"I think it's premature to start changing our policies around facial covering," said Dr. Matt Willis, Marin County's public health officer.
Is it safe to step outdoors without our mouths wrapped in cloth?
A small but growing chorus of health experts thinks so — and urges an end to mandatory outdoor mask requirements. But others say it’s too soon to drop our guards.
Last June, confronted by a novel and terrifying virus, California imposed a mask mandate that requires people wear a face covering while walking on sidewalks, in parks and anywhere else outdoors where a safe 6-foot distance can’t be maintained.
Now, with the prospect of a full reopening of the state on June 15 because of increased vaccination and fewer hospitalizations, such caution is less necessary, some experts say.
“I believe it is important to reevaluate and change as you go along in a pandemic,” said Dr. Monica Gandhi, an infectious disease expert at the University of California, San Francisco, who was an early proponent of mask-wearing.
Masks still make sense in some outdoors settings, such as crowded political rallies or music festivals, she added.
Support for a shift is also coming from other prominent physicians, including Dr. Ashish Jha, dean of the Brown University School of Public Health in Providence, R.I.; Dr. Eric Topol, founder and director of the Scripps Research Translational Institute in La Jolla; and Dr. Paul Sax, clinical director of infectious diseases at Brigham and Women’s Hospital in Boston.
To be sure, enforcement has varied across the state. Some towns rely on voluntary compliance, while others are forcing violators to pay fines from $100 to $2,000.
The rule has created a dance of “mask yanking,” as we quickly hoist our masks whenever passing others walking the dog, hiking through forests or even whizzing by on a bicycle.
But with new cases and deaths reported each day in California, outdoor masking remains important, according to other experts.
Dr. Matt Willis, Marin County’s public health officer, said he supports the statewide mask mandate. He said it’s unnecessary for people to wear masks outside if they are alone, but when traveling with a group of people or coming in close proximity to others, masking can help prevent coronavirus transmission. The risk of transmission is low when people briefly pass each other outdoors, he said.
“Facial covering is one of the most important tools available to us,” Willis said. “At the same time, we want to not be arbitrarily restrictive and want to be guided by the science, and the reality is if we’re picking our battles, covering your face when you’re indoors is far more important to have 100% vigilance around than the minor risk associated with chance encounters in open spaces.”
About one in three Marin County residents has developed immunity to COVID-19 through vaccination, meaning at least two weeks has passed since they received a second shot of the vaccines made by Pfizer and Moderna or one shot of the single-dose vaccine made by Johnson & Johnson, according to Willis.
“I think it’s premature to start changing our policies around facial covering,” he said.
Worried by the increasing incidence of variants and unknown duration of immunity to the current vaccines, some experts say that wearing a mask outside your personal “pod” of friends and family is a minimal inconvenience.
They add: Now that we finally have widespread mask-wearing compliance, why encourage people to stop?
“I think we need to stay the course and hang with what the governor says,” said Dr. George Rutherford, an epidemiologist at UCSF.
Only 25.8% of Californians of all ages are fully vaccinated, he noted. That means almost three quarters of remain vulnerable. Residents should wait until June 15 to reconsider outdoor mask mandates, he said.
“As we as we get closer to having everyone vaccinated, especially adolescents, I think we can start talking about it. But now we need to exercise caution, even if (the virus) isn’t banging on the doors of the hospitals,” he said.
“There are a lot of uninfected people around,” he said. “There’s a lot of transmission around.”
California is one of 23 states that require people to wear masks in public spaces, including outdoors, according to MultiState, a government affairs lobbying group. Six states require masks in certain facilities and five states require masks for employees of certain industries. Sixteen states have no mask mandate.
This week, Colorado eased its mask mandate, releasing the requirement in rural counties with low rates of infection, except for schools, government buildings and personal services settings. The state’s most populous counties keep some form of mandatory masks in indoor public settings, according to Colorado Public Radio.
There are two major reasons for California to drop the mandate, according to Gandhi and other critics of the mask mandate.
One is scientific: There is growing evidence that being outdoors is very safe, they say.
A study of 1,245 cases in China found only three people were infected outdoors — and they were in conversation without masks. Of 232,164 cases in Ireland, 262 were associated with “locations which are primarily associated with outdoor activities.”
“Transmissions do not take place between solitary individuals going for a walk, transiently passing each other on the street, a hiking trail, or a jogging track,” Sax wrote in a blog post on the New England Journal of Medicine website. “That biker who whizzes by without a mask poses no danger to us, at least from a respiratory virus perspective.”
The other is societal: Easing rules will give Americans hope, and boost trust that public health policies will restore a sense of normalcy.
“I’ve watched the distrust that we’ve engendered by some of our public health measures, such as the massive lockdown, and it worries me for the next pandemic,” said Gandhi. “What this does is tell people who were doubtful of the masking: ‘Hey, we take your concerns into account. We’re looking at the data, and it looks like transmission is lower. So we’re going to release this.’ “
As the state looks toward reopening, she said, “It’s time to ask: Does this still make sense?”
IJ reporter Matthew Pera contributed to this report.
