Should you still wear a mask in close quarters in a store, a restaurant or a gym if you haven’t been vaccinated? Yes, you should. What if you have been fully vaccinated with two shots of an mRNA vaccine? It’s probably not necessary to mask up but I still would, as a precaution against the very small chance that you could pick up the virus and transmit it to others.
It turns out the SARS-CoV-2 virus can be aerosolized, meaning that it can hang in the air. Hence, poor ventilation and length of exposure to someone who may be infected are far more important factors than is social distancing.
Multiple population studies over the course of the pandemic have shown that masks have a value, especially indoors among crowds of unvaccinated individuals, but it’s less so now that almost 60 percent of American adults have already received at least one shot of a COVID-19 vaccine and new case numbers are decreasing around the country.
I think that the Centers for Disease Control and Prevention (CDC) should have rolled back their mask guidance several weeks ago, as new case numbers and death rates from COVID-19 began to drop, and as it became clearer and clearer that the vaccines not only kept you from getting sick with COVID-19, but also decreased transmission. Government mask mandates should be removed all across the country, and rules should be left to individual businesses.
The full court press is on to get more people vaccinated. It is good news that 3.2 million Americans received a shot on Saturday and 2.7 million on Sunday. We need to keep up this rate to reach a point where enough people are immune to quash future outbreaks.
At the same time, I believe we need to develop a verifiable proof of immunity — as soon as possible — so that those who have gotten over COVID-19 can claim proof of immunity even before they take at least one dose of the vaccine. Especially if a patient has received monoclonal antibodies against COVID-19, there is a period of time, of several weeks, between when they become naturally immune and can’t catch or spread COVID-19, before which I wouldn’t suggest a vaccine. This group should probably be treated the same, or similar, if they had received a vaccine.
CDC guidelines over the course of the pandemic have often been confusing and conflicting, and they have also been followed too closely. Guidelines are meant to guide. We physicians are loaded up with all kinds of guidelines, some of which we follow, and some we don’t, depending on the patient and the situation.
The hesitancy over parsed and conditional CDC guidelines when it comes to schools and camps has been particularly problematic. Schools should all be open, period, regardless of the amount of COVID-19 in the community, without a focus on social distancing, with masks suggested but not forced, especially among younger children. The loss of face-to-face communication for more than a year has been psychologically damaging (hyperlink needed). Between the increased availability of vaccines and rapid testing, all schools and camps can be safely open and could have been for some time.
I understand the need for caution but, too often during the pandemic, public health measures have been too inflexible, laced with politics and, most importantly, have lagged behind evolving science.
The path from here to the end of the pandemic is simple and straightforward: Take your vaccine, wear your mask in close quarters, return to social and work activities that help overcome torpor, and leave dogma and judgment of others behind.
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."