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So … When Should I Wear a Mask Now?

Caitlin Rivers, PhD, MPH

Linsey Marr, Juliet Morrison and 

Dr. Marr is a professor of civil and environmental engineering at Virginia Tech. Dr. Morrison is a virologist at the University of California, Riverside. Dr. Rivers is an epidemiologist at the Johns Hopkins Center for Health Security.

The Centers for Disease Control and Prevention recently announced that fully vaccinated people do not need to wear masks in most indoor and outdoor settings, while still following federal, state and local rules.

But official guidelines don’t always adequately address individual circumstances, and the issue of masking has become the subject of much debate. We asked three experts from different disciplines — an airborne-transmission expert, Linsey Marr; a virus expert, Juliet Morrison; and an epidemiologist, Caitlin Rivers — to respond to readers’ questions about wearing masks now.

The experts don’t always agree with one another. Their advice reflects different considerations and approaches to risk. — Alexandra Sifferlin, senior staff editor

I live in a state that has just 29 percent of the population fully vaccinated. As my friends and colleagues begin to rejoice from this change, I have no idea how to react and am flabbergasted. I am vaccinated but intend to keep wearing a mask. Aside from the obvious — at my home and outside — are there any other situations where it would be OK for me to not wear a mask? — Bronwyn Miller, Louisiana

Juliet Morrison: I think it was unwise for the C.D.C. to lift the mask mandate for vaccinated people so early in the vaccination campaign. Only 37 percent of people in the United States have been fully vaccinated. The same communities that have been disproportionately affected by the pandemic have also struggled to access vaccines due to poor vaccine distribution efforts. The point of vaccinating most of the population is to get us all to the point where we halt viral transmission. Once we get to that point, everyone can then interact unmasked.

Linsey Marr: I was surprised, too, by the C.D.C.’s latest guidance on masks for vaccinated people. I did not expect this change for another month or two, after more people have had the chance to be fully vaccinated. If you want to be cautious, it’s a good idea to continue wearing a mask in crowded indoor spaces while the vaccination rate in your community remains low and there are still a lot of cases, particularly if a lot of other people are unmasked. Continuing to wear a mask will reduce the chance that you will experience a breakthrough infection. I hope you’re able to encourage other members of your community to get vaccinated, because the vaccines are very effective and will help us get back to normal.

Kids under 12 can’t be vaccinated yet. Will they really keep wearing masks when the adults around them stop? I doubt it. Will this change mean greater risk for kids under 12 in public spaces? — Kathryn Ference, Jefferson, Maine

Marr: There are a couple of angles here, and I speak as a parent of a child under age 12. According to the C.D.C.’s new guidance, anyone who is unvaccinated should continue wearing a mask indoors. This includes unvaccinated children because they still run the risk of getting infected and transmitting the disease. On the other hand, the risk of severe disease and illness is low enough in this age group that I don’t stress too much about children unless they have a pre-existing medical condition. Personally, I worry more about things like online stalking, sports injuries and car/bike/pedestrian accidents with my unvaccinated child than about a bad outcome from Covid-19.

Morrison: Though the risk of severe disease is lower in children, a nonnegligible proportion of children still get seriously ill or die from Covid. When out in public, wear your mask so that your children will want to wear theirs, too. Luckily, they won’t have to wear masks forever. All of us will be able to safely interact unmasked once most of the population is vaccinated.

I’m fully vaccinated but have been invited to an indoor wedding and reception. Should I wear a mask, and what is the risk of removing the mask to eat and drink at a table with others? Or should I skip the wedding? — Mary West, New York City

Caitlin Rivers: According to C.D.C. guidance, you can go without a mask now that you are fully vaccinated. If the host has a mask policy, you should still abide by that, and be conscientious of other guests who may not be vaccinated yet.

Marr: If you are healthy and do not live with vulnerable individuals, then I think it is reasonable to attend the wedding and not wear a mask. If you do wear a mask, removing it to eat and drink at a table with others is the riskiest part of the event, so you could try to minimize time spent doing this.

If we gather outdoors for a party for my son’s college graduation with 20 people, about 10 of whom are fully vaccinated and the rest vaccine hesitant, do we need to wear masks? — Amelia Williams, Nelson County, Va.

Rivers: Outdoor gatherings are a safer way for people to get together, and it’s good that half of the attendees are vaccinated. I think you can go without masks if the unvaccinated guests are comfortable with that. Be mindful of things like piling into the kitchen or using shared serving utensils, to minimize risk among the unvaccinated. Congratulations on the graduation!

Marr: It’s good to hear that you are gathering outdoors, because this greatly reduces the risk of transmitting Covid-19 compared to gathering indoors. Outdoors, masks are needed only for close, face-to-face conversations between unvaccinated people. Those who are vaccinated are well protected, between the vaccine and outdoor setting.

I work in a small, very busy hair salon. We have five employees and try to have no more than four clients in the salon at the same time. We have one stylist who refuses to be vaccinated. Can we remove our masks? — Edwin Gregory, Manatee County, Fla.

