During the cold and flu season, travelers use the New York City subway to test their stomachs. The woman next to you was coughing, the guy behind her was sneezing. Somebody was always fishing for a tissue, that's a distant memory now. The subway is much more pleasant, for one thing-and with riders on board almost universally wearing masks, the chorus of sniffles and coughs has been silenced.
The need for a strict policy on masks in this situation is clear, but should masks stay even after COVID 19 is gone? Before vaccines started rolling out to the general public, masks were among the only tools available for containing SARS-CoV -2, the virus that causes COVID 19. And they seem to have done their job; A mask both provides a physical barrier against germs and prevents them from inhaling potentially infectious droplets into the atmosphere, ideally curbing the amount of circulating virus that can infect others, says the U.S. Centers for Disease Control and Prevention. Areas that implemented mask mandates experienced statistically significant declines in COVID 19 case counts and deaths within 20 days, according to agency data.
Masks are minimally invasive, safe, inexpensive and effective, says Raina MacIntyre, a professor of global biosecurity at the University of New South Wales in Australia, which has studied face masks since long before the pandemic. They 're also controversial, while masks have in the pandemic less certainty than drawbacks; their post-pandemic future is clearly uncertain. Dr. John Conly, an infectious disease physician at the University of Calgary in Canada who has also studied masks, says he would not support masking after the pandemic ends, given downsides like discomfort and difficulty communicating. The American public seems to agree with the ubiquitous thrum of anti-mask sentiment in the United States, it's highly unlikely that they will continue to be a steady sight after the pandemic ends.
But there are certain settings-when riding a packed subway, for example, or visiting a loved one in the hospital-where an extra layer of protection might make sense even after the pandemic era.
Like COVID 19 itself, masks are likely not going to be our constant reality, but they may not fade completely. Before the world knew about COVID- 19, masking was already common in many Asian countries. Face masks became a frequent sight in Hong Kong, Japan and other parts of eastern Asia, particularly after the SARS outbreak in the early 2000s, where people often wore them to protect themselves and others during cold and flu season.
When COVID-19 hit, people in those countries generally were very willing to mask up. In the U.S., the sell has been a bit harder; most people were very rarely, if ever, masked before March 2020. Health officials actually discouraged the public from doing so in the early months of the pandemic, citing incomplete data about masks' effectiveness against SARS-CoV-2 and the need to preserve the personal protective equipment for health care workers. Even after health officials reversed course and began publicizing fabric masks, former President Donald Trump repeatedly downplayed masks' importance.
As the pandemic went on, public consensus shifted to be strongly in favor of masks, and many states and cities mandated their use in scientific settings. And while masks can still pass through-some particles are certainly not perfect -- the data suggest that they 've helped to curtail the spread not only of COVID-19 diseases, but other diseases too. During the flu season 2019- 2020, at least 24,000 people in the US died from the influenza virus.
It is too soon to know exactly how many people will die from the flu during the 2020 -- 2021 season, but it will almost certainly be a much lower number. According to CDC data, less than 500 people in the U.S. and just one child-had died from flu as of April 1. The full season will not end until May, but flu death rates would have to increase astronomically in order to match the traditional season toll of last year. Masks are n't solely responsible for that sudden drop; more people got vaccinated against flu during this season compared to usual ones, as the CDC has issued desperate warnings to stave off a flu and COVID 19.
Distance, social distancing and enclaving of the school keep people away from strangers' germs. During the pandemic many people have been hyper-conscious of hand-washing and other hygiene to avoid harm.
Masks are only one piece of this bundled approach, and it's difficult to tease out exactly how much of a role they played, says Conly, who co-authored a November 2020 analysis of respiratory disease prevention tools. After analyzing nine prior studies on non-N 95 medical masks, Conly and his colleagues found little evidence that they 'd prevent the wearer from catching influenza or a flu-like illness. A controversial and well-publicized study from Denmark in March 2021 concluded that surgical masks did not significantly reduce the wearer's chances of COVID 19. But there are two issues in play when it comes to masks; one is whether they protect the wearer from disease.
