This is a pivotal moment in the pandemic. So much of the year’s anxiety and confusion converges in our relationship to masks, which have come to be about far more than blocking aerosolized secretions. Mask mandates are being lifted around the country as cases of COVID-19 plummet. The all-encompassing threat of the pandemic suddenly feels like a blip on the national radar, thanks to a massive vaccination campaign and a deep-seated desire to talk about anything else at all. When the CDC advised two weeks ago that vaccinated people no longer need to wear masks, indoors or out, the change around New York City was nearly instantaneous. Nationally, the move correlated with a bump in vaccine demand.
For some, this is jarring, even scary—especially for those who have not yet gotten vaccinated, who have post-traumatic anxieties after life-threatening bouts with COVID-19, or who are at high risk of complications. The pandemic is not over, and the past year has seen a barrage of experts insisting that masks save lives. Wear a mask. Wear a mask. Wear a mask. Out in public, it’s impossible to know who’s been vaccinated. Many businesses have opted to continue requiring masks indoors, while others have not.
It is true, from a purely scientific perspective, that vaccinated people don’t seem to pose a meaningful risk to others, or to themselves, if they forgo a mask. We have not seen a terrible number of serious breakthrough cases, and vaccinated people do not seem to serve as asymptomatic spreaders of the disease. But real tensions exist between mask science and mask guidelines. From a guideline perspective, having different rules for vaccinated and unvaccinated people creates a minefield for public venues, businesses, and other institutions where employees have no way of distinguishing between who is and isn’t vaccinated. A school system may be able to verify the immune status of its students and faculty, but a restaurant or grocery store cannot sort everyone who comes through the door.
This has inspired heated debate and inflamed instincts to assign blame. Is the CDC being too vague, too progressive, or simply careless in its advice? Should local governments step in with clear directives? Are businesses supposed to decide for themselves and enforce rules however they choose? Do those decisions involve liability? Are we looking for definitive answers that don’t exist?
This gap between science and guidelines is not new; it’s a constant source of friction in public health. Take, for example, the recommendation that we exercise for 150 minutes a week, or that men limit themselves to two alcoholic drinks a day. These numbers are not divinely ordained. Exercising for an hour every day would likely be even better for our health, as would restricting alcohol intake to one or zero drinks, instead of two. But the guidelines are meant to consider what’s practical and actionable for people in a real-world context, as opposed to the pure dictates of ideal physiology or toxicology. If you advise people that teetotaling is the only true path, or that they need to spend every day in the gym, they may throw up their hands and do neither.