Should masks come back in fall and winter to avoid a COVID surge?

As the United States heads into fall and winter, questions arise about whether the return of masks is necessary to stem a possible surge of COVID-19.

Evidence has shown that COVID cases and hospitalizations tend to increase in colder months when people congregate indoors. Some health officials warn that the virus could rise again in December and January.

Currently, cases and hospitalizations are down in the United States after peaking in late July, according to data from the Centers for Disease Control and Prevention.

Those who are vaccinated and boosted are at a much lower risk of becoming seriously ill and dying from COVID-19. CDC data shows unvaccinated Americans have a five times greater risk of dying than those who received only a primary series and a seven times greater risk of dying than those who also received at least one dose reminder.

Experts told ABC News that while vaccination is the best protection against COVID-19, some people may need to consider masking to protect themselves if infections spike.

“My recommendation for people would be to wear masks when in crowded indoor spaces,” Dr. Stuart Ray, professor of medicine at Johns Hopkins University, told ABC News. “I’ve spent a lot of time with COVID patients who haven’t gotten the infection from what I can tell, both thanks to antibody testing and no syndrome. “

A sign on an entrance door to Geisinger Medical Center warns visitors that they must wear a face mask, Aug. 9, 2021, in Danville, Pennsylvania.

SOPA Images/LightRocket via Getty Images

Dr. Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center in Boston, told ABC News that masks have helped reduce COVID transmission in health care settings.

“I’ve worked in a respiratory infection clinic with COVID patients at peak infectiousness and they’re breathing in my face, and I haven’t received COVID from patients,” she said. “I really believe that PPE works, masks work.”

However, experts admitted it would be difficult to convince Americans to wear masks again after so many cities and states scrapped the mandates.

Los Angeles, San Francisco and Denver remain the three largest cities in the United States where masks are still mandatory on public transport. In most cities, only healthcare settings still require mask mandates.

Ray said he believed a surge, similar to those caused by the delta and omicron variants, would be the only thing that would garner support for the warrants.

“I think people are really tired of this pandemic and there is, culturally, very little appetite for mandates, for masking,” Ray said. “And so, it’s a steep climb to tell people unless there’s a particular context in which it’s important, like a health care facility where there are a lot of vulnerable people.”

He added: “If we were to go into a very disruptive surge then the appetite for a mandate could change as people realize that a bunch of essential services are being disrupted. If hospitals were stressed by the surge, so I think we could see the warrants returned.”

Doron said that while she supports masking, she doesn’t think cities and counties should reinstate mask mandates because many people are taking them off indoors for long periods of time anyway, which is increasing the risk of transmission.

“In the community we had mask mandates where you wear masks unless you eat or drink and if you’ve ever traveled in an airport or on a plane, where was when there was a mask mandate , you know that, you know, people eat and drink pretty much all the time,” Doron said. “And so, he just doesn’t have the ability to do what he’s supposed to do.”

In the absence of mask mandates, experts said people may need to assess their individual risk level and decide whether wearing a mask will help protect themselves and those around them.

“You have to weigh your own susceptibility, your own risk tolerance for long-term complications, which are still somewhat unknown, and the risks you might pose to the people you care for professionally or personally at home,” Ray said. “Now some people can decide – and that’s the judgment part – that they don’t care that they don’t think it’s a big deal, and they’re just going to get infected. and that they are unlikely to be hospitalized.”

Dr. Thomas Murray, associate professor of pediatrics at the Yale School of Medicine, said the risk level assessment also applies to children at school, where many mask mandates have been lifted.

“Children who have a higher risk, such as asthma, could be an example,” Murray said. “What we’re really trying to balance is that children enjoy a normal in-person school experience with the risks of congregating in classrooms when many respiratory viruses are circulating.”

He said if schools did not re-implement masking, other strategies “became critically important” for children, such as screening, testing and keeping them home if they had symptoms.

PHOTO: Pedestrians wear masks in Los Angeles on July 13, 2022.

Pedestrians wear masks in Los Angeles on July 13, 2022.

Medianews Group/Los Angeles Daily News via Getty Images

However, not all masks are created equal. For those who plan to continue wearing masks or choose to start wearing them again during the colder months, experts recommend wearing a high-quality mask.

“I think single-layer cloth masks really don’t offer much protection,” Ray said.

Doron said if you can’t get an N95 or KN95, or if you can’t wear one for long periods of time, a surgical mask will provide protection.

“The surgical mask provides protection, especially if it fits you well,” she said. “And then there are ways to fit it better, ways to fold it or store it and attach the strap for your ears.”

ABC News

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