This week, the governors of nearly a dozen states, including California, New York, Massachusetts, Connecticut and New Jersey, said they would soon lift or loosen indoor mask mandates, citing COVID-19 vaccination rates, “the extremely low risk for young people” and lowered hospitalization rates.
But the U.S. Centers for Disease Control and Prevention is still recommending that people wear masks in areas of high virus transmission and in schools, regardless of vaccination status. Many businesses are still requiring employees to be masked in the office.
“We have and continue to recommend masking in areas of high and substantial transmission ― that is essentially everywhere in the country in public indoor settings,” Dr. Rochelle Walensky, the CDC director, said in an interview Tuesday with Maryland radio station WYPR. “Right now we still have about 290,000 cases every single day, and our hospitalization rates now are higher than they even were at the peak of our delta surge.“
With these conflicting messages, it’s easy to get confused about what you should be doing when you go to work, especially in an indoor office setting.
This is where experts who research COVID and public health measures come in. HuffPost asked COVID health experts what they are personally considering before they decide that they can take off their masks at work. Here’s what they want to see first:
1. When there’s low transmission of the virus in their area, which could be soon but is definitely not right now.
Each expert HuffPost interviewed said that low community transmission is a factor they’ll consider necessary before going maskless at work. None had an exact date of when that might be.
Syra Madad, an infectious disease epidemiologist who works for New York City’s hospital systems, noted that health care workers like herself are under different state and federal masking directives. But for people who don’t work in health care, ”given New York City is still experiencing high levels of community transmission, I would keep masking for a little while longer until case counts come down a bit more.“
When asked if he would be comfortable going maskless indoors at work where he lives, Mark Rupp, chief of the division of infectious diseases at the University of Nebraska Medical Center, replied, “Currently today in Omaha, Nebraska? No.”
He pointed to the rate of infections in his community as a reason why. “We are coming off our omicron wave, but we are nowhere close to where I would like to see it be. Here in our county, we are running 45 cases per 100,000 per day…. I’d like to see that somewhere in the neighborhood of 10 [cases per 100,000].”
He also pointed out that even after low community transmission is reached, employees should keep an open mind and be prepared to go back to wearing masks if another coronavirus variant causes a fresh wave of infections. “We are going to be in this ebb-and-flow situation where another variant is likely to come along. When that happens, people need to be nimble and flexible.”
Deborah Fuller, a microbiologist working on coronavirus vaccines at the University of Washington, estimates that she would start to be more comfortable going maskless at work in April or May, citing daily death and infection projections from the Institute for Health Metrics and Evaluation that are expected to be much lower by April.
But right now, transmission rates are high. “If you walk in a room where somebody had omicron and you don’t have a mask on, you are guaranteed to pick that thing up,” Fuller said.
2. When hospital resources are not past capacity and COVID therapies are easier to get.
“In the coming months, the case rates will go significantly down, and it will be time to throw our masks away,” said Lawrence Gostin, a global health law professor at Georgetown University. “But now is not a good time to get COVID-19. The reason is because cases are still high and our hospitals are at full capacity, so we may not get the best health care.”
In a February article for JAMA Health Forum, a peer-reviewed journal of the American Medical Association, Gostin wrote that it may be too soon to shift to an endemic phase of the pandemic while omicron-related hospitalizations remain high and effective therapeutics are scarce.
“There is an extreme national shortage of effective treatments that can keep us from getting serious disease, hospitalization and even death,” he told HuffPost, citing the lack of access to monoclonal antibodies and oral antiviral pills. “We should continue to take care to avoid getting infected until conditions are more favorable. That is likely to happen in the next couple of months, but it is too soon to throw caution to the wind.”
3. When their colleagues are fully vaccinated.
Madad said to consider what local epidemiological data is saying about the rate of COVID transmission and vaccination. “If vaccination rates are low, cases are high, hospitals in your area are still stretched, you should continue masking indoors,” she said.
For non-health-care workers in New York City, for example, she recommended mask-wearing indoors until COVID case counts go down more.
“My exception is if I’m around colleagues who are fully vaccinated, then I’d be comfortable with going maskless,” Madad said.
Rupp said that people need to look at the vaccination numbers in their specific workplaces, too, noting that offices with “somewhere in the neighborhood of a 90% vaccination rate are highly protected.”
“With some of the variants that we are seeing, vaccination hasn’t been as protective against transmission as we would like,” Rupp said, pointing out this is true of omicron.
Even if all of the workers in a given office are vaccinated, Fuller still advised masking for now because of the high transmission rates. She noted there are vulnerable groups, such as children who cannot be vaccinated yet and elderly people who don’t have a strong immune response to the vaccine, that might be connected to the work bubble.
“You can have a workplace with a 100% vaccination rate and the risk of them transmitting at work is low,” she said, but “this virus does infect vaccinated people, and vaccinated people, even if they’re asymptomatic, could potentially spread that to the old immunocompromised guy at the marketplace.”
Additionally, masking indoors will help the pandemic become endemic sooner, Fuller said.
“If we keep up the diligence, we are probably just a few months away from seeing this become endemic,” she said. “The point is we’re winning right now…. Don’t slow down yet; the finish line is right there.”
4. Whether they are at high risk of severe COVID.
Certain people are at high risk of severe COVID illness and should keep wearing masks in the office even when their colleagues are vaccinated and transmission rates are lower, experts said.
Gostin said to ask yourself “What is my level of vulnerability, such as age, preexisting conditions and vaccination status?” before taking off a mask.
Though risk tolerance is personal, Madad said that health status is one of the main factors that should decide whether you mask up at work.
“If you’re up to date with your vaccinations and have no significant underlying health conditions that may put you in the high-risk category (i.e., immunocompromised), then your relative risk is low,” she said.
5. When staff are spaced out appropriately and indoor ventilation is strong.
Along with factors such as community transmission and work vaccination rates, Rupp said that the quality of the ventilation and filtration system in an office building would be important to know before going maskless.
Rupp said that about 8 to 10 air changes per hour is a good rate for indoor building ventilation. And if a building has upgraded its filtration system to MERV 15 standards or higher, “this is going to supply a very clean air to the occupants of that space,” he said.
Gostin said he would also consider how many people are in the building before taking off a mask.
“I would be distinctly uncomfortable being unmasked if I was surrounded by a lot of people, especially if I did not know their vaccination status,” he said.
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