Experts have known all along that surgical masks do n't block all pathogens. They are likely to provide some protection for the wearer, but they are not an impenetrable barrier, as the above two studies confirm. The second issue, which is harder to measure, is what is called source control. Masks seem to be quite good at trapping many of the respiratory droplets, exhaled by the wearer, that could prevent them from getting out into the atmosphere where they could infect others.
If everyone wears a mask, there's simply less virus floating around, which theoretically translates to fewer sicknesses. Reducing the amount of virus in shared environments is a crucial aspect of pandemic response. And because COVID 19 can be spread asymptomatically, meaning that anyone could be unknowingly carrying the virus and passing it to others, everyone should be doing what they can to avoid spreading it.
The equation is a little more complex in the post-pandemic future. Once we are not living with the constant threat of a dangerous disease, the downsides of masking-annoyance, unwanted communication, acne, possibly even small amounts of microplastic inhalation-can outweigh the source control benefits, Conly says. The balance of the evidence would suggest that this is not a good thing to do, Conly says. MacIntyre disagrees; it likely would not be reasonable to wear a mask 24 7 once COVID 19 is contained, but she says masking is safe enough to justify it in high-impact settings like public transit, long-term care facilities and hospitals.
Once the pandemic ends, mask wearing would n't even have to be universal or mandatory for making a difference. Right now, with COVID- 19 spreading as rapidly as possible, each person who refuses to wear a mask in public could potentially endange those around them. In a post-COVID future, however, every person who chooses to wear a mask would be doing a little extra to keep themselves and those around them healthy, says MacIntyre.
It would be particularly logical for people to wear masks during cold and flu season when there is quite a bit of disease going around. This means that though it's assumed cold and flu seasons would continue to exist in their current forms, which may not be guaranteed if masks stick around.
Australia is an instructive example. Rates of the childhood disease respiratory syncytial virus plummeted there last winter-usually the dominant season for RSV-when most people were at home and wearing masks. As Australia got COVID 19 under control and reopened for its summer season, the country experienced an off-season surge of RSV even beyond what would be expected during a normal winter.
The surge may have been the cost of an earlier RSV season, says Dr. Richard Malley, an infectious diseases physician at Boston Children's Hospital. Human immunity is layered: While exposure to a virus or bacteria can get someone sick, it also often helps prepare their immune system for its next brush with the pathogen.
When did you think about your idea of living by yourself? A RSV season would get plenty of people sick, but it also builds up community-wide immunity in preparation for the next season. If cyclical exposure, immunity likely began to wane over the winter months-so when people encountered RSV in the summer, their bodies were n't prepared for it and they got sick, Malley explains. Malley says that year-round masking could also change disease patterns in the U.S. Malley says.
Instead of uniform disease seasons, viruses could circulate and spread at more defined levels all year round. That could turn out to be a good thing if it meant less disease overall. However, it is not entirely clear what would happen if regular mask wearing reduced exposure to common pathogens enough that some kids were not exposed to routine viruses or bacteria until later in life. For certain diseases that kill kids harder than adults, this delay could be beneficial, even lifesaving.
However, it may also alter the way kids naturally build immunity to certain pathogens over time. This would be, in a way, a national experiment, says Malley. In the case of coronavirus, because of the impact this virus has on society, it goes without saying that social distancing and masking measures are absolutely the right way to go. But this is a much more difficult question to answer over the long term but the question is as follows: At this point, however, Malley doubts that most people would even be willing to wear masks often, without the immediate threat of a pandemic and the mask mandates that came with it.
Malley notes that we ca n't even get some people to do it in the midst of the pandemic. They have been lifesaving, but they do represent, in some extent, the restrictions that have been placed on us all.
There are some lessons from the pandemic that can catch on, even if masks once again fade to the provenance of Halloween costumes. Never before has the American public been so attuned to how diseases spread and the potential consequences when they do. Malley hopes that consciousness and conscientiousness will outlast the pandemic, encouraging people to keep washing their hands, getting vaccines and staying home from work or school even if they think they only have the sniffles. That we 've been telling people for years, he says, may finally sink in.