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On Call: A Turning Point, or the Same Old Story?

Thu, 03/10/2022 - 10:48
Masks are now optional in most settings in New York State, including schools, but some are choosing to keep them on, either to protect themselves or to protect vulnerable family members.
Durell Godfrey

Last week, state and local authorities began to roll back mask mandates in a variety of settings, including schools and public spaces like restaurants. After two years of such mandates, these changes have given many a feeling that the end of the Covid-19 pandemic may finally be upon us.

These policy decisions have been made in response to updated guidance from the Centers for Disease Control. The C.D.C. indicated that in communities with low local prevalence of Covid-19 infections and hospitalizations, it appears that a combination of vaccinations and natural immunity due to infection (particularly after the notably infectious recent Omicron surge) may have provided enough protection for masks to be taken off, at least for now. 

Yet many individuals in both the general public and medical spheres have asked whether or not such a decision is premature, especially with regards to mask wearing in schools. Notably, a report released by the C.D.C. on March 1 illustrated that two doses of the Pfizer vaccine among children ages 5 to 11 years provided strong protection against Covid-19-associated hospitalization with effectiveness of 73 to 94 percent, yet effectiveness against infection waned quickly after vaccination, especially when compared to older children.

The protection against hospitalization emphasizes the continued importance of vaccination, but if children in this age range can still contract Covid-19 and be infectious, does it make sense to stop wearing masks at this point? Not only does this impact the children themselves, but there is some question of risk to the adolescents and adults in school districts, especially the older adults and those suffering from immunocompromised or chronic conditions that place them at higher risk for severe illness. 

Obviously, the hope is that, as mentioned above, the combination of two years of various variants and a high vaccination rate here in New York will offer protection. Yet we have seen time and time again in this pandemic a period of low community prevalence after a surge like the recent Omicron one that has been followed with the rise of a new variant. If this happens again, presumptively local and state health authorities will act quickly to re-implement safety measures such as mask wearing, but the fear persists that such steps could significantly lag behind the surge in infections.

Ultimately, with the removal of the mandates, such decisions are now left in the hands of parents and individuals. Students, workers, and visitors to public places such as restaurants and museums can still choose to wear a well-fitting mask and likely should continue doing so if they have any immunocompromised or chronic conditions that put them at higher risk for severe illness. (Anyone who wonders if they fall into any of the higher risk categories should discuss this with their physician.) Others may choose to continue wearing a mask until more time has elapsed without a significant surge in infections. 

I know that such advice weighs heavily on many. My children came home from school last week overjoyed at the prospect at being able to take their masks off, and my wife and I had to sit down and explain to them that, for now, we were continuing masks, not just to protect them but to protect their teachers and any high-risk family members of their classmates. 

Is it possible that such choices are unnecessary at this juncture? Yes, but I continue to believe the harms from mask wearing are outweighed by the possible benefits, at least for now. As a physician and a parent, the impetus is on me to protect as many as possible while causing as little harm as I can.

There may come a point in the next few weeks that we will allow our children to drop their masks at school if local infection and hospitalization rates continue to be low, but rest assured — we will be paying close attention to those same rates and will not hesitate to ask our children to mask up once more if we see them climbing.

Joshua Potter, D.O., a physician with Stony Brook Southampton Hospital’s Meeting House Lane Medical Practice, oversees the practice’s Shelter Island office. He specializes in family and neuromusculoskeletal medicine. Opinions expressed in this column are his personal and professional views and not necessarily those of his employer.

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