Governors in New Jersey, California, Delaware, Connecticut and Oregon have all said that they are lifting masking requirements in some indoor settings. All but California have set deadlines to end required masking in schools. The governors pointed to Covid-19 case rates that have fallen precipitously after Omicron’s peak, the hospitalization rates that have stabilized or high vaccination rates in their states.
But the Biden administration still recommends masking indoors — a position that has long put it in conflict with some Republican-led states, and now with several Democrat-led ones. The US Centers for Disease Control and Prevention, too, has not changed its guidance, and continues to recommend mask-wearing in schools, regardless of vaccination status.
This divide reflects politics as much as public health realities. But part of the problem is that there has been no clear path laid out by the CDC for when mask mandates should end, and in which settings we can drop them. Instead of a specific formula, we’re getting vague guidance, leaving states, communities and individuals to make these decisions without enough information. We need a route forward set by clear metrics, not this never-ending game of Covid whack-a-mole.
To be sure, the question of when to end mask mandates, and where to end them, is a difficult one, especially in a country where trust in one another feels like it’s at a low point and even a pandemic has been politicized. Many conservatives rejected masks even when they were our only line of defense against Covid-19, and political affiliation remains a significant predictor of vaccination status, with Republicans making up a disproportionate share of the unvaccinated.
Conservative states also haven’t taken other steps to prevent the spread of Covid-19. Compared to blue states, red states have been quicker to lift required indoor mask mandates, and some never implemented them at all. Some Republican governors have even banned (or attempted to ban) mask mandates in schools.
Nationally, we are not doing our best to protect our children. Even though nearly all kids old enough for elementary school have been eligible for vaccination for months, a majority of kids in this age group are not fully vaccinated, and there are the predictable regional divides in children’s vaccination rates. The states with the most vaccinated kids are blue ones, and those with the least vaccinated kids are red.
This largely conservative rejection of science and staunch refusal to do the bare minimum to protect others has been enraging and depressing, and it has been a contributing factor to illness and death. Some liberals, in reaction or out of understandable fear, have also taken maximalist positions on Covid. Many are objecting to the lifting of mask mandates in schools, but less clear is under what conditions they believe masks can be a thing of the past.
We know that masks work to prevent the spread of Covid-19, and that N95s and KN95s are particularly effective. They are a crucial tool in our prevention arsenal. But vaccines are also free, widely available and highly effective for all Americans ages 5 and older (and may soon be available for even younger kids). It’s long past time for the people who refuse vaccination to carry more of the burden of Covid-19 restrictions — to be barred from inessential indoor activities, instead of holding the vaccinated hostage to endless cycles of case spikes and shutdowns.
And yes, if case rates are low, the vaccinated should have more opportunities to live mask-free. Because let’s be honest: Masks do come with costs. They can be uncomfortable, especially when worn for long periods at a time. They interrupt basic human communication — so much of how we understand each other and send subtle cues is through our facial expressions, which masks conceal. When we can’t see each others’ faces, we lose a primary means via which human animals connect, and, at least anecdotally, we can become even more atomized and less empathetic to each other. And while the impact of masking on children is still being studied and experts largely say that kids are flexible and can adapt or catch up, many parents and some experts worry that prolonged masking could impair children’s language skills and their social and emotional development — and argue that kids shouldn’t have to continue catching up and being resilient.
As a society, we have to balance competing interests and potential harms. We do this all the time; we set speed limits and mandate seatbelts in cars, but we don’t expect to have zero traffic fatalities — and we don’t even set highway speed limits low enough to radically reduce traffic deaths because we’ve essentially decided that we need people to be able to get where they’re going, and that is worth the tradeoff.
What we need is not just clear guidance for the here and now, but a clear formula for when mask mandates should lift, where they should lift, and when they may need to be reinstated. Covid-19 is not a static disease, and public health guidance should evolve as the disease does.
Some experts have already weighed in on what that might look like, and it seems to be based on a combination of case rates, hospitalization rates, vaccination rates and variant type. And those will vary. As Dr. Ashish Jha put it on Twitter, we should “think of this like the weather… When it is bucketing rain… Umbrella, rain coat, boots, are all essential… When the storm turns into a drizzle, those become less critical.” In other words, tweeted Jha: “During periods of low infections, restrictions come off… During potential future surges, public health measures may need to temporarily return.”
One common-sense approach would be to require Covid-19 vaccination in schools, given that public schools in all 50 states already require a whole host of vaccinations before students can walk through the doors. In a country where there is a right-wing backlash to basic preventative public health measures, though, it’s hard to see this happening.
But when case rates are significantly down, hospitals aren’t overwhelmed and community vaccination rates are high, it’s time for a reprieve. Students and staff should be able to unmask in these conditions.
Whether that moment is now is above my pay grade. It shouldn’t be on lay people, from CNN columnists to state governors to Twitter warriors, to be making these imperfect calculations. We need the CDC to step up and offer a clear and sensible formula instead of generalized guidance. And we need to start thinking about Covid-19 the way we do about other threats to our lives and health: focus on risk-reduction measures that are specific and targeted, and aimed at allowing us to live our lives balancing, as best we can, public health, pleasure and freedom.
