One size fits all policies rarely fit anyone. The new Centers for Disease Control and Prevention (CDC) mask guidelines focus on the most important metrics as the COVID-19 virus enters its endemic phase.
With around 80 million confirmed cases, likely twice as many more unconfirmed cases, as well as over 76 percent of the entire population having received one or more vaccine doses, population risk has plummeted.
Infections will continue to occur, but with so much population protection against severe disease that requires hospitalization, the new CDC mask guidelines focus not only on new cases, which became far too narrow to be meaningful, but now include metrics that protect the most important asset to ensure personal freedoms, our nation’s hospitals and healthcare system.
Face masks work to reduce (not stop) the spread of the virus, if they are of high quality and used correctly. N95 are the gold standard, although other comparably effective options are available.
Efforts to completely prevent all infection transmissions have proven to be futile, as was observed with the omicron variant and the enormous spike of infections that occurred in January 2022. If a similarly highly contagious variant emerges and new cases spike, with the associated demand on hospitals and the health care system, the CDC face mask guideline metrics will respond appropriately, shifting counties with surging new infections and hospital demand to the highest level of risk.
The new guidelines do not preclude people from voluntarily continuing to wear face masks, and many groups will continue to do so. For example, those who are immunocompromised and remain highly vulnerable to severe disease are likely to continue to wear a face mask while indoors in crowded areas. Continuing to take appropriate precaution will continue to be in their own best interest.
Those with underlying health conditions that place them at higher risk of severe disease may also make this choice. Given that increased age has been associated with increased risk of severe disease, those over 65 years old may also opt to wear face masks in high-risk environments.
The CDC new face mask policy signals a recognition of the endemic phase of the virus. As difficult as the transition was when stay at home orders her implemented in March and April 2020, the transition from the pandemic phase to the endemic phase is fraught with uncertainty and most certainly subject to criticism.
On one extreme, there are those that never believed that the virus was a significant threat and that face masks were unnecessary and ineffective. This group would view the updated CDC face mask policy as not going far enough, and that face masks continue to serve no useful purpose.
On the other extreme, there are those who argue that relaxing previous face mask guidelines is premature, perhaps even leading to spikes in new cases. This was recently observed in Denmark when they dropped all face mask requirements. This group is also sensitive to the needs of the most vulnerable, who need to take all precautions to protect themselves.
We now know enough about the virus and COVID-19 that the new CDC face mask guidelines move closer to more personal risk assessment and responsibility.
The most optimistic endgame is that hospitalization demand will continue to drop across the entire nation, and that every county will be in the lowest risk level, which effectively will mean that face mask use is optional and based on personal preference and choice.
Reaching this endgame will require more safe and effective therapeutics, so that when people do become infected and appear to be on-track to develop severe disease, they can be treated appropriately to ideally keep them out of hospitals and alive.
The new CDC face mask guidelines are a step in the right direction. They guidelines could have been implemented months earlier if the uptake of the vaccines was higher. Nonetheless, they represent a clear signal that the virus is now on the road to becoming endemic.
Sheldon H. Jacobson, Ph.D., is a founder professor of Computer Science and the Carle Illinois College of Medicine at the University of Illinois at Urbana-Champaign. He applies his expertise in data-driven risk-based decision-making to evaluate and inform public health policy.