The US Centers for Disease Control and Prevention issued new guidance on Tuesday that recommended a return to indoor masking, even for vaccinated people, in parts of the country with high and substantial coronavirus spread. The agency also urged that schools require masks for all students, teachers and visitors.
One reason for the change in guidance is growing evidence that vaccinated people may also be able to infect others with the Delta variant of the coronavirus. Therefore, CDC officials advised people who live at home with unvaccinated children or immunocompromised family members to take particular caution and mask in indoor spaces.
Many people have questions about what this CDC guidance means for families. Who should be masking and under what circumstances? What if parents have to go to work – do they need to be wearing masks around their kids? Can grandparents still safely see their grandchildren? Should extended family get tested for Covid-19 prior to getting together – even those who are vaccinated?
To help us make sense of all of this in the midst of changing guidance, we turned to CNN Medical Analyst Dr. Leana Wen. Wen is an emergency physician and visiting professor of health policy and management at the George Washington University Milken Institute School of Public Health. She’s also author of a new book, “Lifelines: A Doctor’s Journey in the Fight for Public Health.”
CNN: What does the new CDC guidance mean in terms of who should be wearing masks and when?
Dr. Leana Wen: The way I understand the new CDC guidance is that there is one group that needs to take particular care in a way that’s different from previous guidance.
Previously, the CDC said that vaccinated people are well protected from severe illness and are not likely to spread the virus to others. Therefore, prior guidance indicated they don’t need to be wearing masks. On the other hand, the unvaccinated are not protected. Especially with the more contagious Delta variant circulating, unvaccinated people are at high risk for contracting Covid-19 and transmitting the virus. They should be wearing masks when indoors.
This remains true with the new guidance. The CDC is now saying that people who are vaccinated should wear masks indoors, too, particularly if they live at home with people who are unvaccinated or immunocompromised.
My takeaway from this guidance is that these people – and I am one of them, with two children under the age of 12 who are not yet eligible for the vaccine – are at elevated risk because of the possibility of passing along Covid-19 to those we live with. We are still well protected ourselves from severe outcomes of coronavirus, but we want to reduce our risk by masking indoors to protect the vulnerable people in our family.
CNN: A lot of grandparents are now wondering if they need to be extra careful to avoid infecting their grandkids. Can grandparents still safely see their unvaccinated grandchildren?
Wen: Yes – though I think it’s a good idea for people who will be around vulnerable, unvaccinated individuals to be cautious and to try to reduce their risk, especially if they are in an area of high coronavirus transmission. That means wearing masks, limiting time in crowded, indoor settings, and recognizing that risk is additive – meaning that if you choose to engage in one high-risk activity, such as going to a large wedding with unvaccinated guests, you should try to reduce other high-risk exposures to cut your overall risk.
I want to clarify that the vaccines are still very effective, but they are not 100%. An analogy I like is that the vaccines are a great raincoat. They’ll protect you in a drizzle and even in a moderate rainstorm. But if you are in daily thunderstorms, at some point, you will get wet.
There are parts of the country that are in a drizzle. The level of vaccination in the community is high and infection rate is low. The chance of your encountering an asymptomatic, infected person is low, and if you’re vaccinated, the risk of you contracting Covid-19 and then being infectious to your grandchildren is very low. If you live in such an area, you can probably go about your normal daily activities without much worry that you could somehow bring coronavirus to your family.
That’s different if you’re in a community that’s undergoing a major surge of cases. Where vaccination rates are low and infections are high, you have a higher likelihood of coming in contact with infected people. In those circumstances, the raincoat may not be enough – maybe you need an umbrella, too. Think of the mask as that umbrella – that additional layer of protection.
You may also want to reduce your exposure to other high-risk activities. I probably wouldn’t be going to indoor bars and crowded gyms where other people around me are maskless. Reducing your risk of exposure will also reduce your likelihood of being an asymptomatic carrier who could bring Covid-19 to your unvaccinated grandkids.
CNN: What about parents who work in jobs where they are exposed to unvaccinated, unmasked people? Should they wear a mask at home?
Wen: This is a tough situation. I hope that workplaces implement procedures to keep employees safe. Ideally, they should require proof of vaccination or at least regular testing. If not, they should still be implementing masking and physical distancing.
If you are in a situation where your workplace does not have these protocols, you can still try to keep yourself safe. That includes wearing an N95 or KN95 mask when indoors and in close quarters with others of unknown vaccination status. Try to avoid maskless gatherings when possible – for example, eat lunch at your desk instead of around others. If possible, raise your concerns with your supervisor and see if you could be reassigned a workspace away from others or if you could at least try to avoid crowded conference rooms.
I think it’s really hard for parents to continuously wear masks in their own homes around their children – except in very specific, time-limited situations, like if they have symptoms or are awaiting a coronavirus test. The best thing to do is to try to reduce risk at work as much as possible.
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CNN: If an extended family is getting together, what’s safe? Let’s say that some are vaccinated, and some are not.
Wen: The safest thing to do is to get together outdoors only. In that case, no one needs to be masked or get tested.
If indoor get-togethers are planned with a group of mixed vaccination status, ideally everyone should quarantine and then get tested. With the Delta variant surging, this is the safest option to help keep families safe.
There is a lot changing with the CDC guidance. We need to do our best to reduce our risk while also resuming parts of our lives that are the most important. Vaccination remains the best way to protect ourselves and our loved ones.