William Miller, MD
CDC’s New Mask Recommendations
Updated: Jul 14, 2021
On May 13th, the CDC revised its recommendations around masking and social distancing to indicate that people who are fully vaccinated do not have to wear masks in most public settings both indoors and out. The recommendations have not changed for people who are unvaccinated. This has caused a great deal of commotion in the news media with some claiming that this came as “an abrupt about-face”. However, that would suggest a surprise, 180-degree turn. Instead, I see this as the next logical step in further relaxing of restrictions as we move towards more people being vaccinated. To me, at least, it is neither abrupt nor a reverse of direction. Here is why.
The evidence has been mounting that the vaccines are effective in not only preventing spread from one individual to the next, but also in reducing the severity of symptoms if infected resulting in decreased hospitalizations. Yes, there will be those who are vaccinated who may still develop a case of COVID. Remember, no vaccine prevents you from becoming infected. Instead, they help prevent you from becoming ill and transmitting the virus. With a 94%+ effectiveness, that still means that about 1 in 20 persons who are vaccinated will become ill if they get infected. However, it is clear that when that 1 out of 20 person does get ill, they don’t get severely sick. Some in the news media are hyping these cases as “breaking through” the vaccine, but that is a false narrative. Such would only be true if the vaccine was expected to be 100% effective, which we know it is not.
This is also true for the new variants in which the vaccine may be less effective. Less effective here does not mean that the vaccines offer no protection. To the contrary, for the most notable variants being the one in Brazil and the one in South Africa, the vaccines still greatly help reduce severity of illness even though they may have an effectiveness on the order of 70%. And 70% is pretty good for any vaccine.
Concern is also raised that some unvaccinated people may lie and say they are vaccinated just to avoid wearing masks. However, as I see it, that is not an issue. The CDC had already directed weeks ago that, based on scientific evidence, a person who is vaccinated does not need to quarantine or take special steps even if they are exposed to a person with known COVID and even if neither were wearing a mask. When I heard that change, it made sense that this new recommendation would soon follow. Thus, it doesn’t matter for you. What this is saying is that if you are fully vaccinated, then you can be around others regardless of their COVID status, their vaccination status or if they are wearing a mask or not.
Since the beginning of this pandemic, there has been a tug-of-war around loss of personal freedom to make one’s own health choices versus the need to protect the public. It seems to me that this strikes a good balance. It encourages people to get vaccinated, which is a personal choice that also helps the public good, and the person may then forgo masking if they so choose. Vaccination is the key to putting this pandemic behind us.
Current US vaccination rates show about 38% are fully vaccinated. An additional 10% are partially vaccinated which still gives an effectiveness of about 70%. That leaves about half the county still unvaccinated. Well, 30% are saying they won’t get the shot no matter what and the remaining 20% are on the fence. As I see it, let’s give that 20% a reason to move forward and get vaccinated.
Having said all of this, we do need to remain clear that the pandemic is not over and no one should be suggesting that it is. If it behaves like similar pandemics, we still have at least a year to go. During that time, we will continue to see new waves and new variants. Cases will ebb and flow, even in America with it’s relatively high vaccination rates. We need to keep in mind that the key to suppressing the pandemic will be through herd immunity from vaccination.
There are some important exceptions to the new guidelines. First, they do not apply to hospitals and other health care settings. In those settings everyone will still have to wear a mask regardless of vaccination status, at least for the time being. Second, it does not apply to any form of public transportation, such as on airplanes, trains, etc.
In the end, if you are fully vaccinated, but are still concerned about your safety, then continue to wear a mask. Doing so will add that extra level of safety and security that you are seeking. The difference is that now you get to make that choice. It is that simple.