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While some fliers cheered the removal of the federal mask mandate, the move has others concerned.
Infectious disease experts weigh in on the safest approach to travel after the federal mask mandate was abruptly dropped last week and as COVID cases are on the rise again.
After a federal court ruling in Florida last week abruptly put an end to the national transportation mask mandate, masks are now optional on domestic flights, trains, and most public transportation. With no guarantee of how many fellow passengers will be wearing masks, how concerned should travelers be about the risks of COVID-19 transmission while in transit?
“With cases rising throughout the country and with children under the age of five still ineligible to be vaccinated, I think that the federal transportation mask mandate was dropped too soon,” says Dr. Shira Shafir, UCLA Fielding School of Public Health associate professor of epidemiology and community health sciences.
Many Americans agree and would prefer to still have everyone masking up while traveling—56 percent of respondents in a recent survey favored requiring masks in transit. That’s compared with 24 percent who were opposed to the transportation mask mandate and 20 percent who didn’t care either way, according to a nationwide poll of 1,085 adults conducted April 14–18 by the Associated Press–NORC Center for Public Affairs Research.
Dr. John Swartzberg, professor emeritus of public health at the University of California Berkeley, also felt the federal transportation mask requirement was dropped prematurely in part because “we don’t have a real good picture of where this current [COVID] wave is going.”
Following the Florida ruling, the U.S. Centers for Disease Control and Prevention (CDC) stated that while the transportation mask order is no longer in effect, the agency “continues to recommend that people wear masks in indoor public transportation settings at this time.”
Just prior to the April 18 decision issued by U.S. District Judge Kathryn Kimball Mizelle, the CDC had announced that it would be extending the transportation mask requirement until May 3 due to the rising number of COVID-19 cases and the spread of the Omicron BA.2 subvariant.
But in light of the decision, the Transportation Security Administration (TSA), which was enforcing the mask mandate, issued a statement that it will no longer be enforcing mask use on public transportation and in transportation hubs, a move that resulted in a domino effect of mask requirements being lifted across the country, including on planes, trains, and in automobiles (Uber and Lyft have dropped their mask requirements, too).
Given that COVID cases are again on the rise, some travelers are worried about traveling now that other passengers aren’t required to wear face masks. In a poll conducted April 19–20 (just after the ruling) by research and analytics firm Ipsos, 53 percent of the nearly 1,000 respondents said they believe that dropping the mask mandate will result in an increase in COVID cases. Nearly half of the respondents say they are very likely to continue wearing masks in airports (46 percent), on planes (47 percent), public transit (46 percent), and trains (45 percent). For half of the respondents (49 percent), the end of the mask requirement doesn’t make them any more or less likely to fly now. For those who say it does make a difference, 27 percent are now more likely to fly, and 23 percent are now less likely.
The airlines say they are offering options—including refunds in some cases—to those who no longer want to travel. But for those travelers who would like to continue with their plans, how can they best protect themselves?
For those who are concerned about infection and transmission and feel more at ease continuing to wear a mask when flying, in an airport, on a bus, or in any public spaces, they may be wondering how protected they are if they are the only ones wearing a mask on a crowded flight.
“There is definitely evidence showing that masks protect the wearer, even if they are the only one wearing one. Since the amount of protection depends on the quality and fit of the mask, I recommend N-95, KN-95, or KF-94 masks while traveling,” says Dr. Shafir.
Pia MacDonald, an epidemiologist and the senior director of applied public health research at nonprofit research institute RTI International, says she flew last week both before and after the ruling came down, but only feels comfortable flying if she is wearing “a well-fitting N95 or KN95 mask for the duration of the flight. Absolutely wear the mask.” She adds that she feels “much safer” wearing a high-quality mask in large part because she hopes to avoid getting infected with COVID, and she hopes to avoid infection because “there is very little known about long COVID.”
Another way for masked fliers to enhance their protection is “to not eat or drink as much as possible,” says MacDonald, noting that the protection is diminished when the mask gets pulled down for food and beverages.
UC Berkeley’s Dr. Swartzberg notes that if everyone on the flight wears a mask, the risk of transmission is lower than if you’re the only one wearing one. But “between being up to date with vaccination and wearing a KN95 you’ve very significantly mitigated your risk,” he says.
Nevertheless, following last week’s ruling, Dr. Swartzberg is postponing an early May trip to Washington, D.C. with his wife to visit their daughter until hopefully sometime in June when the current new wave of cases eases. “We’re going to wait until we see where this current wave of infections is going,” he says.
Dr. Thomas Russo, chief of infectious diseases at the University of Buffalo’s Jacobs School of Medicine and Biomedical Sciences, notes that several groups of people should continue wearing masks while traveling even though it’s no longer required:
For those who want to continue to wear a mask, Dr. Amesh Adalja, an infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security, says wearing a very good mask even when others are not wearing a mask can still provide decent protection. “One-way masking, especially with the high-quality masks available today, works,” Dr. Adalja tells AFAR.
When asked how the risk of flying compares to, for instance, being in a grocery store, Saskia Popescu, senior infection prevention epidemiologist at George Mason University, explains that “there are a lot of factors that impact risk—how long you’re in the space, the ventilation, how many people [there are], etcetera. Usually we’re in spaces for travel, such as planes and buses, for longer periods of time and they involve smaller spaces with more people.”
Popescu adds that typically a grocery store run is shorter than the time one spends on a flight and the spaces are larger. Popescu travels for work and says that when she does so “wearing a mask continues to provide me with protection even if those around me aren’t masked.”
So, what’s considered a “high-quality” mask? N95s have become the gold standard for protection, but infectious disease experts also recommend well-fitted KN95 and KF-94 masks.
“Loosely woven cloth products provide the least protection, layered finely woven products offer more protection, well-fitting disposable surgical masks and KN95s offer even more protection, and well-fitting NIOSH-approved respirators (including N95s) offer the highest level of protection,” the CDC states in its latest mask guidance. (NIOSH stands for National Institute for Occupational Safety and Health.)
While KN95 and N95 masks (or respirators as they are sometimes called) can offer a similar level of protection, N95s are considered a notch above because of the NIOSH approval that ensures they are well manufactured. The CDC reported that about 60 percent of KN95 respirators evaluated by NIOSH during the pandemic were of subpar quality, so it is important to research and buy quality KN95s, typically made overseas, from reputable vendors.
The Justice Department has filed an appeal seeking to overturn Judge Mizelle’s order voiding the federal mask mandate on planes and trains and in travel hubs. The notice of appeal filed in federal court in Tampa came in response to the CDC having asked the Justice Department to appeal the decision.
The CDC said it will continue to monitor public health conditions to determine if a mandate would remain necessary. It said it believes the mandate is “a lawful order, well within CDC’s legal authority to protect public health.”
The Department of Justice agrees, issuing a statement that it “continues to believe that the order requiring masking in the transportation corridor is a valid exercise of the authority Congress has given CDC to protect the public health.”
White House spokesperson Jen Psaki told reporters on April 19 that “public health decisions shouldn’t be made by the courts. They should be made by public health experts.”
Psaki noted that the Biden administration is “abiding by the CDC recommendations . . . and we would advise all Americans to do that.”
Associated Press contributed reporting.
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