For many of us in the U.S., the COVID-19 pandemic fundamentally changed our relationship with face masks. And as the pandemic continues to shift into its endemic phase, that relationship is changing.
The most recent mask guidelines from the Centers for Disease Control and Prevention reflect that evolving landscape. And, according to the latest estimates, 90% of Americans live in areas of the country where masking is no longer necessary — even indoors.
But, as those recommendations and mandates relax, some people may not want to stop masking in all scenarios. And others may have underlying conditions that make it necessary for them to keep wearing their masks.
With the new CDC guidelines, many more people can stop wearing masks indoors
The CDC’s latest guidance on masks uses a new metric called the community COVID-19 level to make its recommendations. That metric includes taking case data into account as well as the stress on the local health care system. When the level in your area is low, you don’t need to wear a mask. But as the level increases, masks and other precautions may become necessary.
“As we roll out vaccines and therapeutics, it is appropriate to change the goal metric from infections to hospitalizations and deaths,” Dr. Megan Ranney, emergency medicine physician and associate dean for strategy and innovation at the Brown School of Public Health, told TODAY.
“I’m excited by the new CDC guidance around masks. I think it is time to update the policy and follow the changing signs of this pandemic,” Amber D’Souza, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, told TODAY.
In particular, shifting to metrics that include hospitalizations is “a reasonable change to make at this point,” Dr. Taison Bell, assistant professor of medicine in the divisions of infectious diseases and international health and pulmonary and critical care medicine at the University of Virginia, told TODAY.
But experts still have two big looming questions about the guidelines, Ranney said. First, can the new CDC metrics accurately predict an increase in hospitalizations and deaths? “We haven’t yet seen the science behind them to support that,” she said.
And, second, are the actions the CDC recommends at different risk levels sufficient — especially when children under 5 still can’t get vaccinated yet? “Really, what it comes down to is a debate about the point at which masks need to be on to help protect vulnerable citizens,” Ranney said.
A shift to more individual decision-making
The new CDC recommendations represent a shift from the kind of collective public health response many experts have pushed for since the beginning of the pandemic to one based more on individual risk and personal decision-making.
“When the mask mandates are being rolled back in many settings, it still allows everyone to proceed based on their own personal comfort and what their risk level is,” D’Souza said.
And that level of personal comfort may even be different in different settings, she said. For instance, you might feel more comfortable entering a grocery store without a mask if you’re the only customer than you would be going to a packed concert unmasked.
But the new CDC metrics don’t offer much specific guidance for people who are immunosuppressed or have other underlying conditions that put them at a higher risk for severe COVID-19 beyond telling them to ask their doctor. “There are still people that are very vulnerable despite doing everything that they can to try to protect themselves,” Bell said. “And they are the ones who feel the most lost in all this and the most left out.”
You might be someone who is high-risk yourself, caring for or living with someone who is high-risk or someone who simply feels more comfortable with a mask on knowing it’s helping to protect the people around you — who could have risk factors you don’t know about. All of those are good reasons to keep masking even when CDC guidelines say you don’t necessarily need to, the experts said.
Don’t expect masks to be gone for good
Based on the new guidelines, it may no longer be necessary to wear masks in your area of the country. But that doesn’t mean they’re gone forever.
“I think (the guidelines) make sense for where we are,” Bell said. “(But) this could reverse, and you never know what’s going to happen with another variant.”
For instance, schools are rolling back mask mandates now, which is generally appropriate, D’Souza said. “But there may be situations next fall where the situation changes and rates increase or hospitals become more stressed and we may need to consider bringing masks back in certain contexts,” she said.
“What I suspect that we will see going forward is masks going on during surges and coming off when surges are gone,” Ranney said.
But whether or not local governments will go as far as implementing mask mandates during those moments isn’t clear yet. “I and other public health professionals would argue that mandates are critically important during moments of surges,” she said.
Some people may choose to keep wearing masks in the long term
Just because the recommendations are changing doesn’t mean you have to stop wearing a mask. And, in fact, there are plenty of COVID-related and non-COVID reasons some people might keep wearing masks in the future.
Many people who are at a higher risk for severe COVID-19 probably will and should continue to wear a mask when in close contact with people outside their household, depending on the advice of their doctor. For others, masks have become an easy way to protect themselves from other circulating illnesses, including the seasonal flu.
Masking may continue to be more of a priority in certain communities. “People from Black and brown communities have consistently wanted masking in indoor environments,” Bell said. “And if you look at the data, you understand why: They’re at the highest risk of having severe outcomes.”
There are practical considerations, too. For instance, Ranney said her daughter is continuing to wear a mask because she’s in a school play in a few weeks and doesn’t want to get sick beforehand. And Bell’s daughter wears a mask outdoors in cold weather even when he tells her she doesn’t need to simply because it keeps her warm. “She calls it her face blanket,” he said.
“Many people may choose to maintain these precautions long term for the sake of continuing to be healthy,” Ranney said.
Bell agreed: “I think it’ll be a part of the lingering effects of the pandemic, but for a good reason.”
D’Souza doesn’t expect masking to be especially common in the U.S. beyond the pandemic. “But I do hope and believe that for a subset of individuals who are more comfortable continuing to have that extra preventive level it will be more widely accepted,” she said.
If you’re among those who want to keep masking in the absence of mandates, all the experts TODAY spoke to emphasized the value of higher-quality masks; an N95 or KN95 respirator will be most helpful when it comes to one-way masking.
Ultimately, masks are just one tool we’ve come to rely on during the pandemic. They can be significantly helpful, but they aren’t our only option. And vaccination is still the backbone of our efforts to reduce COVID-19, Ranney said.