The reopening of the economy amid the pandemic has generated confusion among Americans about whether they should continue wearing masks. The Centers for Disease Control (CDC) says that vaccinated people can forgo the mask, whereas the World Health Organization (WHO) suggests that even those who have already received the double dose against Covid-19 should continue wearing them. There is no federal policy in this regard, and states and counties issue their own guidelines.
Three medical experts speaking at a briefing hosted by Ethnic Media Services warned that masks are here to stay, especially given the rapid spread of the powerful Delta variant, one of the most contagious and deadly of the coronavirus strains identified so far. It is more transmissible than other variants such as P1 and Alpha, and even such diseases as smallpox.
“The Delta variant is a 2.0 pandemic variant,” said Dr. Eric Feigl Ding, a public health scientist who is currently a senior fellow at the Federation of American Scientists. “It is two times more transmissible than the oldest strain Wuhan 1.0, and it causes 4.9 times greater risk of hospitalization than the original strain…Basically it’s faster, it’s more severe and it’s very vaccine evasive.”
Delta is the dominant variant in the United Kingdom and India where Covid infections have skyrocketed. Because even those who have received two shots and gained immunity can still transmit the virus, giving up the masks is feeding the chain of contagion.
“The science is really settled around masks,” Ding said. “Studies, including those from the CDC, show that masks help, especially if you double-mask, by reducing aerosols inhaled by someone else.”
The scientist emphasized that the best protection comes from the so-called premium masks most commonly used by medical personnel: K95, FFP2, N95 and 3M. But using a double cloth mask considerably reduces the risks of contagion.
The biggest debate now is about whether vaccinated people should continue to wear masks, and this answer depends on vaccine efficacy, which is increasingly being tested with the emergence of new variants.
Doctors warn that the constant mutation of the virus will favor the appearance of other strains, because as long as herd immunity is not reached, the coronavirus will continue spreading. And herd immunity is an elusive goal in the United States where only half the population is vaccinated. In some counties, vaccination rates are as low as 20%.
“Anywhere that the virus is growing, whether it’s in a child or a young person, even if there is no disease, the virus is changing, so mutations will continue to accumulate indefinitely,” said Dr. Ben Neuman, chief virologist at the Global Health Research Complex at Texas A&M University.
“The more we let (the virus) mass infect and the less mitigation we take against it, it eventually will find an immunocompromised person or someone suffering from cancer, so we have another immune disorder or even worse mutations,” added Neuman.
In recent weeks, Covid cases have increased across the country. In south Los Angeles, only 40% of the population has received two doses of the vaccine. Dr. José Pérez, chief medical officer at the South Central Family Health Center, said that to protect those unvaccinated, who are the majority, “even vaccinated people should be wearing masks, especially when they are going to be in contact with large groups.”
Despite the severity of the Delta variant, the doctor says that the demand for vaccines in Los Angeles has dropped and that while the CDC “tries to make recommendations for an entire country,” medicine requires seeing each patient’s uniqueness. That makes it necessary to “adapt the message” for different populations and risks.
“A lot of our patients suffer from anxiety and depression…and we saw a tremendous drop in the number of people seeking mental health services because doctors wore masks,” Pérez said.
“We implemented telehealth so they could see our faces because they felt that social cues were missed in these interactions…The message should be that the benefit of maybe missing some of that is the fact that you prevent one, two, three or 1,000 deaths.”
Back to School
As a vaccine is not yet ready for children under the age of 12—clinical trials are expected to be completed in late September and early October—there is concern about the interaction of students who might be carriers with teachers and parents. The CDC has said that the reopening of schools depends on community transmission, without suggesting specific rules regarding vaccines, use of masks or minimum ventilation conditions. These decisions are left to the counties.
“We really need masks for children,” said Dr. Ding. “But more than that, we need ventilation and air disinfection because we can’t always open windows (in classrooms) and you can’t just say that children are immune. That’s not true.
“The solution to an airborne transmission is air disinfection with HEPA [high efficiency particulate air] and UVGI [ultraviolet germicidal irradiation] filters recommended by the CDC…All teachers can buy those for schools with money from the (federal) Covid relief package.”
The scientists agreed that there are many theories circulating on social media promoted by the anti-vaccine movement or those who do not believe in the virus, which can influence people’s decisions.
“I think the CDC is giving credibility to those who say we don’t need rules,” Dr. Ding added. “Local public health leaders need to understand that until vaccinations get high enough, we have to focus on other things like masking, ventilation, disinfection, contact tracing and mass testing wherever there are hotspots.”
Dr. Pérez thinks that “every single American is hearing all these different voices, and they are going to choose one that fits them…Hopefully, the CDC will be a little more aggressive because although there are many people who might not like to hear the idea, I think masks are here to stay.”