The federal requirement to mask up on planes and other forms of transportation was tossed Monday by a federal judge in Florida. But health experts say those who want to protect themselves from the coronavirus as cases rise again should continue to cover their faces — with the best possible mask.
“You can quote me on this: I’m going to continue to wear an N95 mask,” said David Freedman, professor emeritus of infectious diseases at the University of Alabama at Birmingham. “No question. You have no idea who’s on a plane.”
He added: “I think everyone should.”
Freedman and other experts stressed the importance of the coronavirus vaccine and boosters now that travelers will find themselves traveling amid unmasked crowds.
According to Washington Post data, new daily cases over the past week are on the rise while hospitalizations and deaths decline. Before the judge’s ruling, the Centers for Disease Control and Prevention extended the mandate’s expiration date to May 3 to monitor the new wave. On Wednesday, the Justice Department said it will appeal the ruling.
“It’s not an ideal time right now,” said infectious-disease expert John Swartzberg, clinical professor emeritus at the University of California at Berkeley’s School of Public Health.
He said that while early indications are that the current wave will be fairly mild, the new omicron subvariant, BA.2, is “extremely transmissible.”
Swartzberg said he expected the mandate to be lifted on May 3, and he found the judge’s decision to lift it earlier “problematic.” He said he is not worried about his own flight next month because he is up to date on his vaccinations, plans to wear a well-fitting N95 the entire time and understands that treatment is available if he does get sick.
“Wearing my hat as a physician and public health professor, I’m more chagrined that we’re putting people at risk while it’s unnecessary to do that,” he said.
Robert Wachter, chair of the department of medicine at the University of California at San Francisco, said he was shocked by the judge’s decision, though he supported the mandate being dropped in May if a major surge did not materialize.
“I think the threshold for a mandate has to be fairly high, and I think the situation changed enough, so it was reasonable to at least consider removing the mandate,” he said. “To have it be done by a judge rather than public health authorities just strikes me as wrong and a very dangerous precedent.”
Wachter said he believes people should wear masks on airplanes and on public transit, even if they’re not compelled by the government to do so. He said recent flights that he has taken have included maskless people who lingered over food and drinks for hours.
“My attitude is that the planes, as of tonight, are somewhat less safe than they were, but still relatively safe because of the level of ventilation,” Wachter said Monday.
According to the International Air Transport Association, cabin air is refreshed 20 to 30 times an hour, with the air being half-fresh and half-filtered.
Freedman, president-elect of the American Society of Tropical Medicine and Hygiene, said the airflow is most effective when the engines are fully running. But passengers are less protected while in the airport, boarding and sitting on the plane before takeoff, he said. He is in favor of mandatory masking “curb-to-curb” except when passengers are sitting on the airplane with the wheels up.
For those who aren’t willing to wear a mask during an entire flight, he said: “At least wear it during the critical periods, which means before and after you’re in the air.”
Leonard Marcus, director of the Aviation Public Health Initiative at the Harvard T.H. Chan School of Public Health, said masks can lower the risks of transmitting disease by roughly 50 percent. A report by the initiative highlights the importance of multiple layers, including ventilation, social distancing and masks.
“On an airplane, we’re in very, very close proximity to one another,” he said. “So therefore, continuing to wear masks is something I’m going to do and I would recommend others to do, especially if they want to avoid getting the disease.”
Freedman said adults who are immunocompromised should strongly consider getting a fourth dose of a vaccine when eligible and should be sure to wear a mask.
Kids under five years old, who are too young to be vaccinated, should also mask to protect themselves, he said. But the CDC does not recommend kids who are younger than 2 to wear masks.
“It really is the zero-to-2-year-olds that are in the toughest spot,” Wachter said. “Until there are vaccines, if I had a little baby, I would not fly.”
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