Masking Is Not Just a Matter of If, but What Kind and When

We are making headway (maskway?) here in the United States, with more consensus that masks are key. Collectively, we can drive transmission down big time by wearing them. But if we accept that the average person—talking about myself here—can’t wear a mask 24/7, then we need to make sure we have the best masks possible, and that we wear them when it is most critical.

Masks are important because they both block transmission to others and protect the wearer. They don’t do either perfectly—the better the mask, the better it works—but perfect is the enemy of good enough to keep the R0 below one. So, masks are better than no masks. That’s the most important point.

We would greatly benefit from better masks. Folded up T-shirts work, but the better the mask, the less the viral transmission. This is especially true for essential workers and those at high risk of severe disease. Higher filtration masks are key.

How do we get better masks? This will have to happen either through the federal government — which seems unlikely, unless officials invoked the Defense Production Act — or through the private sector. Investors and companies should be racing toward making these, with a huge market opportunity in addition to the massive public health benefit.

Masks are not just needed to stop Covid-19 cases, hospitalizations, and deaths. They are also our ticket to actually reopening safely, getting back to work, and doing the things that we love to do. Without a vaccine, masks are our next, most pragmatic and achievable step to burning out the epidemic.

Masking is not an all or nothing behavior, either. I keep seeing people running outside alone with masks on, yet not masking indoors while socializing with friends and family. When you mask is almost as important as if you mask. If people can only realistically mask for X number of hours, then they must do so when transmission risk is highest.

This means masking indoors. This may very well mean masking around family or relatives as well, especially if they are in vulnerable risk groups and you live in a high-transmission area. In addition, this means masking while riding public transportation and at work.

Masking while alone in your car or when you are on a walk by yourself or for the second you pass by someone on the street is less useful. Your mask here likely won’t do too much as your risk of transmission is already very low.

So in short: Masks work, better masks work better, and masking during high-risk transmission situations matters more than during those which are low risk. Lastly, don’t shame those not wearing a mask. It won’t work. A genuine conversation may go further—but keep your own mask on.