WASHINGTON — Amid continuing confusion and debate over mask wearing, Dr. Anthony Fauci, a top medical adviser to the Biden administration, emphasized that the time has come to let up on wearing face coverings in some situations.
“If you are going into a completely crowded situation, where people are essentially falling all over each other, then you wear a mask. But at any other time, if you’re vaccinated and you’re outside, put aside your mask. You don’t have to wear it,” he said in a television interview on Thursday morning.
His characteristically blunt comments came amid questions about whether the Centers for Disease Control and Prevention is misinterpreting scientific studies and exaggerating the risk of outdoor transmission.
Fauci, who began his career battling the HIV/AIDS epidemic, has typically urged caution. But he also recognizes that exhaustion is setting in, particularly around the issue of wearing masks.
“We’ve got to make that transition,” Fauci said Thursday. Only days before, he predicted that mask wearing could become “seasonal” in the United States, as it already is in some East Asian countries.
But pulling a mask from a cluttered kitchen drawer in the midst of a nasty flu season is not quite the same as universal masking both indoors and out, which is the more immediate issue for a nation where more than 100 million are vaccinated against the coronavirus but thousands are still contracting the pathogen each day.
When the coronavirus pandemic started, people were confused about face masks. Now the pandemic seems to be winding down in the United States, and people are still confused about face masks.
That confusion is no longer about whether masks work (they do, according to scientific studies) but whether they need to be worn both indoors and out, and whether vaccinated people still need to mask up as assiduously as those who have not yet been administered the coronavirus vaccine.
Fauci’s comments were substantively — if not tonally — in keeping with recommendations from the CDC, which revised its outdoor masking guidance late last month. Critics have said that guidance does not go far enough, because even unvaccinated people appear to have an extremely low probability of either spreading or contracting the coronavirus outdoors. Many of those same critics were angered by guidance for summer camps that still requires children to wear masks outdoors in most situations.
Much of the recent criticism has focused on Dr. Rochelle Walensky, the CDC director, who in March spoke of a feeling of “impending doom” about the trajectory of infection rates and hospitalizations. A doomsday scenario hasn’t come to pass, and the comment served only to deepen the divide between the proponents of continued caution and the evangelists of casting off masks and returning to normal as quickly as possible.
Nothing is as indicative of that divide as the face mask, which is perhaps why it continues to be a source of so much political and cultural fascination.
When the pandemic began, Trump administration public officials said masks were unnecessary. They later urged mask wearing, despite a conservative backlash. Trump’s CDC director, Dr. Robert Redfield, went so far as to say that masks offered better protection than vaccines, a comment that attracted the president’s ire.
The benefits of wearing a mask, however, appear to be confined to indoor settings, where physical proximity between people, particularly in poorly ventilated spaces, facilitates the spread of airborne particles. Outdoors, aerosol scientists have found that the particles typically diffuse too quickly to spread the virus.
Yet the latest CDC guidance does not appear to reflect those conclusions, advising that unvaccinated people continue to wear a mask in most situations. Since vaccines have not been approved for children (the Pfizer vaccine was approved for adolescents earlier this week), that means children will be instructed to continue wearing face masks on playgrounds and in other outdoor settings.
Resistance to childhood masking appears to be rising, in part because children seem to only rarely spread or contract the coronavirus.
Criticism of the CDC intensified this week with allegations that it was promulgating a “huge exaggeration,” as one virologist put it, by describing the risk of outdoor transmission as being less than 10 percent. The actual risk, based on studies conducted in Ireland and elsewhere, is about one-10th of 1 percent.
Fauci has attracted plenty of anger from the right, but while he is an expert political operator who has served (and survived) every president since Ronald Reagan, Walensky is new to high-stakes politics. A renowned infectious disease expert at Massachusetts General Hospital, she now faces the scrutiny of poll-wary elected officials and battle-savvy culture warriors.
She is also the head of an agency that lost some degree of credibility during the Trump administration and is eager to return to the good graces of the American people, not to mention of the senators who control the agency’s funding. But while a lack of guidance can prove alarming, so can guidance seemingly uncoupled from scientific reality.
“I understand that they’re in a difficult position,” Dr. Leana Wen of George Washington University told the health-focused outlet Stat News for an article critical of the CDC. “However, caution and indecision also come at a price.”
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