The CDC Updated Its Mask Guidance

If you’re confused by the latest recommendations, you’re not alone

Three mask-wearing individuals in different colored boxes (green, yellow, and red) indicating varying levels of Covid-19 risk.

On May 13, 2021 the CDC issued updated guidance on masks. For the most updated recommendations, please visit the CDC’s website

This week, the Centers for Disease Control and Prevention released new guidance on masks. The updated recommendations for when to wear a mask combine vaccination status and a color-coded schema to assign varying levels of risk — green being safest, yellow less safe, and red the least safe — to different activities.

The hot takes were mixed. Many were glad to see evidence-based recommendations that better outline what’s safe and what isn’t. Others found the update too confusing and cautious. In reality, it’s all those things. With a lot of virus still circulating and only 30% of Americans fully vaccinated, it isn’t easy to give blanket guidance.

Does the new CDC infographic leave you a little confused about how to assess your personal risk and whether you need a mask? Here’s a short summary of how to read the new recommendations.

1. It’s easy if you’re fully vaccinated. You can do a lot more — and do it safely.

If deciphering red versus green, indoor versus outdoor, or masked versus unmasked is confusing, just remember this: If you’re vaccinated, everything for you is now much, much safer.

For unvaccinated folks, the CDC recommends a mask for everything other than low-risk outdoor activities with your own household or others who are fully vaccinated. Unvaccinated and attending an outdoor picnic with multiple families? Unless everyone else is fully vaccinated, the CDC says you need a mask.

But for vaccinated people, it’s much more straightforward. Seeing vaccinated friends outside? Don’t need a mask. What if those friends aren’t vaccinated? Still don’t need a mask. In fact, the only time the CDC recommends a mask when you’re outside is if you’re in a crowd. Jumping in a mosh pit at an outdoor concert? Put on a mask, even if you’re vaccinated. Exercising your constitutional right to take to the streets and protest? Put on a mask.

Otherwise, if you’re vaccinated, you only need a mask when you’re indoors. And that’s only when you’re indoors with unvaccinated people from multiple households. Don’t know if everyone in an indoor space is vaccinated? Assume they’re not and wear a mask.

It’s all pretty straightforward if you’re vaccinated. So, if you’re on the fence and needed an impetus to get your shot, this should be it.

And, by the way, “fully vaccinated” means two weeks after your second shot of the two-dose mRNA vaccines (Pfizer-BioNTech and Moderna) or two weeks after the single-dose Johnson & Johnson vaccine. Getting vaccinated in the morning doesn’t mean you can cast your mask aside that same evening. The vaccines are scientific miracles, but the real magic happens inside your immune system — which takes time.

2. It’s not just about individual risk

Americans are fiercely individualistic folks. And, looking at the CDC guidance, you’d be forgiven for thinking it’s all about you when it comes to your Covid risk. But that’s not how it works.

Everyone will have slightly different risk levels, depending on whether you’re vaccinated, whether you’re gathering indoors, how close you’ll be to others, etc. But the one thing the graphic doesn’t take into consideration is the risk level in your specific community.

Even if new Covid case numbers are dropping nationwide, they still remain stubbornly high in many places around the country. Does being vaccinated substantially reduce your risk of getting Covid? Yes. A lot. And does it prevent you from getting really sick with Covid, even if you do get infected? Yes.

But being vaccinated doesn’t completely negate the risk. That’s why the CDC is still recommending masks for fully vaccinated people on public transit, in museums, during your indoor Pilates class, or in other places of potentially higher exposure.

Being vaccinated allows you to do all sorts of things — inside and outdoors — a lot more safely. But according to the new CDC recommendations, it doesn’t mean you can just throw caution (and your mask) to the wind just yet. And that’s especially true in places where a lot of virus is circulating.

Just like checking your local weather in the morning to know if it will rain, knowing the level of community transmission of Covid-19 around you can help you assess how much risk there is in your daily activities and whether your behaviors should change. Thankfully, the CDC has an interactive map that shows how much virus is circulating and what percentage of each community is vaccinated, all the way down to the county level. Check it out and know your risk.

3. It might take time to adapt

Just because the CDC says you can safely unmask on your afternoon stroll or at a small park gathering doesn’t mean you must.

Let’s be honest, this last year has been tough. Getting used to wearing masks wherever we went wasn’t easy. Feeling comfortable without them will require a difficult adjustment too.

This summer will be wonderful and weird. Sure, it will be great seeing family we haven’t seen in a long time, or having dinner and drinks with friends. But it’s going to feel really strange when we take off our masks, exposing ourselves after being hidden for so long.

Here in New York City, where we were walloped by Covid-19, I bet people are going to hold onto their masks a lot longer than in places that didn’t see the same level of viral destruction. And that’s okay.

If you show up at an event where everyone takes off their mask but you don’t feel comfortable doing so yet — regardless of what the color-coded CDC infographic says — know you don’t have to and shouldn’t feel pressure to do so. Our own risk tolerance doesn’t always perfectly track alongside actual risk. Yeah, the CDC can tell you what’s safe at a minimum. But trust yourself to know what feels right and if stricter measures suit you, listen to your gut.

I’m writing weekly for Medium about my experiences as an emergency medicine doctor during the Covid-19 pandemic. You can read my previous posts on what “herd immunity” really means, global vaccine inequities, and more, here. Or find me over on Twitter.

NYC ER doctor | Ebola Survivor | Director of Global Health in Emergency Medicine at Columbia University | Public Health Professor | Doctors Without Borders BoD

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