How to decide if you still need to wear a mask?

As masking mandates are lifted and new coronavirus infections fall in the United States, there is much confusion about whether and when a mask should be worn.

“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 chair of the department of medicine at the University of California, San Francisco. “It’s the risks and benefits to the people around you.”

A good way to frame the problem is to ask: who is the most vulnerable person in your immediate environment?

For example, if you have reduced immunity, or live with someone who has, it’s a good idea to continue to wear a mask and maintain social distancing around strangers, especially in indoor air-filled spaces where the virus can spread. can gather. Masks are also important if you are not vaccinated or spend time with others who are not vaccinated. Unvaccinated people are at an overwhelmingly higher risk of hospitalization and death from Covid-19. Masks are also a must in hospitals, where there are many vulnerable people.

But if you are otherwise healthy and have received your vaccine and booster shots, your risk of becoming seriously ill with Covid is extremely small. It’s roughly in line with other risks people take on a daily basis, such as driving.

Many people “weigh the fact that they would like to go back to normal and may be willing to take a little bit of risk to achieve a level of simplicity they last knew in 2019,” said Dr. watchman. “That’s not irrational.”

There is also always the risk that someone could develop Covid for a long time, even if they have been vaccinated, although much about the condition remains unknown.

If infection rates where you live are high, which has been pretty much everywhere during the last Omicron wave, the Centers for Disease Control and Prevention continues to recommend masks in most indoor areas. But in many situations, the decision to wear a mask becomes a personal one.

We spoke to experts to give you a guide to the places and situations where it’s a good idea to cover your face.

There is little scientific evidence to show that face coverings provide much additional protection in many outdoor areas, such as sidewalks or parks. With crowds, such as at a concert or sports venue, it gets a little hairier.

“If you can’t feel wind on your cheeks, you probably aren’t in an area with good outdoor ventilation,” says Dr. Asaf Bitton, a primary care physician who is the executive director of Ariadne Labs, a public health innovation center. at Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health. “If you really stand shoulder to shoulder with people, that could be a case of wearing an outdoor mask, at least for now.”

Erin Bromage, an associate professor of biology who studies infectious diseases at the University of Massachusetts Dartmouth, has helped touring music bands assess Covid risks during the pandemic. The main place he’s seen the risk of transmission during concerts is in the standing-only area close to the stage.

“Where the risk is mainly focused, the pits all the way, all the way in front of the stage where people are singing on top of each other, are physically strenuous,” said Dr. Bromage.

However, most outdoor concerts are generally safe, he said. “If you’re standing on a lawn watching a show, there really isn’t any data to support that a mask is doing something to protect you that Mother Nature isn’t taking care of.”

And if the venue requires vaccines or a recent Covid negative test, you’ll be in even better shape.

First and foremost, follow the standards and rules of the business you enter. If the sign by the door says “Mask Required,” you don’t want store associates having to enforce policies that they have no control over. Their work is hard enough and anyone can wear a mask with little to no sacrifice.

If the company mask is optional, consider the space, crowds, and airflow.

dr. Bromage suggests a cigarette analogy: If someone smoked, would the smell and taste of cigarettes quickly fill the air? If so, so would the virus. You would be smart to wear a mask. If not, the chances of getting infected are slim.

“When I walk into a room, I always do,” said Dr. Bromage. “How high are the ceilings? Does the air move? Can I create my own little buffer of space?”


February 19, 2022, 7:09 PM ET

Take a large store with high ceilings. “Those usually 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 airborne transmission of viruses. “The risks are pretty low unless you’re standing in a busy line waiting to check out.”

“If it’s a smaller and crowded space, like Trader Joe’s, or some New York market with small aisles and the people are really crammed in there, then the risk is higher,” she continued. “You may want to wear a mask.”

A hair salon may be a small space, said Dr. Bromage, but there usually won’t be that many people in the company, so the risk of an infected person passing through it will generally be low, especially if the number of cases drops.

In a restaurant, the cigarette smoke from a person at the next table wouldn’t fill the air above yours. But you would smell someone smoking at your own table, so your immediate dining companions pose the greatest risk, said Dr. Bromage.

The gym can feel especially scary. Heavier breathing can expel more virus particles, but most gyms have excellent ventilation systems. (“If gyms didn’t have proper air circulation, they’d stink,” said Dr. Bromage.) That means any virus particles floating around are also sucked out with the sweat odor.

dr. Bromage again uses the cigarette analogy. He had run on the treadmill unmasked, but he had placed an extra treadmill between himself and another runner. But a spin class, in a small room of “screaming, screaming, gasping, puffing people”? Probably not yet, he said.

Public transportation is exempt from local mandates: you are still required to wear a mask, according to federal requirements.

It’s also just a good idea – on buses and subways, many strangers move in and out of a cramped, enclosed space.

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In New York City. The New York Health Commissioner announced that the state would not enforce a booster-shot requirement for health professionals that goes into effect Feb. 21. Too many employees refused to comply, raising concerns that the health care system would be disrupted with a mandate in place.

“That’s somewhere I would probably still wear a mask,” said Dr. marr.

You should definitely wear a mask on airplanes. There is no national mandate that requires airline passengers to be vaccinated, so even if you are vaccinated, you don’t know the status of those around you.

You also don’t want to ruin your vacation or business trip by getting infected and having to quarantine, even if the risk of becoming seriously ill remains low.

Public health experts agree that school mask mandates shouldn’t last forever, but they disagree on whether it’s time to remove them. For parents, changing rules can be confusing.

Here are a few things to consider when making the choice for your own family.

Children almost never have severe symptoms, whether or not they have been vaccinated. Many students have gone to school mask-less during the pandemic – such as in Britain, part of Europe and many US states – and very few children have become seriously ill.

“The risk for children has always been lower than for adults,” said Dr. David Rubin, a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

The jury is also not yet out whether masks hinder social development. But several studies suggest that a mask makes communication difficult and hinders children’s ability to recognize each other or each other’s emotions.

“Children and their schools have had to carry a collective burden, largely to protect the adults in their lives,” said Dr. Rubin, who is also director of PolicyLab at Children’s Hospital in Philadelphia.

And as much of the world opens up, consider all the ways kids interact with each other. Masks can stop the transmission in the classroom itself, but children communicate outside of school hours.

“Masks don’t work if people wear 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 the infection from school to after-school care.”

Also know that the United States is an outlier in its commitment to pediatric masks. The World Health Organization does not recommend them for children under 5 years of age and the European Center for Disease Prevention and Control does not recommend them for children under 12 years of age.

Covid isn’t the only bug floating around, nor the only one that can harm vulnerable people. The flu, for example, kills more than 30,000 Americans in a typical season, most of whom are older adults or immunocompromised.

“Grip and the common cold are probably transmitted in the same way as Covid,” said Dr. marr. “If you feel a little sick, you can spread the virus in the air and pass it on to other people. You should stay at home or, if you have to go out, wear a mask.”

A well-fitting, high-quality mask will protect you, experts say, even if other people aren’t covering their airways.

KN95, N95 and KF94 masks are the best protection out there, but make sure they are not counterfeit. Cloth masks offer limited protection – especially if you don’t add a filter or a second mask – and surgical masks often open.

Here’s a Wirecutter guide to buying N95 and KN95 masks, and how to spot a fake.

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