‘I’m going to continue to mask.’ Triangle doctors on when, why masks still make sense
State health officials say it’s no longer necessary for everyone to wear masks in public to protect against COVID-19, and local governments and school boards across North Carolina are dropping their mask mandates.
But doctors say the coronavirus is still circulating in the state and that it makes sense for some people to continue wearing masks. That includes the 24% of North Carolina adults who haven’t received even one dose of COVID-19 vaccine and people who are at risk of getting very sick with COVID-19 because of their age or overall health.
“I think that folks have to be very thoughtful if they’re at risk for severe outcomes from COVID-19 and continue to mask,” said Dr. David Wohl, an infectious disease specialist at UNC Health. “For me — and I’m not necessarily in that category except that I’m 58 — I’m going to continue to mask for a while in indoor public places until the numbers go down, really to a fraction what they are now.”
The number of new coronavirus cases reported in North Carolina has dropped in the past month from more than 15,000 a day to less than 2,000 a day on average last week, according to the state Department of Health and Human Services.
But that’s still a fairly high number that shows the respiratory virus is still out there, doctors say.
Individual masking decisions
The message on masking from public health officials, from the Centers for Disease Control and Prevention on down, is that each person should decide the risks and consequences of not wearing one.
“So younger, healthier people may say, ‘Well, I’m OK with going back to the way I was mostly pre-pandemic because the consequences of getting infected for me are probably pretty minimal.’ And they’re right if they’re vaccinated and boosted,” Wohl said. “For an older person or person who has immunocompromising conditions or both, the calculus may be very different, and for that person masking makes a lot of sense.”
Dr. Shannon Carson is still wearing a mask in public. Carson, a pulmonologist who has been treating severely ill COVID-19 patients at UNC Medical Center in Chapel Hill for nearly two years now, said he may change his mind in a few weeks if the number of new cases keeps dropping.
“But there’s still a virus out there; you’re still getting positive cases. And we still don’t have the best vaccination rate in this state,” Carson said. “So I think wearing masks to protect those individuals is still important until this settles down a bit more.”
Masks still required some places
Not all mask mandates have gone away. People still must wear them in airports, planes, trains and public buses under a federal executive order. That order is set to expire March 18, but mandates may remain beyond then. Most airlines, for example, required passengers to wear masks before the federal government did.
Masks are also still required in hospitals and many other health care settings and will be for the foreseeable future. Doctors say that’s because many hospital patients are particularly vulnerable to COVID-19.
That vulnerability is true outside of hospitals, said Dr. Lisa Pickett, the medical director for Duke University Hospital in Durham. For that reason, people should be understanding when they see others still wearing masks, Pickett said.
“Even if mask mandates are lifted, and people around them feel comfortable taking their masks off, some of our community members may not be comfortable yet,” Pickett said. “So we’re really promoting respect and kindness for the people around us to allow people to make choices that are right for them. And then being respectful of those decisions.”
Dr. Rodney McCaskill, the chief medical officer at UNC Johnston hospitals in Clayton and Smithfield, said he thinks the decisions to drop mask requirements are based more on politics than science. McCaskill said he isn’t going maskless yet in crowded indoor settings.
“I would recommend wearing masks to those sort of events still,” he said. “I mean nobody really knows where this is going to go, and that’s why it’s tough. And so I think caution is still the right way to go.”
‘A hot-button issue’
Wohl at UNC worries that it may be too soon to give up on requiring children to wear masks in schools, though many schools boards, including Wake, are going that way.
Along with hospitals and clinics, he thinks schools should be among the last places to go maskless, given the intense interactions kids have with each other and that only about half of children 5 and older are fully vaccinated and boosted.
“I know this has become a hot-button issue, but masking in schools is important,” he said. “I just worry that we could have more of a simmer of this and maybe even a little bit of a delay in our complete downward slope of our omicron surge if we pull back too soon from schools.”
This story was originally published March 7, 2022 at 1:20 PM.
