Here’s What Virology Experts Think About Dropped Masks on Public Transport as New Variants Spread

This week, a federal judge ruled that masks can no longer be mandated on public transportation. With Covid infection rates rising, renowned doctors share how passengers can manage the personal risk.

On April 18, a federal judge in Florida struck down the mask mandate that the Centers for Disease Control and Prevention (CDC) enacted on January 29, 2021.

Now, individual transportation entities can make their own policies, which many already have. In less than 24 hours, United, Delta, Southwest, American, JetBlue, Alaska, Spirit and Frontier airlines all decreed masks optional, as did Amtrak. The New York Times reported that some travelers heard the news mid-flight and happily bared their faces. But while some Americans are exhaling in elation, others are concerned they’re trapped in transit.

The decision to lift the mask mandate was a judicial one, not based on public health considerations. So where does that leave you when it comes to protecting yourself and others from infection?

Read Covid-19 Breathing Exercises for Recovery (and Prevention): Respiratory Therapists’ Step-by-Step Process

The trouble with the timing

The masking change occurred just as Covid-19 subvariants BA.4, BA.5, and XE—plus more Omicron variants—are arriving on the heels of BA.2, which recently took the lead as the most dominant Covid-19 strain in the world. Read The New COVID-19 Variant, “BA.2″—Get 9 Facts Straight From Medical Specialists

The Covid-19 virus has continued to do exactly what viruses do: mutate and evolve. XE is a new hybrid variant of Omicron and BA.2 that was first spotted in the U.K. “XE is simply a recombinant version of BA.1 and BA.2, and although several countries have seen cases, this is not expected to be a major concern,” Robert Salata, MD, a professor of medicine at the Case Western Reserve University School of Medicine in Cleveland, OH, tells The Healthy.

Meanwhile, Omicron subvariants BA.4 and BA.5 are circulating in several countries within Southern Africa and Europe, as the World Health Organization keeps its eyes on them.

The jury is still out on what these variants are capable of, Salata explains. “It is not clear yet if they are more transmissible or associated with more significant disease than BA.1 or BA.2.” His prediction? There will be an uptick in cases, but not as many as there were with the original Omicron strain. “Whether this will escalate beyond cases to include significant hospitalization and death remains to be seen,” he says.

Two additional variants—BA.2.12 and BA2.12.1—are now spreading in central New York and appear to be closely related to the BA.2 variant, he says.

So far, it seems that Omicron and its subvariants cause milder disease than their predecessors.

So…to mask or not to mask?

In a nutshell, the decision to mask or not to mask on public transportation and in transportation hubs is now up to each individual. That decision should be between you and your healthcare provider, and based on your personal risk profile. “If you’re in a high-risk group, I think you’d want to be more careful and keep wearing your mask and doing as much social distancing as possible,” says William Schaffner, MD, an infectious diseases specialist at Vanderbilt University Medical Center in Nashville. “For those folks, we recommend that they continue to wear masks indoors, and that includes planes, trains, and buses.” This may also be true if you have a close loved one who is older or immunocompromised.

For anyone who’s getting ready to board a flight, ventilation in planes is actually pretty good, despite how cramped you might feel, says S. Wesley Long, MD, PhD, medical director of diagnostic microbiology at Houston Methodist. “I don’t think people should be unduly concerned.”

Of course, adds Long, anyone who wants to still has the right to wear a mask in peace—and in an interview with The Healthy, Robert G. Lahita MD, PhD, director of the Institute for Autoimmune and Rheumatic Disease at Saint Joseph Health in Paterson, NJ and author of Immunity Strong, says that may still be wise. “The American populous is waning as far as wearing masks and practicing social distancing and are not taking these variants—which seem to pop up every three days—very seriously,” Lahita says. Double-masking could make you feel greater assurance, especially aboard trains or buses, where good ventilation may not be such a sure thing.

