This has made the social-media rounds since yesterday, but it’s been true for the past year or more anyway. “There’s no place for them in light of Omicron,” Dr. Leana Wen told CNN’s Victor Blackwell, but there wasn’t any place for them in light of Delta, Beta, or any other variant either. Cloth masks only provide minimal mitigation against viral transmission of any kind, and their only virtue is their existence in an environment where no other options exist.
That was the mitigation context in April 2020. It hasn’t been the case for well over a year (via Townhall):
.@DrLeanaWen: "Don't wear a cloth mask. Cloth masks are little more than facial decorations. There's no place for them in light of Omicron." pic.twitter.com/Kpoj18sxdi
— Townhall.com (@townhallcom) December 21, 2021
BLACKWELL: Mayor de Blasio says that the city has yet — not yet made a decision if it will cancel the Times Square event for crowds to show up. Right now, you have to be vaccinated, show proof of vaccination if they hold it. But for people who are considering going there to the peach drop in Atlanta or any of these similar events across the country, what would your advice to them be, go, not go, or if you’re vaccinated, you’re fine? What do you think?
WEN: Well, I do not think that Mayor Blasio should be canceling the New York City event because it requires proof of vaccination and it’s outdoors. We should be keeping the events that are safe and also the events that have fun for people too. We can’t be canceling everything, especially if we’re going to be living with COVID for the foreseeable future.
I would say that if you choose to go, make sure that you’re vaccinated and boosted, make sure that you’re wearing a mask, even though it’s outdoors, if there are lots of people packed around you, wearing a three-ply surgical mask. Don’t wear a cloth mask. Cloth masks are little more than facial decorations. There’s no place for them in light of Omicron. And so wear a high-quality mask, at least a three-ply surgical mask. And if you’re going to be visiting elderly relatives or immunocompromised people after, wait three days, get tested, and then see those vulnerable.
The cloth-mask phenomenon has served no other significant practical purpose than virtue signaling. When we had a massive shortage of PPE, it may have served as the only option for mitigation, but cloth masks were only slightly better than nothing — and only then when handled properly, ie, constant disinfecting, washing, etc. We haven’t had “nothing” for personal PPE since late spring of 2020, however, and that’s when cloth masking should have been discarded.
Surgical masks such as those recommended by Wen offer more significant mitigation, but they don’t entirely prevent viral transmission either for a variety of reasons. For one thing, they don’t fit airtight around the mouth and nose, and moisture eventually eliminates the electrostatic functions between the layers. (Plus, touching the outside provides a route for viral transfer.) The best option for masking are N95 masks, manufactured to a standard that does prevent viral transmission, but those are difficult to tolerate for long periods of time because they work so well.
Even those are probably not “full protection” against Omicron, either, but that’s missing the point a bit. It’s about levels of mitigation, not guaranteed prevention. Wen’s advice is rational, although mask-wearing outdoors is almost entirely pointless. Until someone demonstrates any evidence of outdoor transmission of COVID-19 outside of sustained physical contact — we have no reliable evidence of such — there’s no need to mitigate against it. In fact, it’s a waste of surgical masks. Cloth masks outside are even more pointless than they are indoors.
So why does the White House continue to model their use? That’s a question worth asking. It appears to only function as a way for Joe Biden to wear the presidential seal as a brand.
Wen’s other advice today in the Washington Post is also a mixed bag. She argues against the vaccinated canceling Christmas plans and travel, which is certainly rational — especially in light of Omicron’s apparent mildness. However, she wants the unvaccinated to get restricted to quarters:
It would be reasonable for the vaccinated and boosted to decide that they will continue traveling, dining out and seeing friends and family. Generally healthy people could conclude that their chance of getting seriously ill from omicron is very low. Their fear of hospitalization or long-haul symptoms may be outweighed by their desire to return to pre-pandemic activities.
For them, and for much of the vaccinated population, the calculation has changed from the risk that the coronavirus poses to them to the risk they could pose to others. Restricting their activities isn’t necessary or productive and would serve only to disincentivize vaccination.
We’ve been arguing that point on creating disincentives — or at least demotivation for vaccines for the last several months too. Wen correctly diagnoses the problem of imposing more and more burdens on the vaccinated, and especially the boosted. However …
There’s one group that I do think has been grossly irresponsible and is largely to blame for the “viral blizzard” we are in. That’s the group still choosing to remain unvaccinated. These are the same individuals who, by and large, ignore other covid-19 precautions and are therefore most likely to get infected, transmit to others and become severely ill themselves.
If anyone should have their activities limited, it’s the unvaccinated. More cities should follow Los Angeles, Seattle and New York in requiring proof of vaccination to go to restaurants, concert venues and gyms. A federal vaccination mandate for plane and train travel would also incentivize vaccination and reduce the spread of future variants.
That advice also doesn’t hold up well “in light of Omicron.” It’s become clear that the vaccinated and those with naturally acquired immunity can and do become vectors for community transmission. That’s why we’re seeing numbers like this in heavily vaccinated/heavily exposed New York City:
BREAKING: New York City has the nation's highest new case rate, per CDC data, and is now averaging more new cases than at any other point in the pandemic.
Cases in the city are trending up on an exponential curve, surging by about 640% in the last month. https://t.co/tL8j4EbH3H
— ABC News (@ABC) December 21, 2021
Banning the unvaccinated from the public square — especially the outdoor public square — does nothing to significantly change those risks for the vaccinated. With Omicron, even indoor gatherings restricted entirely to the vaccinated and/or boosted could well turn out to be a “superspreader,” and may have already in places with massive case waves. The purpose of such policies against the unvaccinated is entirely vindictive, as Wen implies. It’s also clear thus far that vaccinations and boosters greatly reduce the risks of acquiring a severe case of COVID-19 pneumonia, which means that the unvaccinated now (as before) are assuming the risks in public engagement.
It’s long past time we dispensed with the zero-COVID mentality. There is no “stopping the spread”; COVID-19 is now endemic, variants and all. We have created the tools to begin living with the spread. Those who choose to use them can do so, as they are plentiful enough to be accessible on demand. Let that be their choice, and let’s get back to rational risk assessment and assumption with those choices.