Some cities in the US are debating returning to the use of masks indoors. This is what you need to know

Washington () — It is a confusing time, once again, in the covid-19 pandemic.

Consider this: Covid-19 cases are on the rise in the United States, fueled by the most transmissible variant of the coronavirus yet. Reinfections are also on the rise, and can increase the chance of new health problems. Even President Joe Biden has contracted the virus, forcing him to work in isolation at the White House.

Each of these developments is alarming in its own way. But none of them seem to have shaken the public’s conscience like the previous news about the pandemic. in the last national pollcovid-19 was a central concern for only 26% of voters, far behind the economy, abortion and the climate crisis.

There’s a good reason for this: A significant proportion of Americans are vaccinated—although the percentage who have received a booster is smaller—and there are new treatments that offer better results for those who contract the virus. Despite the fact that Biden’s age puts him at risk of contracting severe covid-19, for example, due to these advances, his experience with the coronavirus should be very different from that of President Donald Trump, who was in the hospital for days. in October 2020. (Biden, who received two boosters, is receiving the antiviral Paxlovid, and his doctor wrote Sunday that his “symptoms continue to improve significantly.”)

But with a subvariant that can overcome vaccination or immunity from recent covid infections, our days of putting the pandemic aside may be numbered.

Take Los Angeles, the second most populous city in the United States, for example. Health officials say the high community level of COVID-19 in Los Angeles County means a universal indoor masking mandate could be enacted as soon as this week. While reported daily cases have leveled off, with some 6,700 new cases a day, Department of Public Health Director Barbara Ferrer said last week that the community level needs to return to “medium” by June 28. July to avoid requiring the use of masks indoors on July 29.

And it’s not just Los Angeles reacting to the rising number of cases and hospitalizations. The proportion of the US population living in a county with a “high community level of COVID-19,” in which the US Centers for Disease Control and Prevention (CDC) recommend universal indoor masking, doubled in the last two weeks. And as Americans have switched to faster home tests, the official case count reflects only a fraction of the true burden of the disease.

That’s why the use of masks indoors has been brought up again, with Boston, for example, issuing a new masking advisory earlier this month. But much depends on local politics, and the merits of such measures—especially mandates—remain a matter of debate.

To learn more about this topic, we turned to Dr. Leana Wen, a medical analyst and professor of public health at George Washington University. Our conversation, conducted via email and lightly edited to make it smoother and shorter, is below.

What matters: Does the recent increase in covid-19 cases require that the use of masks indoors be re-imposed?

WEN: There is a big difference between a recommendation for individuals to wear a mask and a government-mandated requirement. Government requirements for public health precautions should be used sparingly, for emergencies where there is no other option. This is not that time.

I am concerned about the erosion of trust, such that when a mask mandate is really needed – if there is a much more lethal variant or if hospitals are again overwhelmed – there will be no appetite to accept mitigation measures at that point.

What matters: What should policymakers consider when weighing the possibility of reintroducing indoor mask mandates?

WEN: There are now other tools besides mask mandates. This is not 2020. I would advise legislators to use other tools that are very effective in reducing the likelihood of serious illness, but do not carry such a backlash; for example, why not apply boosters and Paxlovid? Why not encourage testing before meetings?

What matters: On an individual level, at this point in the pandemic, when should we mask up and when can we stop?

WEN: That depends on each person and how much they want to continue avoiding covid-19. Those who prioritize avoiding contagion should continue to wear a mask, but should ensure that they wear an N95 or equivalent (KN95 or KF94), that it fits properly, and that it is worn in all enclosed public spaces.

There are many people who no longer prioritize avoiding covid, since they are well protected against serious diseases thanks to vaccines and treatments; they may not want to wear the mask even with high levels of transmission around them. That is why the mask mandates by the government do not make sense at this time of the pandemic.

What matters: Is there anything else you want to add about all this?

WEN: It is true that masks reduce the risk of transmission of the virus and that the requirements for masks are very controversial. I urge legislators to focus on tools that don’t garner as much public backlash and make as much of a difference, if not more, than government-mandated masking.