Mutations will keep coming unless more people are vaccinated

Variants arise in places with significant numbers of non-vaccinated people, including underdeveloped parts of the world, Salata says. The Delta variant, for example, originated in India. “For the most part, having the primary series of two shots, along with a booster, does provide protection against severe disease, hospitalization, and death,” says Salata. If you’re considering the second booster (meaning your fourth Covid shot in total), Lahita suggests discussing the risks and benefits with your doctor. (Read up on the four tasks you should do right away if you’ve got your Covid-19 vaccine card.)

It’s important to remember: Covid-19 is still spreading

That said, SARS-CoV-2, the virus which causes Covid-19, is still with us. The latest incarnation, BA.2, is even more contagious than its parent, Omicron, which already was “extraordinarily contagious,” says Schaffner.

Transmission is relatively low but starting to creep up and, in a statement issued the same day the ruling came down, the CDC emphasized that “traveling on public transportation increases the risk of getting and spreading Covid-19 . . . Wearing masks that completely cover the mouth and nose reduces the spread of Covid-19.”

Vaccinations are reducing severe cases

The good news is that while cases are trending up, hospitalizations and deaths are heading in the opposite direction. On April 15, the CDC reported that about 66 percent of Americans are now fully vaccinated, while 77.3 percent have at least one vaccine.

The new transportation ruling “is just another reason people need to be vaccinated and boosted and then, if they want, to wear a mask,” suggests Long.

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Sources
  • William Schaffner, MD, infectious diseases specialist, Vanderbilt University Medical Center, Nashville
  • The New York Times: “Federal Judge Strikes Down Mask Mandate for Planes and Public Transit”
  • Centers for Disease Control and Prevention: “Requirement for Face Masks on Public Transportation Conveyances and at Transportation Hubs”
  • Centers for Disease Control and Prevention: “COVID Data Tracker”
  • Centers for Disease Control and Prevention: “Covid Data Tracker Weekly Review”
  • S. Wesley Long, MD, PhD, medical director of diagnostic microbiology at Houston Methodist
  • Robert G. Lahita MD, PhD, Director, Institute for Autoimmune and Rheumatic Disease, Saint Joseph Health, Paterson, NJ
  • Robert Salata, MD, professor of medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

Denise Mann, MS
Denise Mann is a freelance health writer whose articles regularly appear in WebMD, HealthDay, and other consumer health portals. She has received numerous awards, including the Arthritis Foundation's Northeast Region Prize for Online Journalism; the Excellence in Women's Health Research Journalism Award; the Journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery; National Newsmaker of the Year by the Community Anti-Drug Coalitions of America; the Gold Award for Best Service Journalism from the Magazine Association of the Southeast; a Bronze Award from The American Society of Healthcare Publication Editors (for a cover story she wrote in Plastic Surgery Practice magazine); and an honorable mention in the International Osteoporosis Foundation Journalism Awards. She was part of the writing team awarded a 2008 Sigma Delta Chi award for her part in a WebMD series on autism. Her first foray into health reporting was with the Medical Tribune News Service, where her articles appeared regularly in such newspapers as the Detroit Free Press, Chicago Sun-Times, Dallas Morning News, and Los Angeles Daily News. Mann received a graduate degree from the Medill School of Journalism at Northwestern University in Evanston, Ill., and her undergraduate degree from Lehigh University in Bethlehem, Pa. She lives in New York with her husband David; sons Teddy and Evan; and their miniature schnauzer, Perri Winkle Blu.
Amanda Gardner
Amanda Gardner is a freelance health reporter whose stories have appeared in cnn.com, health.com, cnn.com, WebMD, HealthDay, Self Magazine, the New York Daily News, Teachers & Writers Magazine, the Foreign Service Journal, AmeriQuests (Vanderbilt University) and others. In 2009, she served as writer-in-residence at the University of Wisconsin School of Medicine and Public Health. She is also a community artist and recipient or partner in five National Endowment for the Arts grants.