On May 13, 2021, the CDC announced new, relaxed, mask-wearing “guidance” for people who were fully vaccinated against COVID. With good medical reasoning, the word from on high said those who were “all shot up” against the Sars-CoV-2 virus could go without masking in most places, except on public travel conveyances or in close quarters like sports events with many fans packed together.
This led to almost instantaneous mask/mass confusion. The unmasked reality is that the pandemic is far from over, especially for people whose immune systems are compromised somehow and can’t seem to mount a decent response to vaccines. It’s also not over for children for whom vaccines are not yet approved. The mRNA vaccines will keep about 90-95% of all takers from getting very sick, going to the hospital, or dying. But … what about the other few percent? Or those who can’t or won’t be vaccinated?
An entry on Facebook’s Winona COVID-19 community hub came from the Macon County Health Department in Decatur, Ill. It said: “If you see someone masked after the CDC/IDPH removed mask requirements for fully vaccinated people, please remember: 1. People may have cancer [immune system suppression]; 2. People may have autoimmune diseases [where their immunity is impaired]. 3. People may have unvaccinated children at home; 4. People may have high-risk loved ones they are protecting [like the elderly whose immunity is down by definition, along with many of their other biological functions]; 5. People may have asthma and have realized over the last year that their symptoms are alleviated by wearing a mask outdoors [!]; 6. People may be unvaccinated. Please be kind. People wearing masks have reasons why they are doing so. Continue to give people their space and be respectful of one another.”
Organ transplant recipients, omitted from the list above, also have good reasons for continued masking. Their immunity is suppressed by design to keep their system from rejecting their new kidney, liver, lung, etc. Someone with an organ transplant very articulately wrote on social media, “If you are fully vaccinated, I genuinely appreciate you and your choice to protect others. … If you’re not vaccinated, I’m not letting you near me. Science is a process, and I follow the science. While the vaccines are extremely effective for those who are immunocompetent, of those who take antimetabolites (anti-rejection medicines), like me, 43% of fully vaccinated transplant patients still do not develop antibodies to COVID-19.” Medical journal references are cited.
A May 30 article from the digital paper Huffpost related the plight of another patient with a different medical malady. Her immune system has been suppressed for 17 years by the treatment for a mysterious destructive inflammatory disease called sarcoidosis, too long to explain here, but not cancer. People can live with it or die from it. “I have no detectable antibodies for COVID-19 even though I’m fully vaccinated. Nobody knows yet whether or not COVID-19 vaccines are effective — fully or partially — for those who are immunocompromised. Not my doctor, not the CDC, not any of the experts I’ve consulted. Whether this means I have zero protection from my Moderna shots is the question mark. Immune function is complex and involves more than antibody function.” She lives in Montana, where there are a lot of anti-vaxxers. She wears a mask inside public places, and won’t go to parties, restaurants, etc.
The crucial point of our complex immune reaction involves parts we don’t and can’t yet routinely measure, involving T-cells or lymphocytes. These are the key memory cells for bad dudes and are sustained indefinitely in lymph nodes, etc. So we don’t have complete knowledge yet of immune competence in any population. It’s coming slowly as the virus teaches us.
From a May 25 NBC News article about continued mask use, “ Masks have consistently been one of the most divisive flashpoints of the pandemic, and those still wearing theirs receive mixed responses. … A Floridian found himself the center of a social media maelstrom after he tweeted, ‘Normalize wearing masks when you have any sort of cold/flu symptoms. Forever. It’s been nice not to even have a cold in over a year.’ … The tweet garnered over 416, 000 likes. But … some people argued he was infringing on their freedom, others called him crazy, and some called for him to be publicly beaten.” This mask behavior is precisely what has been done for decades in Japan, China and other Asian countries!
Individual entities are allowed to make their own rules. Winona Health still requires masks in all areas because there are many vulnerable patients in those halls. The Minnesota Marine Art Museum just announced that “for the health and safety of vulnerable populations, masks covering your nose and mouth are required at all times. … MMAM is an educational institution that serves large numbers of children who are not yet eligible for vaccinations. … We require ... masks ... to protect this vital and vulnerable population from the coronavirus.”
In a recent post on Facebook, “DrProps” quoted a Danish Scientist: “The rest of the world uses masks to great and life-saving effect, but it’s a conspiracy against freedumb loving Americans perpetrated on them by the evil Democrats. You can’t make up this kind of mind-bending stupidity.”
To make mask/mass confusion worse, as this is written Minneapolis and St. Paul have just lifted their mask mandates because vaccination rates are improving! So, as we meander through these next months with mask mandates mutating faster than viral variants, be patient and understanding of those who continue their masked existence, for whatever reason.
Dr. Bures, a semi-retired dermatologist, since 1978 has worked Winona, La Crosse, Viroqua, and Red Wing. He also plays clarinet in the Winona Municipal Band and a couple dixieland groups. And he does enjoy a good pun.