What to consider before taking off your mask on public transit or planes

After a federal judge on Monday struck down the federal mask mandate on planes and public transportation, many Americans cheered the decision, while others wondered whether it is safe to go without facial coverings while traveling at a time when COVID-19 cases are back on the rise nationwide.

The Transportation Security Administration said Monday it wouldn’t enforce the mask requirement while the White House reviewed whether it would appeal the ruling, according to a Biden administration official.

Meanwhile, the Centers for Disease Control and Prevention still recommends that people wear masks while on public transportation or airplanes. To add to the confusion, some local transit authorities (like the Southeastern Pennsylvania Transportation Authority of Philadelphia) have changed their mask mandates after the ruling while others (like the Metropolitan Transportation Authority of New York City) have kept them intact.

To help offer some guidance on mask wearing, Yahoo News spoke to medical contributor Dr. Lucy McBride, a physician in Washington, D.C, who specializes in internal medicine. (Some responses have been edited for length and clarity.)

Yahoo News: What are some factors to consider when deciding to wear a mask?

Dr. Lucy McBride: Vaccination, ventilation and vigilance — those are the three V’s in mitigating the risk for people who are at highest risk for this virus.

Whether or not you decide to mask in public in a crowded space, in a not-so-crowded space, in a concert, in a bar, in a restaurant with your friends, it really comes down to your medical vulnerabilities, your immune status: have you had Omicron or COVID in the past; have you been vaccinated; which vaccine have you had and how spaced apart has it been; and your tolerance for risk.

There’s really no right answer for whether you should [wear a] mask or not. There’s no one-size-fits-all behavior recommendation, because in the Omicron era, this is a wildly contagious variant. We can only delay, we cannot prevent an exposure to coronavirus. Unless, of course, we decided to seal ourselves off from the world, which isn’t compatible for most people. My job is really to arm people with the tools they need to delay the exposure to the coronavirus, and then protect themselves from the severe consequences with mitigation measures that are proven effective and weigh the harms of ongoing restrictions.

What are the highest- and lowest-risk situations when it comes to deciding to wear a mask?

The higher-risk situation in which a patient might want to consider a one-way mask is a poorly ventilated, crowded, indoor public space when you don’t know the immune status of the people around you, if you yourself are at high risk for serious consequences from COVID and in locations where hospitalization rates are high.

Outdoors, we needn’t worry [about wearing a mask].

What is the risk level with public transit?

Public transit, it depends. Airplanes actually have very sophisticated ventilation systems and are probably the lowest risk. There are so many other variables besides just the plane itself. If you had a plane full of people who are teeming with coronavirus, there’s no amount of ventilation to make a difference. I would worry less about an airplane than I would a poorly ventilated subway car where people were coughing and sneezing on each other. But I would also have worried about that in 2019, pre-pandemic.

If you’re not going to travel on public transport because of a [lifted] mask mandate now, you might not travel again, because this virus is here in perpetuity. I would really encourage people to think about how to protect themselves with the proven mitigation measures we have [COVID-19 vaccines] and use the mask as added protection if you want or need to.

Is a person wearing a mask still protected if everyone else in public isn’t wearing one?

One-way masking — meaning an N95 mask that you have well fitted and you don’t take off — is not contingent on the people around you. That’s not contingent on the behavior of people around you. That’s the mental leap we have to get over, is thinking that when other people aren’t masked that we can’t protect ourselves. We can.

What should people know going forward?

Given how contagious and how transmissible Omicron is, and given that this virus is here in perpetuity, we can’t prevent exposure to this virus. We can delay it, and we can minimize the risk of serious outcomes. Which is not to say we should not be careful — it’s to say that we need to accept the unpleasant reality that COVID is here to stay. We have to root our policies and our own behaviors in fact, and not this notion that we can avoid this virus forever, because it’s not realistic.

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