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The Washington PostDemocracy Dies in Darkness

Masks went away. Then anxiety spiked for high-risk travelers.

When the transportation mask mandate dropped, it added another layer of frustration for immunocompromised people

(Daniel Fishel for The Washington Post)
5 min

Kayla Phaneuf has flown all over the country from her home in Virginia — from Los Angeles to Phoenix to Boston. But one week after the federal mask mandate ended on planes and other transportation, the 24-year-old found herself on one of the most stressful flights of her life.

“I almost had an anxiety attack because I was so hyper aware of people coughing who were not wearing masks or people sneezing and not covering their faces with their elbows,” she said. Phaneuf estimates less than 10 people, including herself, wore masks on her flight.

She’s immunocompromised after contracting the coronavirus in January 2021, which has persisted as long covid. It took her over a month to recover from the initial virus, and the effects have since made migraines, brain fog, fatigue, chest and joint pain, and muscle aches a regular part of her life.

For eight months, she had to stop working due to the severity of her symptoms. She dreads the impact a second infection could have.

About 7 million Americans are considered immunocompromised, making them especially vulnerable to severe infection, even if they are vaccinated. When the transportation mask mandate dropped, it added another layer of anxiety and frustration for high-risk travelers.

According to immunologists, the mask ruling came prematurely and without measures to mitigate the effects of future variants. Michael Mina, an epidemiologist at testing company eMed, called the move “dangerously bad.”

“This is not a decision for a judge. This is a decision for the CDC,” he said. “A large amount of data shows that the pandemic isn’t done with us yet, and we continue to see pretty significant jumps in mutations.”

The Biden administration has appealed the ruling. In a statement, the Centers for Disease Control and Prevention said it believes the mandate “remains necessary for the public health.”

What it was like on my first unmasked flight

Purvi Parikh, an immunologist and vaccine researcher at NYU Langone, says that the timing of the decision comes as only about half of Americans have received their booster.

Parikh says the move makes air travel more dangerous for immunocompromised people. Buses, trains and other transportation without HEPA air filtration are also risky.

“When flying, there is no [physical] distancing in TSA lines,” Parikh said. “The ventilation and filtration is poor in these areas as well.”

The lifting of the mask mandate doesn’t mean, however, that immunocompromised people can’t fly, according to Beth Wallace, assistant professor of rheumatology and internal medicine at the University of Michigan.

“Covid-related risks are not the same for every person who is immunocompromised, and the balance of risks and benefits is different for every person,” she said.

Phaneuf had booked a flight for April 22 — four days after the mask mandate ended — to attend a friend’s wedding in Massachusetts. She considered canceling the flights and taking Amtrak instead, although trains also no longer require masks. Ultimately, she continued as planned with a N95 mask and plenty of hand sanitizer.

That chill music when you board a flight? There’s a reason for it.

Since getting covid, Phaneuf says she’s become hyper-aware about the potential risks others posed to her when it comes to getting sick.

“I’m constantly having to think about where people have been, what they’re doing and what they’re touching,” she said.

For Mitra Ghobadi, knowing that she may be one of the few masked people on flights is enough to stop flying, something she previously did every few months. Ghobadi had a recurrence of breast cancer in January, and chemotherapy treatments have made her immunocompromised.

“I was already double-masking and was extremely careful,” she said. “But what this means for me is that I would rather take international flights than domestic flights.”

She was furious when she heard that the federal mask mandate was struck down. Ghobadi finds wearing masks uncomfortable for long periods of time, but did it even before becoming immunocompromised to protect herself and others.

“Obviously it’s inconvenient. … But so is wearing a seat belt and observing the speed limit,” she said.

Ghobadi says her own freedom to live her life as she had before has been “severely constricted” by the lack of masking on planes and trains.

Phaneuf has no plans to fly again soon, if the mask mandate remains gone, as it simply isn’t worth the risk to her.

Both Phaneuf and Ghobadi say they feel isolated by other traveler’s ambivalence toward wearing a mask for a few hours.

“After struggling through this year [with long covid] and not being able to do a lot of things and having to quit my job, to see people rejoice over being able to take off their masks feels very inconsiderate,” Phaneuf said.

Wallace says immunocompromised people are not only facing potential health consequences, but also the social consequences of being excluded from opportunities and events they may have otherwise previously attended. There are also emotional consequences for high-risk individuals feeling that many people, even those close to them, are not concerned about their health and disagree with the precautions they’re taking.

“Several of my patients have had people close to them tell them to stop worrying about covid, or refuse to mask around them, because ‘almost no one is dying anymore’ when the reality is the people who are still dying or getting very sick from covid are exactly the people who look like them,” she said.

For all travelers, Wallace says the best way to protect yourself and others while traveling is to stay up to date with booster guidance and wear a high-filtration mask, as encouraged by the CDC.

“If you choose not to mask, please respect those who do,” she said. “And remember that the risks of contracting covid may be different for them or their loved ones than they are for you.”