By Jen Christensen, CNN
At this point in the coronavirus pandemic, local mask mandates are disappearing as quickly as toilet paper did from grocery stores shelves two years ago. At the national level, the guidance to wear masks is staying put, at least for now.
So, should you mask up or not? Infectious disease experts have some advice for wherever you live.
The mask landscape
Whether you must wear a mask depends on where you live in the United States. Whether you should is an entirely different matter, experts say.
About a fifth of states never had mask mandates. Some states with more conservative governors, such as Florida, punished schools that put mask mandates in place by withholding funds, even when Covid-19 cases were at record levels.
Officials in Illinois, New Jersey, Connecticut, Delaware and California — states that had more strict mask rules — announced this week that as cases drop significantly in their areas, people can ditch their masks soon if they choose.
Some public health experts think now is the right time to remove mandates, particularly in highly vaccinated communities.
“As the cases are decreasing right now with Omicron, you know, in a couple of weeks, maybe removing masks is actually the right thing to do,” said Dr. Carlos del Rio, the executive associate dean of the Emory University School of Medicine.
But the US Centers for Disease Control and Prevention guidelines haven’t changed. The agency still advises anyone 2 and older to wear a mask when indoors in public if they are not up to date with their Covid-19 vaccines.
In schools, the CDC still recommends that everyone wear masks, regardless of vaccination status.
CDC Director Dr. Rochelle Walensky has said it’s not yet the right time to lift the mandates, though she acknowledged Wednesday that her agency is starting to consider updating its guidance.
“We are working on that guidance. We are working on following the trends for the moment,” Walensky said at a White House COVID-19 Response Team briefing, adding that even though hospitalizations and death rates are still high, “we are encouraged by the current trends.”
Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, agreed. He said knows people are sick of masks but urged them to hang in there a little while longer.
“Independent of whether there’s mandates or not, I think people should reasonably wear masks when they’re indoors for the next few weeks until we’re much farther down then where we are right now,” Offit said on CNN Newsroom on Tuesday. “We’re almost there.”
The science behind masks
Masks have proved to be one of the better aspects of the pandemic, Dr. Erica Johnson said.
“Masks were one of our earliest effective tools, and I think it will continue to be an absolutely important tool, particularly when rates are high within a community,” said Johnson, chair of the infectious disease board of the American Board of Internal Medicine. “They work.”
A December review of multiple studies by the CDC showed as much. Masks control the spread of disease, and they protect the wearer, particularly a well-fitting mask that the CDC recommends, such as an N95 or KN95.
Masks work in schools too, studies show; there have been more Covid-19 cases in areas without school masking policies. The American Academy of Pediatrics continues to recommend that all students wear well-fitting masks at school, with an emphasis on indoor masking.
The odds are significantly lower that someone will catch Covid-19 if they consistently wear a face mask in an indoor public setting, according to a study published Friday by the CDC.
That would be the case even if few others were wearing one, said Johnson, who is also an assistant professor of medicine in the Division of Infectious Diseases at the Johns Hopkins University School of Medicine.
“People still derive protection from wearing a mask, particularly an effective mask like the N95,” Johnson said. “They will go a long way in terms of keeping an individual safe.”
Dr. Patty Manning, chief of staff at Cincinnati Children’s Hospital, added that masks also are a good reminder to the wearer.
“When you’re wearing a mask, you’re more cognizant of safe practices,” Manning said. It reminds you that there’s still a virus out there that can make you really sick. So you may be more apt to observe prevention measures like keeping physical distance from others and washing your hands regularly.
Masking after mandates
So, should you continue to wear a mask? It depends.
Even when all the mandates are gone, Johnson said, some people should keep wearing them.
“Removing the mask mandate doesn’t mean that no one should wear a mask,” Johnson said. “There are definitely people who are maybe at higher risk or may just have a different level of acceptance of risk for whom wearing a mask will make sense. And for those people, they should absolutely continue to wear a mask, and in wearing a mask, it will help protect them from the virus.”
People without underlying conditions that put them at high risk of severe Covid-19 illness should make decisions based on a few factors, Johnson said. “There’s going to be a lot of variability.”
People should look at the rate of transmission and hospitalization in their community. If these numbers are high, they may want to wear a mask when indoors in public.
“Different environments have different priorities,” Johnson said.
Professor William Haseltine, an infectious disease expert and the president of ACCESS Health International, said people could think of it like how they watch the weather. “We have to watch the infection rates by area. One thing I’ve always said is that understanding the risk of Covid is very much like understanding the risk of weather. You have to know what’s happening in your area,” he said.
If you’re in a highly public-facing job and interact with a lot of people, for example, you may want to keep masking. In a school, where it’s basically the same people every day and many are vaccinated, you won’t necessarily need one. It depends on your comfort level for risk.
“I think we just need to assume that the reason to wear a mask is a highly personal one and respect people’s choice around it,” Johnson said.
She said people won’t have to wear masks forever, but there will be times when community transmission and hospitalization rates are high enough that they should.
“I think it’s pretty reasonable to expect that, as long as we’re dealing with this virus, we are going to see higher rates during certain times of year,” Johnson said. “So we probably are going to have to go back to wearing masks multiple times throughout all of this. And I think we should be wearing masks right now, to be frank, but the time will come where we don’t need them.”
Manning, who is also an attending physician in developmental and behavioral pediatrics, said she thinks the pandemic has put more people at ease with the idea of wearing masks, and that could help with future outbreaks.
“Despite all the politics around masks, Covid has normalized mask wearing in a way that didn’t exist in this country,” Manning said. “You can wear one and for the most part, you’ll be left alone, and it’s not anybody’s business if you wear a mask or not.”
But as the mandates lift, she said, it will be even more important to remind people to respect those who choose to wear masks.
“Somebody who chooses to wear a mask — they have their personal reasons. They might have somebody in their family that they’re trying to protect. It’s their personal choice, and it’s nice to be respectful of people’s choices. Wearing a mask doesn’t hurt anybody else. It’s their business.”
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