After a judge overturned a US Centers for Disease Control and Prevention (CDC) warrant requiring US airline passengers to wear masks on planes, transportation safety systems stopped enforcing masking at airports. A viral video even showed a flight attendant walking down an airplane aisle asking people to throw away their masks. But with the resurgence of covid cases, what does the abandonment of the mask mean for public health? Although you don’t have to wear a mask on a plane, should you?
It is always difficult to answer these questions. While science has brought us great advances in pharmaceutical interventions such as vaccines and covid treatments, it has provided little new insight into the value of non-pharmaceutical interventions such as masks.
We know far less than we should about the covid risks associated with flying or the benefits of cloth and surgical masks. We know people lower their own risk of getting sick when they wear an N95 respirator around other people. Reducing your own risk also protects others, since you can’t give anyone lust unless you’re infected.
But too little attention has been paid to measuring the impact of public health measures. US public health officials simply decided that face coverings would be America’s main non-pharmaceutical intervention, assuming we needed something to protect people while reopening the economy. But that was just a hypothesis, and one that hasn’t been rigorously tested.
Several controlled trials have shown a small benefit of universal masking with surgical masks: a 10% reduction in cases. Harvard medical professor Edward Nardell says there is good data showing that surgical masks in hospital settings have reduced the transmission of TB – not covid – by around 50%. It’s a different situation, but he thinks it’s reasonable to assume that surgical masks help a bit but don’t make a risky situation safe.
In a recent interview, University of Minnesota epidemiologist Michael Osterholm pointed out that mask mandates can give people a false sense of security. There is little data on the benefits of cloth masks, and these are the masks many people wear on airplanes. Worse still, many passengers remove their masks for large parts of a fight while eating or drinking. If the array of baggy masks most people wear doesn’t stop airborne transmission, people could be taking more risks than they realize. The airflow is good on planes so the risks are not as bad as being in a similar sized stuffy room full of other people, some of whom may have covid, but there is some danger . Harvard’s Nardell said he would recommend those at high risk, or just particularly cautious, wear a fitted mask such as an N95. It’s not easy to carry for a long flight, and you’ll have to avoid snacks and drinks. This should therefore figure into the decisions that high-risk people have to make when deciding whether to take a holiday abroad or a local route. travel.
Not all high-risk conditions are alike, so it’s a good idea to check with your doctor before booking a flight, said Leonard Marcus, co-director of the National Preparedness Leadership Initiative at Harvard University. It would be a good idea even with the mask warrant, although he thinks the end of the warrant will make the theft a bit more risky. He also said that aircraft masking doesn’t have to be all black or white; for example, when cases are low, vaccinated people may make a reasonable choice to remove their mask to eat and drink. However, he said that right now cases in the US are on the rise and we could still see another outbreak of infection from newer Omicron subvariants like BA.2.
It’s not too late to learn more about the impact of masking and different types of face coverings. Controlled studies were not possible during mask mandates. Now researchers could collect data on volunteers who sign up for masked or unmasked flights in America.
This is not the right time to reduce research and mitigation efforts. Vaccines have not ended the pandemic as hoped, and new variants continue to pose new threats. Scientists and public health officials should do more, not less, to learn how to keep people safe. We need more free tests, more help getting antiviral drugs for the immunocompromised, more nudges to boost the elderly, and more scientific research into which activities and situations present the greatest threats.
Earlier in the pandemic, experts said they saw no downside to universal masking and a potential benefit, so it seemed reasonable to do so even without a lot of data. It’s ridiculous that two years later we still don’t have the data we need to know how valuable or not masking is. As covid is here to stay, it would be a great benefit for all of us to know what helps and what doesn’t.
Faye Flam is a Bloomberg Opinion columnist and host of the “Follow the Science” podcast.