Should we still wear a mask against Covid?

With the end of mandatory mask use and the drop in new coronavirus cases in the United States, there is a lot of uncertainty about whether and when people should still wear a mask.

“It’s tricky, because you have to weigh not just the risks and benefits for you,” said Professor Robert Wachter, director of the department of medicine at the University of California, San Francisco. “It’s the risks and benefits for the people around.”

A useful way of looking at the question is to ask yourself: who is the most fragile person in your immediate circle?

If you, for example, have compromised immunity or live with someone who does, it’s a good idea to continue to wear a mask and maintain social distance from strangers, especially in closed environments with still air where the virus can accumulate.

Masks are also important if you are not vaccinated or if you will be living with unvaccinated people. Unvaccinated people are at a much higher risk of hospitalization and death from Covid. The use of masks is mandatory in hospitals, where there are many people in a vulnerable state.

But if you are healthy and you have received your shots and booster shots, your risk of becoming seriously ill with Covid is very low. It is more or less comparable to the other risks that people take every day, such as when they go out in a car.

According to Wachter, many people “are thinking that they’d love to go back to normal life, and maybe they’re willing to take a little more risk to reach the level of simplicity they last knew in 2019.” “It’s not unreasonable.”

There is always a risk that someone will develop Covid-19, even if they have been vaccinated. There is still a lot we don’t know about this condition.

If infection rates are high where you live, something that has been the case pretty much everywhere during the latest wave of the omicron, the CDC still recommends wearing masks. in most closed places. But in many situations the decision to wear a mask or not is becoming something personal.

We’ve talked to experts to come up with recommendations on where and when it’s a good idea to cover your face.

Should we wear a mask outdoors?

There is little scientific evidence that masks provide much additional protection in many open spaces, such as sidewalks or parks. Things get more complicated in crowded open spaces, like at a concert or sporting event.

“If you don’t feel a breeze on your face, you’re probably in an outdoor area with poor ventilation,” said Dr. Asaf Bitton, GP and Executive Director of Ariadne Labs, the center for public health innovation at Brigham and Women’s Hospital and the TH Chan School of Public Health at Harvard University. “If you’re standing shoulder to shoulder with other people, it might be a case to wear a mask outdoors, at least for now.”

Erin Bromage is a professor of biology, an infectious disease scholar at the University of Massachusetts Dartmouth and has been helping touring music bands assess the risks of Covid throughout the pandemic. The place where he has seen the most risk of transmission at concerts is in the area closest to the stage, where it is only possible to stand.

“The risk is concentrated in the area at the front of the stage, where people are huddled together, singing and exerting themselves,” he said.

But for him, most concerts in open spaces are risk-free. “If you’re on a lawn watching a show, there’s no data to substantiate that a mask will do anything to protect you that Mother Nature isn’t already doing,” he said.

And, if the organization of the event requires vaccines or a recent negative Covid test result, even better.

And in supermarkets and gyms?

For starters, obey the establishment’s rules. If the sign on the door says “mask required,” don’t force employees to implement policies over which they have no control. Their work is hard enough. Putting on a mask is not a big sacrifice for anyone.

If masks are optional at the establishment, consider space, number of people in place and airflow.

Bromage suggests an analogy with cigarettes: if a person were smoking, would the smell of cigarettes fill the air quickly? If so, the same will happen with the virus. It would be smart to wear a mask in that case.

“I always do this when I walk in anywhere,” Bromage said. “I look at the height of the ceiling, see if the air is still or not. See if I can create a little protective space around me.”

Think of a supermarket or other large store with a high ceiling. “These spaces tend to have good ventilation, and because of the high ceilings, there’s a lot of dilution,” said Virginia Tech engineering professor Linsey Marr, who studies airborne virus transmission. “The stakes are low, unless you’re in a long line near the checkout.”

Gyms can seem like scarier places. Panting breathes out more virus particles. But most gyms have great ventilation systems (“if they didn’t have good air circulation, they would smell bad,” Bromage explained). This means that any virus particles that may be floating in the air will be sucked out, along with the smell of sweat.

And when my child goes to school?

Public health experts agree that mask use should not remain mandatory in schools forever, but they disagree on whether it is time to remove them. Changing the rules can leave parents confused.

Here are some things to keep in mind when you make choices for your family.

Vaccinated or not, children almost never have severe symptoms. Many students have been attending school without a mask during the pandemic – in the UK, for example, in parts of Europe and in many US states – and very few have become seriously ill.

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

There is still no consensus on whether masks hinder social development. But several studies suggest that they make communication difficult, inhibiting children’s ability to recognize and capture each other’s emotions.

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

And now, when much of the world is returning to normality, think about how children live together. Masks can prevent transmission in the classroom, but children interact outside of it.

“Masks don’t work when people wear them in one circumstance, but they take them off later,” said Bromage, who has consulted with schools on wearing masks. “In that case, all we’ll be doing is moving the school broadcast to after school.”

​What kind of mask should you use?

According to experts, a high-quality, well-fitting mask will protect you even if other people are not covering your airways.

KN95, N95 and KF94 masks offer the best protection available — just make sure they’re not counterfeit. Cloth masks provide limited protection, and surgical masks often leave room for airflow.

^{Translation by Clara Allain}