It is revisionist history for public officials to say now that the main reason they didn’t recommend mask use at the beginning of the pandemic was because there was such a scarcity and they needed to save them for health professionals.
In fact, there were other main reasons. There appeared to be little virus around (though certainly much more than we knew), and the science behind mask-wearing hadn’t yet been laser-focused on the physical properties of the SARS-CoV-2 coronavirus itself and how it spread. We were relying on influenza models before, during and after the 2009 swine flu pandemic, a less contagious virus that rides on larger respiratory droplets and doesn’t travel as far.
I can still remember last February when Asian Americans were falsely targeted because of the masks they wore in public intended to decrease coronavirus spread, driven by cultural norms. It turns out they were right.
We were learning as we went, and over time it became clear that the virus not only spread by small droplets but by aerosols, meaning that it could hang in the air and infect you even if you weren’t standing close to someone.
The degree of asymptomatic spread was also far greater than we realized at first. Models of masking as well as multiple population studies from the Centers for Disease Control and Prevention (CDC) and around the globe revealed the value (protecting both the wearer and those around him or her) of a well-fitting surgical mask in public, with cloth masks being less effective.
Unfortunately, despite the growing scientific value, the politicization of masks led to a pseudo-religion where a dirty mask hugging your chin became your ticket to a pious heaven, whereas the mask deniers eschewed any sort of compliance, putting themselves and others at risk. Practical public health rules were also quickly suspended for rallies, rodeos and riots.
But over the months, masks gradually became the norm, with a majority of Americans wearing them, though too often improperly. Overall, they have clearly been very important in our fight against the dreaded virus.
Flash forward to now, when all states are in various stages of reopening, despite the fact that the COVID-19 terrain is changing rapidly with more and more people being vaccinated. Thirty states, the District of Columbia and Puerto Rico continue to mandate mask-wearing. Recent studies show a very low risk of transmitting COVID-19 once you are fully immunized with either the Pfizer or Moderna vaccines.
So what’s the holdup in state governments telling us it’s okay to at least remove our masks once we are fully immunized, beyond the politics of fear and the need to control? Fear of emerging variants likely is one reason for the caution. Another likely reason is a desire not to be proven wrong if the virus comes roaring back. The CDC’s statement last Thursday was far too cautious: “The evidence isn’t clear whether they can spread the virus to others. We are continuing to evaluate the evidence.”
A much more helpful public health answer would be that we already know that your chances — if you are a fully vaccinated person — of spreading it to others is very low, but you should still wait until the amount of virus in the communities diminish before removing our masks indoors. This would be helpful for a shopkeeper, for example, who probably couldn’t tell the difference between a vaccinated person without a mask or an unvaccinated one. In the meantime, I, as a medical professional, will continue to wear my mask in public as a precaution as well as a courtesy.
Make no mistake, we, as a society, have suffered deep psychological wounds from all the avoidant, mummified behavior that will take months — if not years — to heal. We have over-personalized the risks of COVID-19 and feel it could get us at any time, even if it is barely possible once we have been vaccinated. Consider that masks, though clearly useful, have also become a crutch against fear of the virus that we continue to cling to.
At the same time, the last thing we need are more alarms and fear-driven messages coming from our leaders. CDC Director Dr. Rochelle Walensky’s comment about “impending doom” may have been a well-intended caution about the emerging viral variants that are spreading rapidly, and I understand that she doesn’t want to be caught underreacting. On the other hand, it is far more realistic to believe that rapid vaccination (combined with the natural immunity that already exists) can overcome these variants as it already has in Israel, the United Kingdom and parts of the U.S.
Worst-case scenarios may be a politician’s best friend, but they are often a patient’s worst enemy. The new vaccine reality is that we may not be needing these masks come late summer. They have had their important use, but their time is passing. It isn’t yet time to discard your mask, but I also wouldn’t invest heavily in a mask company.
Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID: the Politics of Fear and the Power of Science.”