At least temporarily (the Biden administration is appealing), the judge’s order ended obligatory mask-wearing on airplanes — a requirement that has lead to screaming fights between passengers and even assaults on flight attendants. Which raises the question, is it really safe to stop wearing masks, especially now that the highly contagious omicron subvariant BA.2 is causing COVID-19 cases to spike in some parts of the country? We asked Carlos del Rio, MD, distinguished professor of medicine in the division of infectious diseases at the Emory University School of Medicine in Atlanta, for his take on all things masking. The following interview has been edited for clarity and length. Everyday Health: Is the end of all these mask mandates a bad thing for Americans trying not to get COVID-19? Dr. del Rio: At some point it was always clear that mask mandates had to be ended. And I think with the way the COVID-19 numbers are in the United States right now, lower than they have historically been, you can say it makes sense for the end to be now. Plus, you have to ask whether people were really following the mandates at this point in time. “Mask” is a very broad term; Some people were wearing a bandana, which is not that protective. And many weren’t wearing their mask properly. I was in a grocery store in New York and I counted about 30 percent of the people wearing their mask under their chin or under their nose. So the most important question isn’t should we still have a mandate, but how can we ensure that people who want to wear a mask can continue to wear one. EH: What would stop people from wearing a mask if they want to? del Rio: Masking has become such a divisive issue in our country. People who were wearing masks were upset at people not wearing them, screaming and shouting at them. And vice versa. We all need to develop a certain degree of tolerance at this point in time, so everyone can choose to do what they want when it comes to masking. EH: Are masks still effective if you’re the only one wearing one? del Rio: In theory a person would be better protected if everyone around them was properly wearing a mask. But in reality that’s not the way it turned out to be, because as I mentioned, even people who were wearing masks often weren’t wearing them correctly. If you are wearing a well-fitted, high quality mask, even if you’re the only one, you should feel you are well protected. Throughout the pandemic I have been seeing patients who have COVID-19 where I’m wearing a mask and they are not, and I have not gotten infected. And I recently traveled on a plane wearing a mask, after the mandate ended, and I felt very comfortable. EH: What is required for a mask to be most protective? del Rio: People should be wearing N95, KN95, or KF94 masks. There are some counterfeit masks out there so you need to be careful about what you buy. [The Centers for Disease Control and Prevention (CDC) lists some counterfeit N95 masks to avoid on its website.] Importantly, the mask needs to fit well, which means it’s snug on your face. If you can get your fingers underneath the mask or if you can blow hard and feel the air outside the mask, that’s not sufficiently protective. You can wear each mask for several days or even a week in most cases before it needs replacing. As long as it doesn’t get wet, have a tear, or look misshapen, it’s fine. EH: Are there some people who should always wear a mask in a crowded indoor space? del Rio: The choice of mask wearing is going to be up to each individual based on their personal risk tolerance and their specific health situation. If you’re immunocompromised you might want to be more cautious. Same if you have children under 5 who cannot yet be vaccinated. It’s going to be an issue of each individual deciding how much risk minimization you want to do for yourself and for those in your family. Think of it this way: There’s no public health mandate that I’m aware of for wearing shoes. So there are some people who wear no shoes sometimes and others who wear flip flops that don’t protect their feet very much. But if you’re diabetic and don’t want to injure your foot, you probably wear shoes that are highly protective. It’s up to each person to make the choice of what’s best for them. Obviously, the pandemic has not gone away, omicron is highly contagious, and there’s a lot of COVID-19 in some communities. Because of this if I go to a crowded place where there are a lot of people I don’t know — the grocery store or public transportation, say — I’ll probably wear a mask. Plus, I like that masks are not only useful for COVID-19; they help prevent other infections like influenza or other respiratory viruses. Other people will make different choices and we have to be tolerant and respectful of that. The only people who need to wear masks all the time around other people are those who have COVID-19 and have isolated at home for the CDC’s recommended five-day period. [During the next five days if the person is asymptomatic or their symptoms are improving, the CDC no longer requires them to isolate but it does require they wear a mask around others to reduce the chances of spreading the virus.] Also others who are around someone who has COVID-19, such as if a family member in their household, should keep your masks on when near them. EH: Do you think some people are too worried about wearing a mask and avoiding risks when it comes to COVID-19? del Rio: We all have to live with some degree of risk, right? I mean, if you stay home and never go anywhere you won’t die in a traffic accident. But none of us do that because we’re willing to accept that risk so we can do things we enjoy. If someone is a healthy 25-year-old who has been vaccinated and boosted, it’s probably not going to be such a big deal if they get infected. That person maybe should reasonably decide to take more risks than an 80-year-old individual might take. For me, because I’m vaccinated and boosted, I’m doing things today that I wasn’t doing in 2020, like going to a restaurant where clearly I can’t be wearing a mask if I’m eating. EH: Aside from masking, what are the most important things people can do to keep themselves from getting very sick? del Rio: The most important thing is to be vaccinated as well as up-to-date with all recommended boosters. Regular hand-washing is also important hygiene. And if you get infected, take a test so you can be diagnosed, and isolate from other people to keep them from getting sick. There are better treatments now than there have ever been. If you do get COVID-19 and you are high risk and concerned, get a prescription and start treatment with an antiviral medicine right away.
