5 years after the pandemic started, COVID-19 is still around. Masks? Not so much.
Has your COVID-era mask been a constant companion or is it collecting dust? Americans' relationship with masking has been fraught (and politicized) since the beginning of the pandemic, a time when many balked at mandates to wear them while others wouldn't leave their home without that level of protection.
Five years on, have we moved closer to a happy compromise? Mask requirements have largely ceased, and deciding whether to wear one is up to the individual. And some people do make that choice, particularly during cold and flu season, though polling suggests that masks are both less commonplace and a bit less polarizing these days. Here's how we got here — and what to know about the current state of masking in the U.S.
Before the COVID-19 pandemic, you'd rarely see any Americans outside of an operating room wearing surgical masks — and you would probably raise a lot of eyebrows if you wore one in public. But Dr. David Wohl, a professor of infectious diseases at the University of North Carolina, tells Yahoo Life that in parts of Asia it was fairly common to mask up, especially when the wearer had a respiratory illness they didn't want to spread.
As Voice of America (VOA) reports, people in countries such as China and Japan have been wearing masks for decades for many reasons — from blocking out air pollution to putting up a 'social firewall' to avoid awkward interactions on public transit. But masking became especially prevalent during the SARS outbreak in 2002; after that, it was normal for people, especially in congested cities, to wear a mask in public as a courtesy to others if they were feeling under the weather.
Wohl says regular outbreaks of respiratory viruses in that part of the world likely led many people to incorporate mask-wearing into everyday life, along with 'a sense of responsibility to not pass an infection on to others.' In this way, masking became a common courtesy, almost like covering your mouth when you sneeze or cough — making surgical mask-wearing more of an altruistic act than one of self-preservation.
'I suppose wearing a mask, especially when I occasionally cough due to giving a lesson after some consecutive hours, makes others feel safe,' one Taipei middle school teacher told VOA at the beginning of the COVID pandemic. 'It's not just for myself, but a way to decrease the fear of people around me.'
But here in the U.S., we don't have 'that same type of social consciousness,' Wohl says. 'We are more likely to wear masks to avoid infection rather than to prevent forward transmission of a germ to others.'
Even at the peak of the pandemic, how much people masked depended a lot on where they lived, and that's likely still the case today. Dr. Jessica Justman, a professor of medicine and epidemiology at Columbia University, says it may be different elsewhere, but in New York City, where she works, it has become common to see some people masking up in public.
Dr. Rachel Amdur, an assistant professor of medicine at Northwestern University, tells Yahoo Life that while the U.S. is likely not at the same level of comfort with wearing masks in public as countries in Asia, it's more common now to see people wearing masks in public here than it was before COVID arrived on the scene.
And Dr. Dean Winslow, a professor of medicine at Stanford University, tells Yahoo Life that he still wears a mask when he's somewhere that's crowded and indoors. Masking up in more health care settings — not just inside an operating room — is also less of an anomaly, he adds.
'As health care providers we are still asked to wear a mask with face-to-face encounters with our patients to avoid, potentially, causing infection in our patients — many of whom are immunocompromised,' Winslow says.
Wohl says he's 'heartened' when he sees people of all ages wearing masks in public places, like on airplanes and at supermarkets, and speculates that some of these maskers may have weaker immune systems, 'while others just are not in the mood to get sick.'
And in California and areas affected by wildfire smoke, masking also saw a recent boost as health experts encouraged tight-fitting N95 masks to protect against dangerous particulates in the air.
Still, recent polling from the Pew Research Center reveals that while mask-wearers are still out there, they are few and far between — and their numbers have plummeted since the beginning of the pandemic. According to Pew, 80% of Americans say they rarely or never wear a mask in stores or businesses. Four years ago, those numbers were reversed, with 88% of Americans saying they had worn a mask or face covering in stores all or most of the time in the past month.
And while most Americans (74%) say they think it's extremely or very important for people who are sick to avoid contact with vulnerable people, they're less enthusiastic about taking action to protect others; 43% of Americans feel it's extremely or very important to wear a mask in crowded settings when you have cold-like symptoms.
In fact, Pew found that masks are now so underutilized that even the divide between Republicans and Democrats has narrowed. Once highly politicized, frequent mask-wearing has now almost equally been discarded by both parties, with just 6% of Democrats and 2% of Republicans saying they frequently wore one in the past month. (The partisan differences were less stark, however, when asked if they had worn a mask at all recently — with 76% of Republicans and 47% of Democrats saying they had never masked up in the past month.)
Our knowledge about masks — and what works and what doesn't — has evolved a lot over the past five years. Some of the cynicism about masks and whether they actually stem the spread of infection, Wohl says, was likely rooted in resistance to the mitigation measures that were enforced during the height of the pandemic — but that doesn't detract from their effectiveness.
'The reality is we may not like wearing masks, but they do protect us from getting and giving COVID-19 and other respiratory infections,' Wohl says.
Of course, not all masks are created equal. Whereas pre-COVID, most of us not working in health care had never thought about the merits of an N95 versus a surgical mask, today, laypeople are much more informed. Wohl points out that any middle schooler could tell you that while a cloth bandana is no match for someone coughing in close quarters, and N95 respirators are the gold standard for protection, surgical masks are a good middle ground — striking a decent balance between cost, ease and effectiveness.
Winslow says that when properly fitted, N95 masks provide excellent protection to both the wearer and those around them. 'However, N95 masks are uncomfortable to wear for long periods of time, need to be fitted and are quite expensive,' Winslow explains. 'In contrast, surgical procedure masks are inexpensive and comfortable to wear.'
But while surgical masks do provide some protection to the wearer, Winslow says, they're most effective at preventing the wearer from spreading viruses to others.
Still, Amdur says we 'have a long way to go' with understanding how masks work to prevent respiratory illness. In the meantime, she says it's probably a good idea to wear a mask in public if you have symptoms of an upper respiratory virus — such as nasal congestion, sore throat or fever — or if you're immunocompromised and in a crowded public space. Justman also suggests masking up when RSV, flu and COVID cases in your area are high.
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