Injecting a Community Perspective in CDC Mask Guidance

Concerns have been raised over the practical implications of recent CDC guidance relaxing recommendations for mask wearing among vaccinated people.  Some of this stems from issues of trust: will the majority of unvaccinated people responsibly wear masks when close to others in public and indoors? 

This is of particular concern for people who are immunocompromised, or who can't be vaccinated yet, including younger children.  Even if they wear masks themselves, the presence of unvaccinated, unmasked people in shared settings such as supermarkets would put them at greater risk than before.

I too fear that some people who refuse to get vaccinated will also be likely to not wear masks, whether from a lack of belief in the severity of COVID-19, a general resistance to authority, political feelings or whatever.  

I would suggest incorporating a community health aspect into the official guidance:

• On an individual level, if you are vaccinated and with other people who are vaccinated, you don’t have to wear a mask.
  
• In terms of public policy, mask restrictions should only be dropped once the level of vaccination in the community reaches a certain point, such as 60% or more or whatever the science dictates.
  
• Information on the level of COVID-19 in the community*, such as by monitoring sewage or through other methods, could also be incorporated in the guidance as a refinement. 
  

This would make sense from a risk-mitigation and disease-reduction perspective, and could add incentives for people on the fence to get vaccinated so they do not feel themselves part of the group holding the community back from relaxing restrictions.

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* Regarding estimating the level of COVID-19 in the community, I have long felt that the commonly cited "percent positivity" measure would be much more informative if one additional piece of optional information were collected at time of testing:  "Why are you being tested today?"   

Choices could include: 

1. Possible exposure to someone with COVID-19
2. Experiencing symptoms
3. Planning to travel or be around others
4. Required by my employer or school
5. Other
6. Decline to say

The reasons why people are tested change over time and between communities, and the lack of a consistent denominator makes comparisons harder and less informative.   Some states do break out Higher Education rates from those of the general population.  But asking for this one additional and optional piece of information could only help give a more accurate impression of what is actually happening.

Dan Gruen | Gruen Design Research LLC