5 Reasons to Wear a Mask Even After You’re Vaccinated

Yves here. Even though this Kaiser Health News story appears to be getting some good play, I thought the message on continuing mask discipline was so important that it warranted featuring here. I hope you’ll circulate it to friends and family.

In addition, this is an opportune spot to highlight a tweet that appeared in Links a second time. It appears that one recommendation is to secure your mask headband-style if it is not already a headband type mask. I happened to use an N95 mask that was headband style for the first time and found that the fit on the face was much tighter than for the ear-loop type.

I also wondered if readers had any clue as to what the difference is between a procedure mask and a surgical mask. The difference in effectiveness is significant.

By Liz Szabo, an award-winning Kaiser Health News senior correspondent. Before coming to KHN, Szabo covered medicine for USA TODAY and The Virginian-Pilot in Norfolk, Virginia, including an award-winning series that led to new laws in Virginia disciplining physicians. Originally published at Kaiser Health News

Although she is fully vaccinated against Covid-19, Dr. Eugenia South plans to continue to wear a face mask in public for fear she could still spread the virus. (PENN MEDICINE)

As an emergency physician, Dr. Eugenia South was in the first group of people to receive a covid vaccine. She received her second dose last week  — even before President-elect Joe Biden.

Yet South said she’s in no rush to throw away her face mask.

“I honestly don’t think I’ll ever go without a mask at work again,” said South, faculty director of the Urban Health Lab at the University of Pennsylvania in Philadelphia. “I don’t think I’ll ever feel safe doing that.”

And although covid vaccines are highly effective, South plans to continue wearing her mask outside the hospital as well.

Health experts say there are good reasons to follow her example.

“Masks and social distancing will need to continue into the foreseeable future — until we have some level of herd immunity,” said Dr. Preeti Malani, chief health officer at the University of Michigan. “Masks and distancing are here to stay.”

Malani and other health experts explained five reasons Americans should hold on to their masks:

1. No vaccine is 100% effective.

Large clinical trials found that two doses of the Moderna and Pfizer-BioNTech vaccines prevented 95% of illnesses caused by the coronavirus. While those results are impressive, 1 in 20 people are left unprotected, said Dr. Tom Frieden, a former director of the Centers for Disease Control and Prevention.

Malani notes that vaccines were tested in controlled clinical trials at top medical centers, under optimal conditions.

In the real world, vaccines are usually slightly less effective. Scientists use specific terms to describe the phenomenon. They refer to the protection offered by vaccines in clinical trials as “efficacy,” while the actual immunity seen in a vaccinated population is “effectiveness.”

The effectiveness of covid vaccines could be affected by the way they’re handled, Malani said. The genetic material used in mRNA vaccines — made with messenger RNA from the coronavirus — is so fragile that it has to be carefully stored and transported.

Any variation from the CDC’s strict guidance could influence how well vaccines work, Malani said.

2. Vaccines don’t provide immediate protection.

No vaccine is effective right away, Malani said. It takes about two weeks for the immune system to make the antibodies that block viral infections.

Covid vaccines will take a little longer than other inoculations, such as the flu shot, because both the Moderna and Pfizer products require two doses. The Pfizer shots are given three weeks apart; the  Moderna shots, four weeks apart.

In other words, full protection won’t arrive until five or six weeks after the first shot. So, a person vaccinated on New Year’s Day won’t be fully protected until Valentine’s Day.

3. Covid vaccines may not prevent you from spreading the virus.

Vaccines can provide two levels of protection. The measles vaccine prevents viruses from causing infection, so vaccinated people don’t spread the infection or develop symptoms.

Most other vaccines — including flu shots — prevent people from becoming sick but not from becoming infected or passing the virus to others, said Dr. Paul Offit, who advises the National Institutes of Health and Food and Drug Administration on covid vaccines.

While covid vaccines clearly prevent illness, researchers need more time to figure out whether they prevent transmission, too, said Phoenix-based epidemiologist Saskia Popescu, an assistant professor in the biodefense program at George Mason University’s Schar School of Policy and Government.

“We don’t yet know if the vaccine protects against infection, or only against illness,” said Frieden, now CEO of Resolve to Save Lives, a global public health initiative. “In other words, a vaccinated person might still be able to spread the virus, even if they don’t feel sick.”

Until researchers can answer that question, Frieden said, wearing masks is the safest way for vaccinated people to protect those around them.

4. Masks protect people with compromised immune systems.

People with cancer are at particular risk from covid. Studies show they’re more likely  than others to become infected and die from the virus, but may not be protected by vaccines, said Dr. Gary Lyman, a professor at Fred Hutchinson Cancer Research Center.

Cancer patients are vulnerable in multiple ways. People with lung cancer are less able to fight off pneumonia, while those undergoing chemotherapy or radiation treatment have weakened immune systems. Leukemia and lymphoma attack immune cells directly, which makes it harder for patients to fight off the virus.

