So you think you can tell
Heaven from hell?
Blue skies from pain?
Can you tell a green field
From a cold steel rail?
A smile from a veil?
From Pink Floyd, Wish You Were Here, 1975
On Friday, May 14th, The Center for Disease Control announced, somewhat unexpectedly, that our masks could come off. That is, if you were vaccinated, and not in certain types of facilities or venues, such as airports, public transportation, or hospitals, you no longer need to wear a mask in indoor or outdoor spaces, to protect yourself or others.
It seems that we were waiting for this day since this whole catastrophe started. But when the announcement actually came that the restrictions were lifted, the reaction that I heard most was, “What? Wait a minute.” Part of the public’s reaction was due to the clumsy nature of the announcement. Most governors, when making major changes to Covid-19 restrictions, did so by picking a date a few days hence, so that people and businesses would have time to make necessary adjustments. By declaring the change was immediate, many of us felt confused, and unsure what to do next.
Most of us needed some time to get the spinach out of our teeth and pick the hair that was growing out of that mole on our upper lip. Our lower faces had been unknown to the world for 15 months, and some time was in order for getting spackled up and smoothed over. Could we tell a smile from a veil? In terms of our health, was this a good idea?
The most recent decline in Covid cases, hospitalizations, and deaths was dramatic: Positivity rates of Covid testing fell to below 5% in 45 out of 50 states and below 3% in 20 states. The reproduction or R number, which predicts future infectivity of the virus, fell below 1 in 46 states, indicative of a contracting infection nationwide. About half of the states had succeeded in vaccinating at least 50% of their population and vaccination progress remains fairly strong. (Mississippi, Alabama, and Louisiana are lagging pretty far behind, but hey, they still eat grits for breakfast down there)
Maryland is in better shape that any time since the Pandemic began, with a positivity rate of 2.6% and low numbers of new cases. Maryland has vaccinated 55% of the adult population with at least one dose of vaccine. These statistics suggest that it will be pretty hard for the virus to gain another foothold here, masks or not.
We can be sure that the grip of the virus is loosening here and in some parts of the world by the return of normalcy. This includes a new confrontation in the Middle East, the resumption of weekly mass shootings around the U.S., traffic jams, and long security lines at airports. So, you think you can tell Heaven from Hell?
Are you ready to remove the veil and show your smile? If you are fully vaccinated, I think this is totally safe in most venues including the supermarket, the Home Depot, and the dry cleaners. If you have not yet been vaccinated, you are still at risk of contracting the virus and spreading it, so put that sucker back on and go get a shot. One factor in the CDC announcing the change in guidance, was evidence that vaccinated individuals do not spread the infection almost at all. If you are traveling by air, you are still required to wear a mask in the airport and while in the airplane. This makes some sense, given that you are basically sucking face with the person in the middle seat every time you get on a crowded plane. If they don’t give you the coronavirus, they will likely be giving you something else, even if is a whiff of the digested burrito they ate for lunch.
In our office, we request that you still wear a mask in the waiting room, reception areas, and lab areas for now. Once in the exam room, if you have been vaccinated and feel comfortable removing your mask, please do so. Our staff has all been vaccinated, so the risk of transmission here is extremely low. If you would rather leave your mask on, we get it, please do whatever makes you feel comfortable. We will be updating this recommendation as conditions on the ground permit. It does feel awkward to be letting down our guard but the data support doing so.
Over the summer, it is likely that all restrictions will be removed from indoor and outdoor gatherings, and this is appropriate. In the fall when our offspring return to school, it is likely that mask requirements will be in place for students who have not been vaccinated. This will include all kids under 12, for which the vaccine will not likely be approved until late in the year, and those 12 and up who have not yet received the vaccine. It is possible that viral caseloads will be at such low levels over the summer, that even young children will not be required to wear masks at school.
So here is to a summer of blue skies and green fields, unless you have not been vaccinated. Then you are looking at a hellscape of cold steel rails and pain. Apologies to Pink Floyd. Get the shot!