Many Americans who had been vaccinated against COVID-19 were confused earlier this week when the Centers for Disease Control and Prevention announced updated guidelines encouraging them to wear a mask when indoors, in public areas in areas with “hazardous health.” substantial or high” levels of the virus. The move is a 180 from the guideline released in mid-May, which stated that people who have been fully vaccinated against COVID-19 no longer need to wear masks.
There has been very much of talking about what exactly this means for people – and a lot of questions. “Can anyone tell us what substantial or high means????” a person wrote on Twitter. “Why schools and no other indoor [institutions]? I understand that, since younger children cannot be vaccinated, primary schools [but] why K-12?” another said.
There have also been many questions about what this means for things like attending weddings and wearing a mask in your own home when you have company. The CDC hasn’t covered all the nuances, but infectious disease experts have some insight. Here’s a rundown of some of the biggest questions many people have about remasking, and what it means for you.
How do you know if you need to mask indoors?
The CDC has a user-friendly interactive map online that allows you to search for COVID-19 data by state and province. Simply enter your information and you will get results that tell you if the transmission of COVID-19 in your area is low, moderate, substantial or high. It also lists vaccination records in your area, such as how many adults have been fully vaccinated.
Should you start masking indoors in your home?
It depends on a few things, including your personal risk tolerance. Technically, the updated CDC guideline “applies only to places of high or substantial transmission and only to public places, so [it] does not suggest that people wear masks in their own homes,” infectious disease expert Dr. Amesh A. Adalja, a senior scientist at the Johns Hopkins Center for Health Security, told Yahoo Life.
But it’s important to consider the vaccination status of your guests, Dr. William Schaffner, an infectious disease specialist and professor at Vanderbilt University School of Medicine, tells Yahoo Life. “If your guests are vaccinated, you don’t have to wear a mask,” he says. “It’s having unvaccinated people come to your house where there’s a real concern.”
Are doctors changing their behavior with the latest guidelines?
Not really. “I have some gray hair, so I’ve always worn my mask,” Schaffner says, pointing out that he wears his mask when he’s running errands on Saturday mornings and in other public areas.
But Adalja says he’s “not changing my behavior,” which includes dining indoors. Nor has Dr. Thomas Russo, a professor and chief of infectious diseases at the University at Buffalo in New York. “I haven’t used masks in indoor or outdoor settings,” he says. But, he emphasizes, he lives in an area with a “moderate” distribution. “We still have a little wiggle room,” he adds.
“Personally, I don’t think the science supports masking for vaccinated people at this point,” says Dr. Lewis Nelson, chairman of the emergency medicine division at Rutgers New Jersey Medical School, told Yahoo Life. “But the problem is there is no way of knowing who has been vaccinated and who has not. From a personal safety point of view I am not too concerned about getting COVID as I am immunized. From a public health point of view I am I am very concerned about the people who are not immunized and become factories of the next COVID variant that may go undetected by the current antibodies generated by the vaccine.”
In the end, “Some of us have stayed more careful than others, but I would definitely urge everyone now to get your mask out of that drawer and put it back on,” Schaffner says.
Should Vaccinated People Be Tested?
Regular testing is not recommended for people who have been vaccinated against COVID-19 unless they have symptoms, Adalja says. “However, the new guidelines state that vaccinated people who have been significantly exposed to COVID will be tested three to five days later,” he emphasizes.
Testing is likely to become more important as we get into cold and flu season, Schaffner says. “As the weather gets cooler, we may be doing a lot more testing to differentiate between flu, RSV and COVID, even in people who have been vaccinated,” he adds.
Nelson says he is “very concerned about the guidance on testing people who are fully vaccinated,” calling it “terribly regressive.” He adds, “There’s really no data that says they’re contagious — just that they have the virus.”
Many places require vaccination certificate or a negative COVID-19 test result within 72 hours for public events. Why 72 hours?
Lollapalooza is the latest festival to apply this rule, but Adalja says 72 hours is nothing magical when it comes to COVID-19 risk. “The 72-hour window is more of a function of how quickly people can get test results back,” he says.
Schaffner agrees. “Everyone is trying in their own way to follow these general recommendations and apply them in a way that seems to work pretty well,” he says. “Testing unvaccinated people within 72 hours of attending a concert isn’t perfect, but it will rule out some people who are positive. It’s an attempt to lower the risk, but not ‘safe’.”
How can you stay safe at bigger events like weddings this summer?
Many couples who are postponing wedding plans at the height of the pandemic are now moving on with them — but the revised CDC guidelines have caused some confusion. “If you’re attending a big event, make sure you’re vaccinated and urge organizers to only allow vaccinated individuals,” Adalja says. “The odds of a fully vaccinated person having a significant breakthrough infection are very slim.”
Schaffner agrees. “If not everyone in attendance is required to be vaccinated, why didn’t the bride and groom insist on it?” he says. “You have to know the policy, including whether there will be an encouragement that everyone will be masked.” Based on this, you can make a decision about your personal risk.
Are you at risk if your fully vaccinated partner does not want to wear a face mask?
Schaffner says there is “no single formula,” pointing out that this is something couples “have to work out.” Still, he adds, “If you’re both vaccinated, that’s a really good start.”
How can ordinary people estimate their risk?
Schaffner recommends going to your local data on COVID-19 cases for insight. “No community is COVID-free, but some have more transmission than others,” he says. “Also, who are you and what are your underlying health conditions? All of these things should play a part in your personal sense of how persistent you want to be.”
Keep this in mind, according to Adalja: “If you’re a normal person and are fully vaccinated, your risk of significant illness from COVID is vanishingly small.”
What else should I pay attention to when switching mask guidance?
Schaffner urges people to remember that the CDC is trying to update the guidelines to reflect the latest data. “They react to changing circumstances,” he says. “We have to be flexible. It’s the reality.”
But Adalja is not convinced that the new guidance is necessary for many fully vaccinated people. “I don’t think the CDC guidelines for masked persons are justified,” he says. “This is a pandemic of unvaccinated people, and the marginal — if any — benefit of vaccinated people wearing masks in a high-prevalence environment isn’t going to have much of an impact.”
He is also concerned that the return of masks to indoor environments will further discourage people from getting vaccinated. “It will undermine confidence in the vaccine and probably won’t make much of a difference to the people who have abstained from vaccination until now – they wouldn’t see a reason to get vaccinated now if it doesn’t change anything for them,” he says. .
Russo urges people to keep this in mind: “The honor system has failed. Mask mandates will hopefully get the unvaccinated people to wear masks. But in the end, vaccination is our ticket to get out of this.”
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