Happy new year everyone!
I recently flew to Washington DC for work, and I was one of about 5 people masking on the whole plane, so I have been meaning to write about this.
The politics that has swirled around masking, an evidence-based prevention method, has definitely not been helpful.
As the United States experiences a diligent push to return to a “pre-COVID” version of normalcy, people who still wear a mask to protect themselves and their community were recently called out by large mainstream media outlets as ‘the last holdouts’ and public health professionals who still advocate for masking were portrayed as a fringe group who choose to ‘mask forever’. Largely absent from these critiques of masking, however, are the rational explanations about protecting one's self, protecting immunocompromised or vulnerable people, preventing long covid, or preventing new, more dangerous variants that could emerge via uncontrolled spread.
According to a 2022 survey by the Kaiser Family Foundation, nearly six in ten adults surveyed (59%) felt that Americans should continue to wear masks in some public places to minimize the spread and avoid another surge in cases. There were significant divides in the survey results by political partisanship and vaccination status, but also by race, ethnicity, and income with the groups most negatively affected by the COVID-19 pandemic advocating for continued mask wearing. Large majorities of Black adults (88%) and Hispanic adults (69%) said that people should continue to wear masks in some public places to minimize the spread of COVID-19. Around two-thirds of those with a household income of less than $40,000 a year (68%) said the same.
So, should we still wear a mask even if no one else is?
Data from many experimental and observational studies supports the use of face masks to prevent the spread of COVID-19 as well as other respiratory viruses. Masks work best to protect everybody when they are universally worn by all community members, but there is also evidence to suggest that a high quality facemask (N95/KN95) can protect the wearer even if no one else is masking.
What about the HEPA filters on airplanes?
Most modern jet aircraft are equipped with high-efficiency particulate air (HEPA) filters. They contain close knit fibers which trap impurities, removing 99.97% of them from the air.
It is important to remember, however, that even if the HEPA filtration on the plane is very effective, it is not operational during boarding or disembarking. It also obviously doesn't apply to flight-adjacent settings like the airport, boarding area, jet bridge, etc where most people are no longer masking either. So masking isn’t rendered obsolete in any of these settings because of airplane cabin air filtration.
What do I recommend?
We are still in a pandemic, and there are absolutely valid reasons to mask to protect yourself and others around you. Masks also protect really well against other respiratory viruses. We saw a markedly decreased incidence of influenza during 2020-2021 while under the mask mandates.
Airplanes are transient, heterogeneous populations, containing people with different risk behaviors and from areas all over the countries with varied COVID-19 incidence rates, so the risk of being infected with COVID-19 from one flight to the next can be completely different. If you wear a mask, that is at least one protection you can keep constant, as well as other easy mitigations like keeping up to date with COVID-19 vaccines, wiping down your seat/tray area, and keeping your hands clean.