With cases of COVID-19 continuing to fall, communities across the country are peeling back pandemic restrictions, and as a result, many Americans are ditching their masks. There are still a few places where you’re all but guaranteed to see them — on airplanes, in the subway and in many health care settings, for instance — but by and large, once-ubiquitous face coverings are becoming less so.
New guidelines introduced in February from the Centers for Disease Control and Prevention (CDC) say that’s OK, at least for the majority of U.S. counties that light up green on a map on the CDC’s website that takes into account hospitalizations, hospital capacity and COVID-19 cases. But older adults might want to think twice before heading out the door without their N95s.
“All adults, and especially older adults and medically vulnerable people, absolutely have to remain vigilant,” says Nicole Iovine, M.D., an infectious disease physician and chief hospital epidemiologist at UF Health in Gainesville, Florida. Adults 50 and older account for more than 90 percent of all COVID-19 deaths in the U.S. and about 70 percent of hospitalizations. Despite recent improvements in both metrics, Iovine cautions, “This pandemic is still going on, and there’s no reason that there won’t be another surge.”
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Cases are once again rising in Europe, most likely due to the spread of omicron’s sibling variant, BA.2, and experts say these trends could foreshadow a similar pattern at home. In the U.S., the BA.2 subvariant, which is more transmissible than omicron but not thought to be more severe, is now responsible for nearly a quarter of new COVID-19 cases. A few weeks ago, it was to blame for about 7 percent of infections. What’s more, wastewater surveillance is registering higher levels of the virus, which could indicate that infections are on the rise.
Older Americans shouldn’t isolate themselves, but they “cannot completely let their guard down and fall back to what we consider normal behavior,” adds Rama Thyagarajan, M.D., an assistant professor in the Department of Internal Medicine at the University of Texas at Austin’s Dell Medical School. That may work for younger folks, who are less likely to get severely ill from COVID-19, she explains, “but it does not work for seniors,” who are more susceptible to COVID-19 infection and severe disease.
All the experts interviewed by AARP agree: Grocery stores, theaters, hair salons and other public indoor venues are safer with a mask. Several studies, including one published by the CDC in February, show that masks help control the spread of the disease. Researchers found that people who wore an N95 in public settings were 83 percent less likely to test positive for COVID-19 than those who wore no mask.
There may be times when it’s OK to go without one, but that hinges on each individual’s situation and risk tolerance.
Weighing your risks
While the CDC’s new community level tool is helpful for a few things — it can warn you if your local hospitals are overwhelmed, for example — it doesn’t give a clear picture of how much virus is circulating in your area, and that’s an important metric to know, says Seth Cohen, M.D., medical director of infection prevention at the University of Washington Medical Center. The CDC has another map for transmission rates (your local health department should have data, too), and Cohen recommends checking it out when weighing your risks. If “fair amounts” of the virus are circulating, he says it makes sense to be on the conservative side and mask up. If levels are truly low, “it may be OK” for some people to take their masks off.
That said, consider a few other things first, like any underlying health conditions that put you at greater risk for COVID-19 complications (roughly 85 percent of older adults have at least one chronic condition), as well as the health of others in your household.
Another key factor: your vaccination status. Experts strongly recommend that all adults, and especially older adults, get a booster shot to better the odds that the body will be able to fight off the ravages of the virus if infected. Federal data from January shows that COVID-19 hospitalization rates among adults 65 and older were 15 times higher in unvaccinated individuals compared to those who had their booster. And in December, unvaccinated individuals were 21 times more likely to die from COVID-19 than those who were boosted. Still, an AARP analysis finds that 1 in 3 nursing home residents and nearly 2 in 3 nursing home workers have not received their booster dose.
Will it be crowded where you’re going? And if so, will there be lots of unmasked people? These are other points to ponder. You should also think about whether you are able to quickly access testing and treatments if you do get COVID-19, Thyagarajan adds, emphasizing that masks are just one piece of the puzzle when it comes to preventing the worst outcomes.
“The important things are just thinking about what it would mean for your life and your family if you were to develop COVID,” Cohen says. “If you’re somebody who’s fully vaccinated and boosted and is relatively healthy and not immunocompromised, your risk tolerance may be higher than [that of] somebody who, say, is getting chemotherapy.”
And of course, talk to your doctor if you have any questions about your health and your risks.
What about outside?
In most cases, masks are not necessary outside, experts say. So walks, hikes or small outdoor gatherings with vaccinated friends where there’s plenty of room to spread out are all pretty safe activities to do maskless, though some people with multiple chronic conditions may still choose to wear a mask, Iovine notes.
It’s a different story if you’re headed to a crowded concert or sporting event where people will be singing or screaming and standing close to one another — pack a mask. “But for most outdoor activities, I would say the risk is extremely low,” Cohen says.
Another tip: Make sure the mask you’re wearing fits well and is one that’s considered high quality, like an N95 or KN95. “The days of cloth masks are over — and that’s regardless of risk level,” Cohen says, explaining that cloth masks are no match for the omicron variant.
N95s and other so-called respirator masks filter out virus-sized particles and are protective even if others around you aren’t covering their mouths and noses, Iovine says. A surgical mask is another option that provides more protection than a cloth mask, although it’s considered less effective than respirators.
Don’t have a high-quality mask at home? You should be able to get one for free at a local pharmacy or community health center. The CDC’s website can help you find a location close to you — just make sure to call ahead of time to double-check availability.
And keep it handy: You may find that you don’t need your mask one day but do the next. “It’s important to keep in mind that this is very dynamic. It’s really something that changes week to week,” Cohen says of trends and corresponding recommendations.
Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.