Is it finally time to take off your mask? Here’s how to decide

Mask rules are about to change, signaling the end of official oversight of our pandemic behavior.

But now it’s up to us, not health officials, to decide when masks are needed in most places. A very public act has just become personal. Attending even the simplest social gatherings – from book clubs to bars – will require a quick calculation of risk.

“It’s hard to navigate,” said UC San Francisco infectious disease expert Dr. Peter Chin-Hong. “The approach is less of a sledgehammer – ‘everyone has to do the same thing’ – to a more individual approach.”

California’s statewide mask order expires at midnight on Wednesday, February 15, so fully vaccinated people will no longer need to wear masks in most public indoor settings. Alameda, Contra Costa, Marin, Monterey, Napa, San Francisco, San Mateo, Santa Cruz, San Benito, Solano, Sonoma counties and the city of Berkeley will also waive universal mask requirements for those vaccinated.

Only Santa Clara County is maintaining its rule that residents wear masks in indoor public spaces, whether or not they have been vaccinated. This is in line with guidance from the US Centers for Disease Control and Prevention, which suggests masking in places with high COVID-19 transmission rates.

There are places where the rules don’t change, such as in nursing homes, health care facilities, and public transportation. And masks are still required in most public places for unvaccinated Californians.

While COVID-19 cases and hospitalizations are declining, the pandemic is far from over. A study published Friday by the Centers for Disease Control and Prevention found that booster shots of the Pfizer-BioNTech and Moderna vaccines lose substantial effectiveness in preventing outpatient visits after about four months — dropping from 87% to 66%. But they still provided important protection by preventing people from entering the hospital.

“People have to keep in mind that we’re still in a wave,” said Dr. Anne Liu, clinical associate professor of medicine at Stanford/Lucile Packard Children’s Hospital and Clinics. “There’s still a lot of COVID out there.”

Be patient, the experts agreed. Even for the most cautious people, masking doesn’t last forever. The situation will continue to improve over the next few weeks as new infections decline – and supplies of treatments, such as antiviral drugs and monoclonal antibodies, start to climb.

But we are not there yet. And everyone will make a different decision, based on risk tolerance.

If you or your loved ones are at risk of serious illness, it’s not worth throwing this mask inside. Or maybe you don’t want to miss work, school, a big social event or a trip, experts say.

“If a financial services provider gets sick or they provide multi-generational care, getting sick has huge implications,” said UC Davis epidemiologist Dr. Lorena Garcia.

Where are you going? That matters too.

“If people are packed in like sardines and there’s no ventilation, no one has a mask and they’re partying like it’s 1975, that’s a high-risk situation,” he said. said UCSF epidemiologist Dr. George Rutherford. “If it’s 8 a.m. on Old Folks Morning at Trader Joe’s, then I’m probably fine without a mask. But everyone will look at me like I’m Attila The Hun.

A combination of these two assessments – who you are and where you are going – will help guide your decision. For advice, we turned to four experts: Drs. Liu, Garcia, Chin-Hong and Rutherford.

Who are you

Without mask:

  • You’re healthy, under 65, “boosted” and can endure a week or two of feeling lousy and self-quarantining while your body fends off an infection. You have paid sick leave and are okay with the illness, knowing that you are very unlikely to be hospitalized. Your roommates are the same.
  • This may seem particularly important if your daily work is greatly hindered by wearing the mask – for example, if you work with children who have speech or hearing problems.

Mask maybe:

  • You are healthy, under 65 and boosted. Your roommates are the same. You have easy access to medical care. But getting sick and missing a job – or a big social event or an upcoming trip – would be a hardship.
  • You are over 65 and boosted.

Mask on:

  • You are healthy, under 65 and boosted but living with someone who is not.
  • You are healthy, under 65 and boosted, but live with someone too young to be vaccinated or immunocompromised.
  • You are in good health and under the age of 65, but absolutely cannot do without work, a social event or a trip.
  • You are at risk of contracting a serious illness because you have health problems that seriously impair your immune system. Maybe the vaccines haven’t boosted your immune protection.
  • You are over 65 and not boosted.
  • You have a low income, so all the medical bills would be stressful.
  • You live in a rural community where you cannot get tests or prompt medical care if you need it.

Where are you going?

Without mask:

  • Good ventilation.
  • Small gathering, with few crowds and little mixing.
  • The venue requires a vaccination or negative test results.
  • The community has a low number of cases. Think rural or suburban Contra Costa, San Mateo, or Marin counties.

Mask maybe:

  • Moderate ventilation.
  • Medium-sized gathering, with some exchanges.
  • No vaccination or testing requirements.
  • The community has a moderate number of cases. Think of the higher density Santa Clara or Alameda counties.

Mask:

  • Poor ventilation.
  • Large gathering, with lots of mixing, chanting or shouting.
  • No vaccination or testing requirements.
  • The community has a high number of cases. Think of towns in the San Joaquin Valley, like Fresno.

“These are all really tough decisions,” Liu said. “We live in very confusing times.”

“I understand why people can’t keep a muscle flexed all the time,” she said. “We have to relax it from time to time so that we have the energy and the courage to be able to do it again when another variation comes along. We are here for the long term.

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