at a house party? I asked four experts, and received … four different answers that depend on your personal risk tolerance, living situation, and geographic location. If you’re vaccinated, you’re justified in either masking or not masking indoors. Here’s how to decide.
The case for wearing a mask indoors
Remember the multi-hued coronavirus-case-count maps that we thought we could leave behind in 2020? It might be time to revisit those. If you live in an area with a lot of cases, some experts say, it might be worth wearing a mask indoors, even if you’re vaccinated. This is especially true in situations where you don’t know the vaccination status of everyone around you, such as at church or a concert. “For example, I am wearing a mask at the grocery store again, but I am not wearing one at work, where I know almost everyone is vaccinated,” says Linsey Marr, an aerosols expert at Virginia Tech. Marr says she mostly does this to minimize the risk to herself and her family, because although it’s rare for the coronavirus to “break through” and infect a vaccinated person, it can happen, and it’s more likely to happen during a large COVID-19 outbreak. (Still, 97 percent of people who are hospitalized for COVID-19—and almost all who die of it—are unvaccinated.)
Determining what constitutes an area with “a lot” of cases remains tricky and subjective. Caitlin Rivers, an assistant professor at the Johns Hopkins Bloomberg School of Public Health, puts the number at 10 cases per 100,000 people. Right now, many counties in Missouri are over that threshold, and so are parts of Florida, Texas, California, and other states.
According to Rivers, the vaccinated should keep masking indoors in these places until children under the age of 12 can get vaccinated. “I don’t think we should give up on mitigation until we can offer kids the same protection afforded to everyone else,” she says.
Though children are at low risk of getting seriously sick with COVID-19, they could still pass the coronavirus on to unvaccinated people because they themselves aren’t vaccinated. Though your heart might not break for your local anti-vaccine conspiracy theorists, 2 to 4 percent of American adults are immunocompromised, which means the COVID-19 vaccines do not work as well for them. By masking, you are protecting yourself from breakthrough infections, but also protecting kids and the immunocompromised.
The case against wearing a mask indoors
Those arguing for a return to indoor masking typically say something like “What’s the big deal? It’s just a mask!” But masks have downsides. They’re hot, they fog up your glasses, and they muffle speech to the point that I have to scream “O!-L!-G!-A!” at every barista. Once everyone started masking, I stopped seeing friends in person, because driving an hour just to stare at someone’s eyeballs is not my idea of fun. Like many Americans, I was happy to wear a mask until the vaccines arrived, and I was happy to be rid of it once I got jabbed. Few people would likely prefer to wear a mask every day if they didn’t have to.
And if you’re vaccinated, you technically don’t have to. “I agree with what the CDC says: If you’re vaccinated, you don’t need to wear a mask,” says Joseph Allen, an environmental epidemiologist at Harvard. Indoor masking may be reasonable in areas with large outbreaks, but a top-down mask mandate for all of America no longer makes sense, he says.
Allen worries that encouraging vaccinated people to keep masking undermines confidence in the vaccines. You can’t claim you “believe in science” unless you also believe in the science of vaccine efficacy. Mask-free living can also be a carrot: Look, if you get vaccinated, you can lose these things once and for all!
While there is technically a chance that a vaccinated person might transmit the virus to someone who transmits the virus to someone who just had a bone-marrow transplant, that risk is small. Especially if you’re in a place like a grocery store. “Grocery stores, we don’t think, are super-high-risk places,” says Ashish Jha, the dean of the Brown University School of Public Health. If an immunocompromised person pops into Walmart at the same time as you, a vaccinated person, “the amount of exposure you are going to create for that person is really low if you’re asymptomatic.” Someone who’s vaccinated and doesn’t have symptoms is likely not shedding enough virus to infect an immunocompromised person as they silently cross paths in the cereal aisle. And the immunocompromised could wear a high-quality mask to protect themselves, just in case.
Jha says he’s not worried about picking up the virus and spreading it to his 9-year-old, who can’t get vaccinated yet. Sometimes when he goes to the grocery store in his highly vaccinated town, he doesn’t wear a mask, even though people look at him funny because, well, he’s Ashish Jha.
What’s more, the masking endgame seems unclear. Vaccination has slowed to a crawl, so when do we stop masking? If mask mandates return, Jha says, cases will go back up again when they end. “This is not a long-term solution,” he says. “The long-term solution is to get more people vaccinated.”
It’s the unvaccinated who are putting everyone at risk. They can get sick, they can easily transmit the virus, and they are keeping the pandemic raging. Vaccines offer significantly better protection against COVID-19 than masks do.* A national mask mandate, at this point, would be highly unpopular. Vaccine mandates for all indoor communal settings would probably be unpopular too. But they might do more to end the pandemic.
* This article originally stated that face masks reduce the risk of catching the coronavirus by 65 percent and that vaccines reduce it by 94 percent. The actual percentages for protection against the Delta variant are less clear.
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