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The Plague That Won't Go Away

Updated: Jul 20, 2021

Sensible Solutions to Everyday COVID-19 Masking Situations

Unless you have been living under a rock (while some of us have been living like monks), you know we seemed to be on the up side of the COVID-19 pandemic. We all cheered the encouraging news from health policy experts that, finally, there is a light at the end of that pandemic tunnel.

Deaths from COVID were plummeting, admissions to the intensive care units from COVID-19 were decreasing. Frontline healthcare workers could get a break. And an increasing number of states began completely dismantling the general recommendations of wearing a mask when in public and maintaining social distance.

Restaurants and bars opened. Sporting events kicked off. People were back in church. Businesses that survived reopened. Theaters popped the popcorn and welcomed movie goers.

But wait, hold on.

Let us temper the current optimism with a piercing reality: COVID variants, aggressive mutations of the virus that may well be more lethal, more contagious, and more infectious than the original viral strain. Although data are still emerging, it is not yet compelling or obvious if the available vaccines will have a 90-95% benefit rate against these emerging strains.

With the onset of warmer weather and with the uptick in travel and with the loosening of social distancing and masking guidelines, some experts are concerned that we are now weathering a calm before the storm. We have become too complacent, and the results can be disastrous.

I wrote that last paragraph two months ago. I didn’t have a crystal ball nor a tarot card reading. My prediction has become our new reality.

Now what do we do? Here are some prudent guidelines:

  • Will the vaccines protect me? A Mayo clinic study analyzed 39,000 patients who had screening tests for COVID-19 as part of a pretesting program involving patients scheduled for surgeries and other procedures. After adjusting for a range of factors, the researchers documented an 80% risk reduction of testing positive for COVID-19 among those individuals who had received two doses of one of the two approved vaccines. This study is crucial because it documents the efficacy of the vaccine to limit the spread of the virus by individuals with no symptoms and who may unknowingly shed the infection to others. The “asymptomatic shedder” was clearly a concern in the spread of the virus. And at the same time recipients of the vaccine are at a very low risk of becoming ill themselves from the virus.

  • Can I see people now? Shall we examine some scenarios:

--Let’s say a couple is basically healthy, has received the vaccination according to plan. They invite to their home another couple with the same situation. Okay, remove the masks and be good to enjoy dinner together.

--Grandparents are healthy, they have been vaccinated. Sure. Invite the grandkids over. Risks to everyone should be negligible. You are vaccinated and are blessed with good health.

--You are greeted in a shopping center parking lot by other people you know but not well. You don’t know their vaccination status. Everyone wears a mask. Say hello, don’t hug.

--Your hot water heater needs to be replaced. You call the plumber. Two workers knock on the front door, neither are wearing masks and obviously you do not know their vaccination status. A prudent position: Ask them to please put on a mask, preferably double mask, you mask up and keep your distance. No big discussion about the biology of the virus, just a commonsense approach.

--A community organization is sponsoring a four-hour round-trip bus excursion to a Broadway production. Tickets must be purchased upfront for the event in five months. Social distancing in the theater has not been spelled out. Tickets are not refundable. This is another judgment call. Even if you are vaccinated and you mask the entire trip, if your health is marginal, is it worth the risk to become possibly infected with long-term consequences?

--A couple in their late sixties is totally vaccinated and both have some chronic heart disease and lung problems. Their three adult children want to come for a visit. They too have been vaccinated. But they will be traveling through airports and mingling with vaccine-status-unknown people. A tough call. The risk of someone becoming ill from the gathering is low. But because there are two high-risk individuals involved, the visitors certainly would be well advised to wear a mask to decrease the risks to the elderly couple.

  • What about schools? This is the tricky one. I refer to the CDC guidelines on in-person back-to-school advice. This may be updated as the delta variant is unwinding progress we've made, but parents need to do what seems comfortable for them. [UPDATE: The American Academy of Pediatrics is now saying as of late July 2021 that children should wear masks in school.]

  • What I do. Like most of us, I, too, have been seeking professional guidance from the experts on these difficult decisions. Individually each of us must assess our risks, recognize there are no rock-solid predictable guidelines, make judgment calls, and only we can determine what is right for us. I don’t have any problems being the lone mask wearer in situations, even at church, where the vaccination status of everyone is unknown (not assumed to be fully vaccinated). This is no inconvenience. Yes, my risk is low of contracting the virus, but I don’t want to take that risk.

No vaccine is 100% foolproof. Nobody wants to be the one to spread illness. You don’t know the vaccine status of anyone else (even people who say they have been vaccinated). And you really don’t want to be around anyone who says they have not been vaccinated (and those who say they had COVID and don’t need vaccination). That’s just ignorance.

We are not out of any woods yet. Nobody has a get-out-of-jail-free card. Be aware, be sensible (even when you’re the only one in the grocery store wearing a mask or the lone mask wearer at the dance recital or nail parlor).

There is no magical formula for a lot of these decisions, but you need to be street smart and savvy. And recognize that there are no clear guidelines just general recommendations.

Image from Unsplash.


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