Mask guidance is changing again. Here’s why

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Editor’s note: As what we know about COVID-19 evolves, so could the information contained in this story. Find our most recent COVID-19 blog posts here, and learn the latest in COVID-19 prevention at the Centers for Disease Control and Prevention.

After weeks of fully vaccinated people going without masks, the Centers for Disease Control and Prevention are asking people to switch gears and put those masks back on in certain situations. The goal is to maximize protection from COVID-19 as cases tick back up across the country.

In particular, the CDC recommends vaccinated people wear masks indoors in parts of the country with high COVID-19 infection rates. You should also wear a mask if you have a weakened immune system or an underlying health condition that puts you at risk of severe infection. It’s also advised if you live with someone who has a weak immune system, is high risk of severe infection or is unable to be vaccinated such as children under 12.

Masks continue to be required on public transportation, at hospitals and doctor’s offices, and in K-12 schools, regardless of vaccination status. Businesses may ask customers to wear masks too.

Why is the CDC making this change?

Public health officials are recommending masks because there is clear and mounting evidence that COVID-19 infections, many due to the delta variant, can occur in people who are fully vaccinated. Additionally, fully vaccinated people can readily spread the infection to others without realizing they’re carriers.

Why do vaccinated people need to wear masks?

The recommendation that fully vaccinated people continue wearing masks is primarily intended to protect three groups:

  • People over the age of 12 who are not vaccinated.
  • People who are vaccinated but have medical conditions that place them at higher risk if they are exposed to COVID.
  • Children under age 12 who are not yet eligible for vaccines in the U.S.

There’s a lot of talk about breakthrough infection with the delta variant in vaccinated people. How will this change in masking guidelines help?

The concept of a breakthrough infection – a COVID-19 infection in a vaccinated person – is misleading. It implies the vaccines have failed when, in reality, they are fantastically successful. In fact, the current vaccines protect against severe infection resulting in hospitalization or death in 99.99% of vaccinated people who get COVID.  

The revised CDC masking guidelines are really aimed at protecting specific groups of people, most of whom are unvaccinated.

What does viral load mean? Should we be concerned about it?

Viral load is simply how much virus one has in their body. The higher the viral load in the body, the more readily someone can spread the infection and also the sicker one may get if they are unvaccinated. 

Data have shown that the delta variant results in much higher viral loads than previous variants of COVID-19, even in vaccinated people, hence the more rapid spread of this variant.

I hear most new cases are in unvaccinated people. If I’m vaccinated, why do I need to wear a mask?

COVID-19 cases are skyrocketing across the U.S., mostly due to the delta variant in unvaccinated people. Masks are an important tool to curb the spread due to the extremely high transmissibility of the delta variant. Fully vaccinated people can readily spread this virus even though they may be unaware they have the infection. Hence, the recommendations from the CDC to wear masks once again.

I’ve been wearing a mask for more than a year. How can I cope with mask fatigue?

We are all exhausted from having to take these disruptive precautions that affect our daily lives. It is important to recognize that masks will go away when the rates of vaccination across the U.S. and the world increase. Vaccination is our best tool to finally end the pandemic.

Jonathan Parsons is a pulmonologist and director of the Asthma Center at The Ohio State University Wexner Medical Center and professor of internal medicine at The Ohio State University College of Medicine.