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When Will Mask Mandates End? What a COVID-19 Vaccine Means for Masking

How the vaccine will affect mask policies

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On Nov. 16, pharmaceutical company Moderna announced that preliminary data showed the COVID-19 vaccine developed in collaboration with the National Institute of Allergy and Infectious Diseases was 94.5% effective. The update followed a similar announcement from Pfizer and BioNTech, which showed their COVID-19 vaccine was also 95% effective.

Fast-forward into December, the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) have approved the use of Pfizer’s vaccine for people over the age of 16, and about 20 million people could get vaccinated before year’s end.

Priority population groups, including health care personnel, residents in long-term care facilities, home caregivers, people with certain underlying medical conditions and more are expected to receive the vaccine first, with a planned rollout to the general public in the following months.

Among the countless questions circulating about the COVID-19 vaccine, one that’s top of mind for many is “Can we stop wearing masks?” John Segreti, hospital epidemiologist and medical director of infection control and prevention at Rush University in Chicago, provided some answers and offered a tentative timeline for when life might return to normal.

What is herd immunity?
Herd immunity is necessary for life to become normal again. Segreti compared this concept to a brush fire in the forest. “If you’ve got a lot of dead and dry vegetation, the fire is going to take off, but if you have forests that are lush and green and aren't great fuel, then the fire will burn itself out and won't destroy the entire forest,” he said. The whole idea of herd immunity is that there are enough immune people in the population so that if a few people get sick, the vast majority won’t get sick or spread it to anyone else. Infectious disease experts believe the vaccine is the best way to achieve herd immunity.

How long will people have to wear masks?
“Until we do have herd immunity and the number of cases is down to zero or close to zero, we would still recommend people continue to wear masks,” Segreti said. A lot of that has to do with the unknowns, including the fact that trials haven’t yet shown whether vaccinated people can still be silent spreaders. “No vaccine is 100% protective and these two vaccines that will be available soon are 95% effective, but that’s in studies,” he said. “In real life, it’s generally a little bit lower than the efficacy people see in studies given the types of patients that will be vaccinated in real life compared to vaccinated in trials.” So until experts see the number of cases down to close to zero, masks are here to stay.

When will things be back to normal?
Many Americans want to know when life will be back to pre-COVID days. The truth is, no one, not even epidemiologists, can say for sure. But they can predict the best-case scenario. “I would say probably for at least six to nine months, we’ll still continue to have to wear masks and have social distancing,” Segreti said. “I think things will — if enough people get vaccinated and the vaccine works as well as predicted and we see the numbers going down — get back to normal at that point.” That takes us roughly into fall 2021, assuming there are no roadblocks with vaccine supply and distribution, and enough people step forward to be vaccinated.

Since masks are here to stay, are some better than others?
Based on information from the CDC, there are three categories of masks: N95s, basic surgical masks and cloth masks. N95 is the top grade, but unless you’re a healthcare worker on the frontline, it’s not necessary and should generally be avoided to save the supply. Per the CDC, surgical masks are the safest and most accessible, while cloth masks come with some criteria. “In the hospital, at least here at Rush, we don't allow cloth masks for our employees or visitors and so you do have to wear a hospital approved [surgical] mask,” Segreti said. “The CDC has said that cloth masks in the community are perfectly acceptable and they do have some criteria for what makes for a better mask.” Segreti elaborated the main criteria is that masks should not have any vents and cloth masks should have two or three layers.  “What's important is the material that will block the droplets that you produce to protect everyone else and stop the droplets other people produce to protect you. But what's critical is that you wear it correctly,” Segreti said. “You can have a great mask and if you wear it around your chin, it's not going to do anyone any good.” 

Will social distancing protocols loosen up with the vaccine?
Another challenging question experts are faced with is whether the requirements around social distancing will relax once the vaccine is up and running. According to Segreti, until 70-80% of people are immune from vaccination or natural infection, social distancing protocols must be followed and the country cannot let up.

Should I wait until I’m vaccinated to do certain activities?
While normal life is still out of reach, there is definitely a glimmer of hope and an end in sight. But in the meantime, Segreti recommends that everyone keeps doing what they’re doing. “I think if you follow the guidance that’s been given, you can feel pretty confident going to the grocery store even now without getting vaccinated, but you don’t want to be indoors outside of your home without a mask and you want to stay separated,” he said. “That's what we've been doing for the last nine months and it seems to work. And when it doesn't work, that's because people aren't doing what they should be.” If you’re still wondering how this pandemic might play out, here’s what happened with other major outbreaks throughout history.