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Should You Wear a Mask on Planes? Or maybe anywhere?

Mask mandates are rapidly fading. Is it, however, truly safe to go without a mask? Carlos del Rio, MD, an infectious disease expert, weighs in.

When a court in Florida abruptly knocked down the federal mask mandate for public transit on April 18, 2022, Americans reacted with a range of emotions, from joy to fear.

The judge’s judgment stopped mandatory mask-wearing on airlines, at least temporarily (the Biden administration is appealing), a policy that has resulted in scream battles between passengers and even assaults on flight attendants.

Is it really safe to quit wearing masks now that the extremely contagious omicron subvariant BA.2 is producing an increase in COVID-19 infections in some parts of the country?

Carlos del Rio, MD, distinguished professor of medicine in the division of infectious diseases at Emory University School of Medicine in Atlanta, gave us his thoughts on the subject. For clarity and duration, the following interview has been modified.

Is the termination of all these mask restrictions a bad thing for Americans seeking to avoid contracting COVID-19?

Dr. del Rio: It was always evident that mask mandates had to be repealed at some point. And, given the current state of COVID-19 numbers in the United States, which are lower than they have been in the past, I believe the end is near.

Furthermore, you must consider if individuals were actually following the mandates at the time. “Mask” is a broad term; other people wore a bandana, which isn’t very protective. Many of them were also not wearing their masks properly. I was in a New York grocery store and saw that roughly 30% of the customers had their mask on under their chin or under their nose.

So the most pressing question is not whether we should keep the requirement, but how can we assure that people who wish to wear a mask may do so.
EH: What’s to stop folks who want to wear a mask from doing so?

del Rio: In our country, masking has become such a contentious topic. People who wore masks were enraged by those who did not, screaming and shouting at them. Likewise, vice versa.

At this point, we all need to establish a certain level of tolerance so that everyone can do anything they want when it comes to masking.

EH: Is it still effective to wear a mask if you’re the only one wearing one?

del Rio: A person would be better protected in theory if everyone around them was wearing a mask properly. However, it was not the case in reality, because, as I previously stated, even persons wearing masks frequently did not wear them appropriately.

Even if you’re the only one wearing a well-fitting, high-quality mask, you should feel well protected.

Throughout the pandemic, I’ve seen patients with COVID-19 who aren’t wearing a mask while I am, and I haven’t been infected. And, after the requirement ended, I traveled on an aircraft wearing a mask and felt perfectly safe.

EH: What does a mask need to be the most protective?

People should wear N95, KN95, or KF94 masks, according to del Rio. There are some fake masks on the market, so be cautious about what you buy. [On its website, the Centers for Disease Control and Prevention (CDC) warns against counterfeit N95 masks.]

The mask must also fit well, which means it must be snug on your face. If you can reach your fingers underneath the mask or feel the air outside the mask when you blow hard, it’s not properly protective.

In most circumstances, each mask can be used for many days or even a week before it needs to be replaced. It’s alright as long as it doesn’t get wet, has a tear, or is deformed.

EH: Should some persons always wear a mask in a crowded indoor environment?

del Rio: The decision to wear a mask will be made by each individual depending on their unique risk tolerance and health state. If you have a compromised immune system, you should exercise caution. Same goes for youngsters under the age of five who have not yet been vaccinated. It will be up to each individual to decide how much risk minimizing they wish to do for themselves and their families.

Consider this: I’m not aware of any public health mandate mandating the wearing of shoes. So some people go without shoes on occasion, while others wear flip flops that aren’t very protective of their feet. If you’re diabetic and don’t want to harm your foot, though, you’re undoubtedly wearing highly protective shoes. It is up to each individual to decide what is best for them.

The epidemic hasn’t gone away, omicron is highly contagious, and certain areas have a lot of COVID-19. As a result, if I go somewhere busy with a lot of people I don’t know — instance, the grocery store or public transportation — I’ll almost certainly wear a mask. Plus, I like that masks are useful for preventing diseases other than COVID-19, such as influenza and other respiratory viruses.

Others will make different decisions, and we must be tolerant and appreciative of their choices.

Only persons who have COVID-19 and have isolated at home for the CDC’s recommended five days need to wear masks all the time around other people. [If the individual is asymptomatic or their symptoms are improving after five days, the CDC no longer advises them to isolate, but they must wear a mask around others to prevent the virus from spreading.] Others who are in close proximity to someone who has COVID-19, such as family members, should wear masks.

EH: Do you believe that some people are overly concerned with wearing a mask and avoiding hazards when it comes to COVID-19?

del Rio: Isn’t it true that we all have to live with some level of risk? You won’t die in a car accident if you stay at home and never leave. But none of us do it because we’re willing to take that risk in order to pursue our passions.

If you’re a healthy 25-year-old who has been vaccinated and boosted, being sick is unlikely to be a major problem. That person may be able to rationally decide to take more risks than an 80-year-old person.

I’m doing things today that I wouldn’t have done in 2020 because I’m vaccinated and boosted, like going to a restaurant where I can’t wear a mask while eating.

EH: Aside from masking, what are the most significant precautions people can take to avoid becoming really ill?

del Rio: The most important thing is to be fully vaccinated and current on all necessary boosters. Hand washing is also essential for good hygiene.

If you become infected, be tested so you can be diagnosed, and isolate yourself from others to prevent them from becoming ill.

There are better treatments available now than ever before. If you contract COVID-19 and are concerned about your risk, acquire a prescription and begin antiviral therapy right once.

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