However, with the new CDC guidelines, many of us are confused about mask etiquette. When should be we wearing masks? Only indoors? Is it okay if everyone is fully vaccinated? To find out more, we spoke to top doctors in the field. Here’s what they had to say.
Who needs to wear masks outside?
Dr. Erica S. Shenoy, MD, PhD, FIDSA, FSHEA and Associate Chief of Infection Control Unit at Massachusetts General Hospital and Associate Professor at Harvard Medical School says that’s it’s always important to check with your state or local requirements since while the CDC provides national guidance, but local rules “rule.” “As an example, while the CDC makes a distinction regarding vaccination status related to outdoor masking, I live in Massachusetts and our rules do not make that distinction in our state masking order. So as long as you can keep six feet away from people not in your household while in public outdoor locations, no masking is required in Massachusetts as of April 30,” says Dr. Shenoy. “It has been noted that the risk of transmission outside is very low, so really anyone who is outdoors, whether vaccinated or not, who can maintain physical distance from individuals outside their own household can do so without a mask and be reassured of the safety.” For instance, you can go for a walk in public locations where you can keep your distance from people not in your household. If you’re getting together at a private outdoor gathering with a small group of people—your friends, for example—and you’re all vaccinated, then again be reassured of the safety of not masking in that situation. If that same group has a mix of vaccinated and unvaccinated, then that’s also a low risk for transmission when outdoors. But whether or not to mask up is in the bucket of personal risk tolerance, especially if there are some present who are at higher risk of severe disease if they were to be infected, including some who may be fully vaccinated but immunocompromised. Once you start getting into crowded outdoor events, while the risk of transmission is lower outdoors than indoors (and will vary by how much virus is circulating in the community), it’s likely that local rules will tend to favor masking regardless of vaccination status.
When we do have to wear our masks indoors?
This is another confusing one: When can we ditch the mask indoors? “For the foreseeable future, I believe we should continue to wear masks indoors unless one is in a private office,” says Dr. Dean Winslow, MD, infectious disease physician at Stanford Health Care. There is still enough COVID-19 circulating in most communities that risk is still high for indoor exposure, Dr. Winslow explains. In the indoor environment, one person shedding virus can generate small particle aerosols that can remain suspended in the relative stagnant indoor air that can remain suspended for three to four hours and infect many people. Dr. Shira Doron, MD, Infectious Disease Physician and Hospital Epidemiologist at Tufts Medical Center, notes that vaccinated people are very well protected against infection, and when they do get infected (which is very rare) they almost never get a severe disease that lands them in the hospital. Especially as cases are declining in the country and continue to do so, a vaccinated person can do almost anything without a mask on. But you have to remember that no one knows your vaccination status in a public place. “In public places and settings where strangers interact with each other, we simply need to all wear a mask so we’re all doing the same thing and not creating chaos,” Dr. Doron explains. When you are in a private setting behind closed doors and you know the vaccination status of the people around you, it’s a different story. For instance, if you have unvaccinated people who don’t live together, they should not be mask-less indoors. But vaccinated people can be unmasked anywhere. Dr. Purvi Parikh, MD, allergist and immunologist at NYU Langone Health, says it’s important to always wear a mask indoors if you’re in a public place. “You should wear a mask in any public place that isn’t your home or the home of a vaccinated individual, such as gyms, grocery stores, and restaurants,” Dr. Parikh explains. “Even other people home who haven’t been vaccinated. If you are high risk for infection I would likely wear a mask anytime outside of your own home.”
In what situations is it unnecessary to wear a mask indoors?
“Where” to wear masks is the important part here, Dr. Shenoy explains. “Yes, fully vaccinated people interacting together is safe, but if you are in a public location or business or other location where the vaccination status of those around you is not known and close interactions are anticipated, or if your employer has established requirements for masking regardless of vaccination status, then you’ll be masking up.” It should also be noted that while study after study shows just how effective the vaccine is (which is fantastic news), there is emerging evidence that some individuals may not be as well-protected—specifically those individuals who have weakened immune systems or do not respond to the same way to vaccination. Because of this, in healthcare settings at least, we are advised by the CDC to apply the same practices we would for unvaccinated individuals to vaccinated individuals who are immunocompromised, Dr. Shenoy adds. Individuals with one of these conditions should certainly discuss any questions they have around masking decisions with their providers. Dr. Meghan Baker, MD, a physician from the Division of Infectious Diseases at Brigham and Women’s Hospital recommends wearing masks indoors (outside of your own household) with a few exceptions. “Fully vaccinated people who are not immunocompromised can consider visiting with fully vaccinated people indoors without wearing masks,” Dr. Baker states. “They can also consider visiting with unvaccinated people from one household who are at low risk for severe COVID-19 without wearing masks.” Next, here are the 10 biggest COVID-19 vaccine myths, debunked.
Sources
Dr. Erica S. Shenoy, MD, PhD, FIDSA, FSHEA, Associate Chief of Infection Control Unit at Massachusetts General Hospital and Associate Professor at Harvard Medical SchoolDr. Dean Winslow, infectious disease physician at Stanford Health CareDr. Shira Doron, MD, Infectious Disease Physician and Hospital Epidemiologist at Tufts Medical CenterDr. Purvi Parikh, MD, allergist and immunologist at NYU Langone HealthDr. Meghan Baker, a physician from the Division of Infectious Diseases at Brigham and Women’s Hospital
