Time to wear a mask again, health experts say

Masks are back and, this time, not just for COVID-19.

The “triple epidemic” of coronaviruses, influenza and respiratory syncytial virus (RSV) plaguing the United States has led several cities and counties, including New York and Los Angeles, to again recommend the use of masks in enclosed public spaces.

Nationally, RSV-19 case and hospitalization rates have skyrocketed by 56% and 24%, respectively, in the past two weeks.

The Centers for Disease Control and Prevention estimates that there have already been 13 million people ill and 7,300 deaths from the flu this season, and these numbers are expected to rise in the coming months.

(Over the past decade, annual flu deaths have ranged between 12,000 and 52,000 people, peaking in January and February.)

And while RSV finally appears to be on the wane, the infection rates they remain high in much of the country.

The CDC officially recommends mask wearing in each county based on community levels of COVID-19, which factor in virus-related hospital admissions, bed capacity, and case rates.

However, in an interview with NPR last week, CDC director Dr. Rochelle Walensky said:

“You don’t have to wait for the CDC’s recommendation, of course, to wear a mask.”

Rates of COVID-19, influenza, and RSV “may be higher or a little lower in parts of the country, but in reality, the whole country is affected,” said Dr. William Schaffner, professor of preventive medicine at Vanderbilt University School of Medicine.

This is why he urged all those who live in high-risk homes to “put their masks back on” when in public spaces.

High-risk families include people over the age of 65, pregnant women, people with pre-existing conditions such as heart disease, diabetes or lung disease, and anyone who is immunocompromised.

Dr. Helen Chu, an associate professor of allergy and infectious disease at UW Medicine in Seattle, took it a step further, recommending that everyone wear a mask while infection and hospitalization rates are so high.

“I think it’s a good time to dress up,” she said.

“Given the current situation with hospitals full, especially children’s hospitals, with RSV and flu, I think anything that can be done to slow down community transmission will be helpful.”

There is strong evidence that masks help reduce the transmission of various respiratory viruses.

A study published in 2020 by Hong Kong researchers showed that people sick with COVID-19 or flu exhaled fewer viral particles when wearing a surgical mask.

(However, the masks weren’t as effective for rhinovirus, which causes the common cold.)

A study of COVID-19 policies in Boston-area schools found that lifting the mask requirement in 2022 was linked to nearly 12,000 additional cases among students and staff.

Rates of influenza and other respiratory viruses flattened substantially during the 2020 and 2021 winter seasons, largely attributed to the country’s protections to prevent the spread of COVID-19.

“What COVID has shown us, because we have been social distancing and wearing masks, is that flu, common cold viruses, RSV are greatly suppressfrom these small individual behaviors, Schaffner said.

The masks filter both the tiny aerosol particles through which the coronavirus is primarily spread, as well as the larger droplets thought to be responsible for most influenza and RSV transmission.

They also prevent you from touching your face in case you’ve picked up virus particles on your hands from a doorknob or subway pole.

And while masks are more effective at stopping the spread of these viruses when worn by an infected person, protecting yourself from disease with a mask is still helpful, especially if you’re using a high-quality version like N95, KN95, or KF94.

“The basic truth is that masks work,” says Syra Madad, director of the system-wide special pathogen program at New York City Health + Hospitals.

“Whether it’s COVID-19 or other respiratory viruses like RSV and influenza, wearing a mask will help protect against all of these respiratory viral diseases.”

Other public health measures, such as hand washing, cleaning surfaces and filtering the air, are also important in limiting the spread of respiratory viruses.

The White House and CDC have placed a heavy emphasis on vaccination, and it’s imperative to get a flu shot and get the latest COVID-19 booster if you haven’t already.

But vaccines are the best protection against serious illness if you get infected with a virus.

The masks are there first line of defense against transmission

“Frankly, neither antivirals nor vaccines have done a very good job of preventing transmission,” said Dr. Abraar Karan, an infectious disease researcher and postdoctoral fellow at Stanford Medicine.

“What prevents the transmission is actually the masking and probably the air filtration“.

When considering when and where to dress up, Madad recommends paying attention to the “Three Cs”:

close contact, crowded spaces and confined spaces with poor ventilation.

Experts have urged wearing masks when traveling by plane or on public transport and have strongly suggested doing so when shopping and giving gifts.

At small Christmas parties with acquaintances, it’s okay to do without masks if the guests are tested beforehand and to stay at home if they don’t feel well.

Realistically, not everyone in America — or a given city — will be wearing a mask.

In fact, you may be the only person in a store or on an airplane carrying one.

Don’t be put off.

For starters, remember that no one thinks about you as much as you do.

In social psychology, this is called Illusion of the center of attention, explains Gretchen Chapman, professor of social sciences and decision making at Carnegie Mellon University.

“I can feel like everyone is watching me because I’m wearing a mask, but it’s probably number 11 on their list of concerns,” she says.

Additionally, Chapman said:

“There are many situations in life where we do something that makes us uncomfortable, but if we think it’s important enough, we do it anyway.”

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