C.D.C. Urges Better Masking for Increased Protection
Massachusetts is offering a shot to anyone who accompanies an older resident to a mass vaccination site. A W.H.O. panel recommends AstraZeneca’s vaccine even in countries where variants have been found. New York’s governor says arenas and stadiums can open this month with spectators, at very limited capacity.
Wearing a mask — any mask — reduces the risk of infection with the coronavirus, but wearing a more tightly fitted surgical mask, or layering a cloth mask atop a surgical mask, can vastly increase protections to the wearer and others, the Centers for Disease Control and Prevention reported on Wednesday.
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New research by the agency shows that transmission of the virus can be reduced by up to 96.5 percent if both an infected individual and an uninfected individual wear tightly fitted surgical masks or a cloth-and-surgical-mask combination.
Dr. Rochelle P. Walensky, director of the C.D.C., announced the findings during Wednesday’s White House coronavirus briefing, and coupled them with a plea for Americans to wear “a well-fitting mask” that has two or more layers. President Biden has challenged Americans to wear masks for the first 100 days of his presidency, and Dr. Walensky said that masks were especially crucial given the concern about new variants circulating.
“With cases hospitalizations and deaths still very high, now is not the time to roll back mask requirements,” she said, adding, “The bottom line is this: Masks work, and they work when they have a good fit and are worn correctly.”
Virus-related deaths, which resurged sharply in the United States in November and still remain high, appear to be in a steady decline; new virus cases and hospitalizations began to drop last month. But researchers warn that a more contagious virus variant first found in Britain is doubling roughly every 10 days in the United States. The C.D.C. cautioned last month that it could become the dominant variant in the nation by March.
As of Feb. 1, 14 states and the District of Columbia had implemented universal masking mandates; masking is now mandatory on federal property and on domestic and international transportation. But while masks are known to both reduce respiratory droplets and aerosols exhaled by infected wearers and to protect the uninfected wearer, their effectiveness varies widely because of air leaking around the edges of the mask.
“Any mask is better than none,” said Dr. John Brooks, lead author of the new C.D.C. study. “There are substantial and compelling data that wearing a mask reduces spread, and in communities that adopt mask wearing, new infections go down.”
But, he added, the new research shows how to enhance the protection. The agency’s new laboratory experiments are based on the ideas put forth by Linsey Marr, an expert in aerosol transmission at Virginia Tech, and Dr. Monica Gandhi, who studies infectious diseases at the University of California, San Francisco.
One option for reducing transmission is to wear a cloth mask over a surgical mask, the agency said. The alternative is to fit the surgical mask more tightly on the face by “knotting and tucking” — that is, knotting the two strands of the ear loops together where they attach to the edge of the mask, then folding and flattening the extra fabric at the mask’s edge and tucking it in for a tighter seal.
Dr. Brooks cautioned that the new study was based on laboratory experiments, and it’s unclear how these masking recommendations will perform in the real world (the experiments used three-ply surgical and cloth masks). “But it’s very clear evidence that the more of us who wear masks and the better the mask fits, the more each of us benefit individually.”
Other effective options that improve the fit include using a mask-fitter — a frame contoured to the face — over a mask, or wearing a sleeve of sheer nylon hosiery material around the neck and pulled up over a cloth or surgical mask, the C.D.C. said.
Even as vaccines are being slowly rolled out across the country, the emergence of the new variants, which may respond differently to treatments or dodge the immune system to some degree, has prompted public health officials to emphasize that Americans should continue to take protective measures like masking.
In a bid to get more residents age 75 and older vaccinated, Massachusetts officials say they will also inoculate the people accompanying them, regardless of age, to mass vaccination sites, which can be confusing to navigate.
“The idea for a mass vaccination site can seem a bit daunting,” Marylou Sudders, the secretary for health and human services in Massachusetts, said at a news conference on Wednesday.
The knowledge that the person accompanying them to the vaccination site will also be inoculated, Ms. Sudders said, may “bring an extra level of comfort to those who may be hesitant or don’t want to bother their caregiver or loved one or a good friend to book an appointment.”
Massachusetts has administered almost a million doses of the vaccine at nearly 130 sites statewide, said Gov. Charlie Baker. About 10 percent of residents have received at least one dose of the vaccine, and 2.8 percent have received both doses, according to a New York Times tracker.
Companions should be able to schedule their vaccine along with that of the older resident, the governor said, and effective Thursday, they now can.
Joan Hatem-Roy, the chief executive of Elder Services of Merrimack Valley, a nonprofit group in Northeast Massachusetts, called the idea “a game changer.”
“I get nervous going to a Patriots game at Gillette, so I can imagine a senior trying to think about going to Gillette Stadium,” one of the vaccination sites, Ms. Hatem-Roy said.
Some expressed concern that younger people who are less susceptible to serious illness from the virus might get a vaccine before people who are 65 or older or who have chronic health conditions.
But Governor Baker said the immediate goal was to make sure people 75 and older are vaccinated.
“Those communities are far more likely to lose their life and get hospitalized as a result of Covid,” he said. “We want to make sure that we make it as easy as we possibly can for folks who fall into that over-75 category to get vaccinated and to get vaccinated early in this process.”
The state’s decision to vaccinate companions came as a surprise to Dr. Ashish Jha, the dean of Brown University’s School of Public Health, who said Massachusetts had not moved as quickly as he had expected on vaccinations. He said he would rather see more vulnerable groups be deemed eligible for the vaccination first and for any transportation issues to be resolved without companions getting shots.
“I do know that the governor is feeling a lot of pressure to improve the performance in the state,” Dr. Jha said. “That may be part of the motivation for doing this, because it will certainly bump up those numbers.”
He does not expect other states to follow suit — at least, not right away.
But Dr. Jha said it might be different in April or May, when the supply of vaccine may outweigh the demand.
In some places, a similar model has been attempted on a smaller scale.
In Albemarle County, Va., 70 caregivers and family care providers for people with intellectual disabilities were vaccinated, according to local affiliate NBC29. In Texas, older and disabled residents said they wanted their home health workers to be vaccinated, but many workers were refusing the inoculation, according to The Texas Tribune.
With fraud already popping up in everything from vaccines to tests to stimulus checks, Dr. Jha worried that scammers might try to use the new Massachusetts program to take advantage of older residents.
“I don’t know how you carefully police that,” he said. “There are bad actors who may try to manipulate this.”
Ms. Sudders offered her own warning on Wednesday, urging older residents’ not to accept offers from strangers to be their vaccine companions.
