How I Made My Mask Optional Decision



One of the most dangerous aspects of a novel pathogen is that the population has no underlying immunity and are highly susceptible to infection and disease. This was our situation early in the pandemic. Mask mandates were necessary to attempt to slow the spread of the virus and keep vital components of our society open — like in-person education. Thankfully, much has changed since the early days of the pandemic. The virus can still be very dangerous to some individuals, however the benefit of being two years into the pandemic is that large portions of the population are no longer vulnerable due to the combination of widespread vaccination and/or prior infection. 


When LMSD decided to go mask-optional, I had a decision to make as to whether or not I should remain masked. I ultimately chose to go maskless after assessing three major criteria. First, I consider the impact on my household. Every member of my household is as vaccinated and/or boosted as they are eligible to be. We are fortunate that we do not have any high risk individuals, which was evident when the coronavirus came to our house over the winter. The infection ranged from barely noticeable to flu-like symptoms depending on the individual, and thankfully no one experienced any of the more serious symptoms that more vulnerable individuals can get. If I had more vulnerable members of my household, I would likely wear a KN95 mask to work to protect that family member, but given the low-risk nature of my young and largely healthy family, this does not seem necessary. 


Even though my family has always been low risk, earlier in the pandemic it was important that everyone did their part to slow the spread until the community was more protected. As we have seen, allowing a virus to spread too quickly through a population can overwhelm healthcare services, which has the obvious impacts on ICU beds for COVID patients but also the less obvious, but very significant impact on non-COVID patients avoiding receiving routine treatment and therefore having severe outcomes that could have been avoided. Mask mandates were useful and necessary to slow this spread when we had no other defenses; however high community vaccination rates, prior infection, and the antiviral medications now at our disposal are much more effective tools. This is why the CDC has correctly tied their mask recommendations to community hospital usage. Since our community hospitals fall in the low category, mask usage for the greater good of the community does not seem warranted at this time. 


The third consideration that weighed on my decision was concern for the most vulnerable members of our community. About 3% of the population is moderately-to-severely immunocompromised and either cannot get vaccinated or their body does not respond to the vaccination to the same degree as the majority of the population. These individuals, under no fault of their own, have an increased risk of severe disease from infection and part of being a responsible member of a society is to protect our vulnerable. It may seem paradoxical, but the worst scenario for an immunocompromised individual is for the healthy members of society to avoid exposure to this virus. Our immunity protects them. The best way to protect these people is to reach herd immunity safely. This is done by widespread vaccination of eligible healthy people and then slow, subsequent mild breakthrough infections to keep immunity levels high throughout the community. Removing the mask mandate in a community that is largely vaccinated supports this end and arguably benefits our most vulnerable.


Lastly, many are understandably concerned with inevitable future variants of the coronavirus and wish to remain masked to limit these variants. This is a global virus that has infected hundreds of millions of people around the world. It has a well-studied, predictable rate of mutation and the next variant will come as will many after that. The best protection against future variants is to get a yearly vaccine booster to keep your individual level of immunity as high as possible. Breakthrough reinfection will occur for some individuals seasonally, but the more exposed you are to the most recent variant through vaccination, the more likely you are to have a very mild outcome.