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  • Writer's pictureDr. Bow Tie

COVID-19: #MASKSUP Again



Welp. The fourth wave is here, it is already bad, and has the potential to get much worse.

On Tuesday the CDC announced that everyone, including vaccinated people, must go back to wearing masks in areas with “substantial or high transmission,” which right now…is most of the country. Cases and test positivity rates are rising everywhere, and with that, hospitalizations have risen sharply as well (in some places, ICUs, emergency departments, and medical floors are filled and overwhelmed). I mentioned this in my last blog post and things quickly got worse. Of course, I can already see some of you tensing up and getting ready to push back on this. But (and I usually enjoy being right), it’s not like we did not see this coming.


In my May post, I mentioned a frustration with the CDC at this announcement. So did many others on the COVID frontlines. The idea was to encourage people to get vaccinated because, “Look what you can do! No need for a mask if vaxxed!”

However, with no provisions or guidance to businesses, restaurants, or employers regarding checking vaccination status, or time to get remaining employees vaccinated, or any accountability for those unvaccinated, the “honor system” fell apart pretty quickly. People who were unvaccinated quickly abandoned masks and exposures and spread went up. The CDC isn’t changing mask recommendations again on a whim - it’s because Delta variant is spreading and now responsible for tens of thousands of COVID admissions to the hospital every day. 99% of those cases were unvaccinated. And not enough people are vaccinated to even get close to "herd immunity."

So as we face this 4th wave that threatens to take us back to 2020, we must go back to donning masks indoors in many parts of the country. I can already feel some of you pulling away. But let's break it down:

Vaccines are nearly 100% effective at preventing severe illness and hospitalization, and also great at preventing mild/moderate or even asymptomatic infection, AND they cut down on transmission...but not 100%, and especially not in such low numbers of full vaccination. In addition, not everyone creates as robust of an immune response due to age, immunosuppression, or other factors. Too many people are still vulnerable.

Let's talk about what this is not. This is not about "cOnTrOl" or governments trying to "keep us down" or whatever conspiracy is going around. And no, Ben Shapiro, this is not about wearing masks in your own home with your children. It IS, however, about wearing masks elsewhere so that when you get home to your children (or wife, or parents, or whoever), they are protected from the potential presymptomatic/asymptomatic infection you may have brought home with you from being in public (either indoors or outdoors in big crowds like at concerts). Because that's the level of risk some places are at right now.

Now, if you're at a less crowded or private place with people you know are fully vaccinated, no need for a mask unless you want! It's when you don't know the vaccination status of those around you that you should probably wear a mask (and so should they).


Masks provide another layer of protection. When you drive, you wear your seatbelt, you stay between the lines, and you obey traffic signals, in order to protect yourself and other drivers. Vaccines+masks+hand washing work similarly.

And masks DO NOT cause harm.

Several parents have asked me about or expressed frustrated concern about their children having to go back to school in the fall with COVID-19 surging again. Not that they do not want to send their kids back to school (we all want that!), but they want their kids to be safe. The CDC finally got their head on straight about that, too. Kids in school K-12 (really anyone 2 and up) should be masked! There has been a great deal of disinformation about masks being "harmful" to children or not having benefits in schools, and these were unfounded. There was also a recent paper that was published in JAMA saying that masks increase carbon dioxide inhalation that was actually retracted because of how poorly the study was done and the incorrect use of measurement devices. The American Academy of Pediatrics and other academic medical bodies have recommended that kids in school K-12 wear masks universally. Children under 12 cannot yet be protected by vaccines (and approval likely won't come until midwinter), and not enough children 12-17 (and older) are protected, either. Remember, multiple variants (especially gamma and delta) affect children way more (and way more often) than original COVID-19. Most kids have adapted well to masking if they have good role models - so let's be that for our youngest loved ones! If we want to protect our children and our other loved ones to whom they may unintentionally spread COVID-19, they should be masked in school, along with hand-washing and distancing where able.

Finally, the vaccine is free and masks can be cheap! A hospital admission (and everything that may come with it) is decidedly not.

I know this is disappointing. I have loved being in public places without a mask again. I played a gig recently and my cheeks hurt from smiling/grinning so much as people bopped along. You may ask yourself when this is going to end. The answer is, when everyone (not just in the US, but the world - because this is a global pandemic) is fully vaccinated. That takes time, but it is absolutely doable if we prioritize correctly. Until then, variants may continue to emerge unless we protect ourselves and each other and for now, that means wearing a mask and getting everyone vaccinated. Do you have friends/neighbors/relatives who do not want to vaccinate? Reach out to them (if you feel comfortable and have the mental strength), not hostilely but patiently. As Dr. Kimberly Manning often asks, "What's your why?" Everyone has someone or something in their life for whom/which vaccination is protective and/or a release to go back to pre-pandemic levels of fun or peace. We all need to remember those things when we get frustrated with the measures we have to take against COVID-19. In addition, nearly every concern about the vaccine (whether based in reality or not) has been answered and the vaccines are proven safe for nearly everyone. This virus remains our enemy, so we must protect each other from disease and disinformation.

So keep washing your hands, maintain distance when needed, put your mask back on in crowded places, and get your vaccine! I welcome your questions.



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