Mask or not?

Lately nothing sets off debate more easily than the issue of face masks. Can we go without, safely and in good conscience?

As recently as March 19, Centers for Disease Control Director Dr. Rochelle Walensky warned about her “impending sense of doom” about another spike in COVID-19 cases as states began relaxing or eliminating mask mandates and social restrictions.

On May 14, the CDC announced new guidelines specifically stating that fully vaccinated people can safely go without masks indoors and outdoors, with limited exceptions. Confusion is understandable.

CDC guidelines have changed with new data showing that vaccines provide 95 percent protection against COVID-19. These data were collected from front-line workers, those most significantly exposed.

Original guidelines were based on incomplete data regarding the extent to which the vaccines protect against “silent transmission,” in which vaccinated people might still be able to carry the virus, spreading it to others despite being asymptomatic.

The latest data have put that fear to rest. Three major studies have now shown that fully vaccinated individuals are protected from even asymptomatic cases. Eighty-nine percent of vaccinated people studied carried no virus at all. Those who did acquire asymptomatic cases still only had one fourth the viral load (amount of transmissible virus particles) as non-vaccinated people.

Overall, vaccinated individuals are highly unlikely to become infected or carry the virus to others. The J&J vaccine has been known to protect against asymptomatic infections since its clinical trials measured the efficacy of the vaccine by using Polymer Chain Reaction testing rather than simply looking at symptomatic infections. So why are some people still unwilling to stop wearing masks?  

Some of the confusion is likely due to previous CDC guidance issued before data emerged that non-symptomatic transmission of the virus is extremely unlikely in vaccinated people. Other reasons are more complicated, like not being able to tell who has been vaccinated.

Nearly all state requirements for masks and social distancing are essentially unenforceable. Most states have either no consequences for non-compliance with mask ordinances, or law enforcement reluctance to enforce any penalty. And recently, some states have done away with mask requirements altogether. So why do so many people still wear a face mask?

One reason many people still wear a mask is because vaccines aren’t 100 percent effective. Sure, 95 percent effectiveness is amazing for any vaccine. Unless of course you’re in the five percent not protected. In that case, you may still be both infected with and spread the SARS-CoV-2 virus.

No one wants to be the reason for someone else becoming infected, and there’s doubt we will reach herd immunity, since only 69 percent of Americans say they have been or are willing to be vaccinated. The original theory was that 70 percent immunization would result in herd immunity, but that, too, has been revised, due primarily to the B.1.1.7 variant, first discovered in Britain, now widely circulating in the United States.

This strain is 60 percent more transmissible than the original or “native” strain of the virus. Now it’s estimated that 80 percent immunization would need to be achieved to reach herd immunity. Available data reflect only the percent of United States adults who have been or plan to be immunized. It does not include children, who are less likely to become seriously ill from COVID-19 but who may spread the virus to others, and who are less likely to become vaccinated than adults.

Another reason some may not ditch the mask is because they have either not been made aware of the latest research data or don’t trust it. Recent news from the CDC that vaccinated people don’t carry the virus hasn’t garnered full belief. Also, the fear of transmitting the virus to vulnerable populations remains a concern. Because the vaccines aren’t 100 percent effective, the immunocompromised or unvaccinated populations remain at risk.

Why did the CDC change the mask guidance? Could it be that the new guidelines were written for the sake of enticing more folks to be vaccinated? Are there are people asking, “What’s in it for me?” Although the CDC denies it’s caving to such thinking, several states have been using incentives to vaccinate, including free lottery tickets in New York, Maryland, Kentucky, and Ohio. New Jersey generously offers “a beer and a shot.”

In my interview with Don Stewart, MD, of Birmingham, Ala., he said, “I will continue to mask, if for no other reason than my community is only around 30 percent vaccinated, with a high proportion of anti-mask, and anti-vax sentiment in the population. This means that there is a large group of people here who are potential carriers of COVID-19. I understand that as a fully vaccinated person I have a low, even negligible chance of acquiring or transmitting the initial strain of the SARS-CoV-2 virus.

“We have seen more contagious variants erupt and spread in other parts of the world, with new mutations liable to emerge anywhere, without warning. Until we reach effective community immunity, we are all at risk of catching and transmitting not only the standard virus and its known variants, but whatever may crop up in the interim.

“Masking, hand washing, and social distancing remain the best ways to prevent spreading and generating disease, and we already know how to do it. Until this virus is more effectively under control, I will continue to wear my mask – to protect myself and other members of my community.”