To Mask, Or Not to Mask

That is the question I am most often asked

To mask, or not to mask, that is the question:
Whether ‘tis nobler in the future to suffer
The fevers and coughs of infectious disease,
Or to mask up against an evolving virus
And through prevention end illness…

While Shakespeare scholars may be appalled by my rewriting of Hamlet’s soliloquy, it feels both timely and appropriate. When Hamlet asked “to be, or not to be,” he was depressed and fed up with the world around him; he was bemoaning how unfair life can be. I can relate to those emotions as we pass the 15-month mark of the pandemic. The pandemic is not over. The WHO is urging everyone (those who are vaccinated and those who are not) to continue to wear a mask indoors. CDC, on the other hand, is saying if you are vaccinated masks are no longer necessary.

This begs the question — to mask? or not to mask?

The short answer is YES, I am still masking. I have a 9 year old son who cannot get the vaccine. I also live in a county where less than 40% of the population is vaccinated. When I am inside - grocery shopping, at the library, at my favorite coffee shop, or in other places with others I do not know and do not know if they are vaccinated - I will be masked for the foreseeable future.

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Everyone (12+ years) needs to get vaccinated.

“If you are vaccinated with one of the vaccines authorized in the U.S., you are well protected from COVID-19.” ~ Dr. Leana Wen

YOU are protected. But individuals in your family, social circles, office, or community are not protected by your vaccination. We do NOT yet have herd immunity. To end the pandemic, we need to vaccinate a large proportion of the population and use other mitigation tools — masking, physical distance, proper ventilation, and proper handwashing.

We are in an “AND” moment in the pandemic. We need to be vaccinated AND using masks AND washing our hands AND, AND, AND…

To create healthy communities in the midst of a pandemic, we prioritize vaccines. If you are going to take one action to stop the spread of COVID, get vaccinated.

Wearing a mask indoors (regardless of your vaccination status) is also a great way to protect yourself AND slow/stop disease transmission. Here’s why I believe masks are still important —

1. Children under 11 years cannot get the vaccine and are at risk of developing COVID-19. A large proportion of the U.S. population (48.6 million kids) is not able to get the vaccine. Each of these kids is susceptible to a COVID infection and needs the protection of a mask. Set an example; normalize mask wearing. Kids really should be masked while indoors until they can get the vaccine.

2. Individuals (of all ages) with compromised immune systems may not develop immunity even after vaccination. They are also susceptible to illness and at high risk of developing severe COVID.

3. Breakthrough cases of COVID-19 do occur (these are cases of disease among individuals who are fully vaccinated). The vaccines were designed to prevent severe illness, hospitalization, and death. They have the added bonus of preventing symptomatic disease (in the majority cases). Vaccines offer tremendous protection, but they are not perfect.

4. The COVID vaccines reduce disease transmission - meaning a vaccinated individual is unlikely to transmit the disease to a susceptible individual - but they do not eliminate disease transmission. It is possible (though unlikely) for a vaccinated individual to pass the disease onto another susceptible individual. Masking adds an extra layer of protection against this.

5. New variants are being identified each week. The mRNA vaccines (Pfizer & Moderna) work well against the newest (most concerning) variant, Delta. Data from J&J regarding its vaccine and the Delta variant should be coming soon, but the public health community is optimistic that it will be effective. But Delta is more transmissible and may be causing more serious disease.

We cannot end a pandemic without collective action.

We all need to participate in the work to slow/stop disease transmission. This means…

• GET VACCINATED (if you are old enough)

• Mask up indoors in public spaces — masks provide an extra of protection and work to (further) protect our children, protect those with compromised immune systems, prevent breakthrough cases, reduce disease transmission, and slow the development of new variants.

• Continue to wash your hands.

If you have any questions about whether or not you should wear a mask indoors, please consult this guide —

Low vaccination coverage = less than 50% of the population; high rate of disease transmission = more than 10 cases per 100,000 individuals per day. And a huge shout-out/thank you to my daughter, K, who created this flow chart.

Bottomline — wearing a mask indoors is a simple way to show you care about our community’s health. When you see me out and about with my mask on, I am signaling to you that I want to live in a healthy community AND that I want to protect those who are unable to get the vaccine at this point in time.