I work in a grocery store. How is this new guidance going to change workplace rules? There needs to be better guidance for employees who work continuously with an ever-changing flow of people indoors. — Roberta Smith, Pennsylvania

Morrison: If everyone is vaccinated at your workplace, you do not need to wear masks. If you work in a business that serves people whose vaccination status you don’t know, you and your co-workers should still wear masks on the job, especially if you have unvaccinated or immunocompromised people at home. I wear a mask when interacting with unvaccinated people or people whose vaccination status I do not know because I have friends and family who are still not vaccinated with whom I spend time unmasked.

Marr: The hair salon seems like exactly the type of situation the new C.D.C. guidelines are intended to address. The unvaccinated stylist and any unvaccinated clients — or all of them if their vaccination status is not known — should wear masks. Regarding the grocery store, the Occupational Safety and Health Administration is considering a temporary rule for employers to adequately address the risks faced by workers.

The C.D.C. chart shows eating at an indoor restaurant or bar is safe for vaccinated people wearing a mask. Given aerosol transmission and the fact that you can’t eat or drink without removing your mask, is that actually safe? And if not now, when, if ever, will it be? — Angela Jordan, Mobile, Ala.

Morrison: Since you won’t know the vaccination status of the other restaurant patrons, I would encourage you to wear a mask and remove it only when eating and drinking, especially if there are unvaccinated or immunosuppressed people in your life that you interact with unmasked. When I dine indoors at restaurants, I choose restaurants that have good airflow, ample space between the tables, and masked servers.

Marr: Given the efficacy of the vaccines, I am now willing to eat indoors at a restaurant for the first time in 15 months. If you are healthy and do not live with vulnerable individuals, the risk now seems reasonably low. You can further reduce your risk by seeking out uncrowded, quieter restaurants compared to crowded, loud ones.

My husband and I have been wearing masks since March last year and are now fully vaccinated. When on an intercontinental flight, is it advisable to take the mask off at all? — Dirk Evenson, Bay Area, California

Rivers: When I flew recently while fully vaccinated, I wore a high-quality mask, but I took it off to eat and drink as needed. There is still a mask mandate on planes and other modes of transportation, so be sure to follow the airline’s policies, but I think you can safely stay hydrated.

Morrison: I agree with Dr. Rivers. Now that I am fully vaccinated, I look forward to flying again. I plan to wear a regular two-ply mask while walking through the airport or flying on the plane. Also, I will remove my mask only to eat and drink. If everyone on the flight is also following these guidelines, the risk of transmission is low.

My choir wants to begin indoor rehearsals again in a week. We will be masked and distanced, but with the aerosols created during singing, it sounds like that may not be enough. Is it safe to attend? I am vaccinated and will be masked, but I’m not sure if all the other singers are also vaccinated. — Elaine Cooper, Arizona

Rivers: Since you are vaccinated, you can attend indoor choir. I agree with you that it’s a high-risk activity for people who are unvaccinated, so for them, I would not recommend participation, even while masked.

Marr: The combination of the vaccine, masks and distance greatly reduces your risk. As long as you are healthy, it seems like an appropriate time to return to rehearsals. If unvaccinated people are attending, it would be better to hold the rehearsal outdoors, as singing is known to produce a lot of aerosols that could carry the virus if someone is infected.

What level of Covid-19 in the community (cases per 100,000) would make it safe enough to use face shields, rather than masks, while partner dancing (contra dance) in a group of about 30 people, all of whom are vaccinated? We would be indoors with the windows open. We change partners between dances. — Michael Hanson, Seattle

Rivers: If you are fully vaccinated, you can resume dancing without a mask, regardless of incidence, according to C.D.C. guidance. If you can’t be certain everyone is vaccinated, personally, I would feel more comfortable wearing a mask until community transmission is low. C.D.C. defines low community transmission as fewer than 10 cases per 100,000 people per seven days. Face shields are not very effective when used alone, so I don’t think you need that. For people who are unvaccinated, I recommend holding off altogether (or better yet, get vaccinated).

Marr: Isn’t it great that the vaccines are enabling us to return to these types of activities? Dr. Rivers is better qualified to address the question about cases in the community, and I can add that neither face shields nor masks are needed. For future reference, face shields do not offer protection against aerosols and should not be considered an alternative to masks. They can be worn with masks to add an extra layer of protection, particularly to the eyes.

I have multiple sclerosis and, like many with cancer and other conditions, I am on an immune-system-suppressing medication. As a result, I have not developed antibodies for full protection, even though I have been vaccinated. I am also at higher risk for severe Covid-19. What mask protocols should I follow, and what should I require of others, particularly in indoor gatherings? — Andrew Tomlinson, New York City

Rivers: I would continue to wear a high-quality mask in public and avoid public gatherings. The good news is that as incidence falls, the risk of encountering the virus is declining. But since you haven’t developed a strong response to the vaccine and are at higher risk of severe illness if you do become infected, I would continue to take careful precautions.

For small indoor gatherings where you are confident that everyone else is vaccinated, you have more flexibility to decide, based on your risk tolerance.

Morrison: Unfortunately, immunocompromised people may not mount good responses to vaccination. If you are immunocompromised or taking immunosuppressive drugs, you should follow the recommendations for unvaccinated people. The good news is that you won’t have to wear a mask forever. All of us will be able to safely interact unmasked once most of the population is vaccinated and viral transmission is low.

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