Doctors don’t know much about how people with cancer will respond to vaccines, because they were excluded from randomized trials, Lyman said. Only a handful of study participants were diagnosed with cancer after enrolling. Among those people, covid vaccines protected only 76%.

Although the vaccines appear safe, “prior studies with other vaccines raise concerns that immunosuppressed patients, including cancer patients, may not mount as great an immune response as healthy patients,” Lyman said. “For now, we should assume that patients with cancer may not experience the 95% efficacy.”

Some people aren’t able to be vaccinated.

While most people with allergies can receive covid vaccines safely, the CDC advises those who have had severe allergic reactions to vaccine ingredients, including polyethylene glycol, to avoid vaccination. The agency also warns people who have had dangerous allergic reactions to a first vaccine dose to skip the second.

Lyman encourages people to continue wearing masks to protect those with cancer and others who won’t be fully protected.

5. Masks protect against any strain of the coronavirus, in spite of genetic mutations.

Global health leaders are extremely concerned about new genetic variants of the coronavirus, which appear to be at least 50% more contagious than the original.

So far, studies suggest vaccines will still work against these new strains.

One thing is clear: Public health measures — such as avoiding crowds, physical distancing and masks — reduce the risk of contracting all strains of the coronavirus, as well as other respiratory diseases, Frieden said. For example, the number of flu cases worldwide has been dramatically lower since countries began asking citizens to stay home and wear masks.

“Masks will remain effective,” Malani said. “But careful and consistent use will be essential.”

The best hope for ending the pandemic isn’t to choose between masks, physical distancing and vaccines, Offit said, but to combine them. “The three approaches work best as a team,” he said.

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  1. cocomaan

    The public health officials made a few huge mistakes on masks, one of them being that any mask is better than no mask.

    Rather than convincing people to seek out better masks because theirs might not be sufficient, it convinced people that wearing a piece of cheesecloth was sufficient. It was a dumb move. A family member in his 30’s, who is super freaked out about covid and got everyone socially distancing at Thanksgiving, showed up in a bandana. I showed up in an n95. One of us is way more freaked out about covid than the other. We ended up going in entirely separate directions on mask wearing. It reminded me how stupid things are today.

    I feel like the messaging on masks has never been worse.

    1. Knifecatcher

      It’s infuriating that the DPA wasn’t invoked to mass produce enough effective, high quality N95 or similar masks for the whole country. Trumps most reprehensible failure, IMO. The ROI on “free masks for all” would have been incredible. Hopefully Biden steps up since there’s obviously still a need, especially with the new more transmissible virus strain spreading.

      1. Shtucb

        I have a $15 bet with my mother over Biden invoking the DPA before June 1st for domestic mask production. I bet Biden would not activate it, but I’m hoping I lose the bet.

        1. Louis Fyne

          one can import all the KN95 masks you can want from China for $0.25 each delivered to the US. today.

          US N95 masks are a bit different as the bottleneck is the meltblown fiber.

          Why the US let this happen? Ask Jares or ask the media why they didn’t push Fauci and Kusher harder on the mask front

    2. Keith

      And then is the new mask, which I saw for the first time at Costco. It is a piece of plastic an inch or two away from the mouth.

      If that is masking, why even bother? To me, it seems, it doesn’t do anything that masking is supposed to do, yet it is apparently acceptable.

    3. Synoia

      I’m fond of the three Cork and One Mallet masks, two small and one large ocork, designed especially for insertion to the right.

      Inserting each cork in a front of head orifice, and driving them firmly home with the mallet, produces the expected result: Zero Viral Emissions. /s

      This method of reducing viral emissions is not recommended for Children.

  2. XXYY

    One of the things I worry about with the introduction of vaccines is people thinking “I got the shot, I don’t need to take any precautions anymore!” In a society where large numbers of people seemed to think this even before the vaccines became available, the upshot could well be a gradual devolution in the hard-won practices that have kept COVID from running absolutely amok. So we may be perversely worse off now that the vaccines are out.

    Public health officials need to come together on this and put out a standard position on this issue (presumably “we need to keep carrying out all precautions at least through summer”) and keep pushing it every chance they get.

    1. PlutoniumKun

      Yes, this is my big worry too. I worry that the models they are using will assume that the vaccinated will behave the same way as the unvaccinated, but there is plenty of evidence that this is not the case. Back in summer I know young medics who were flouting basic social distancing because they’d tested positive for antibiotics.

      We need education, but unfortunately I think we also need compulsion on issues like indoor mask wearing. I’m pretty sure we’ll have situations soon where people are going into places maskless proclaiming ‘its safe! I had the vaccine!’. There is going to be a lot of confusion and uncertainty as the vaccines are rolled out.

      1. vlade

        TBH, I don’t see it happening, as just about anyone had it with the lockdowns etc., and the pols, as usual, promised that the vaccine will be the silver bullet to solve all our ills (pun intended).

        So I’d not be surprised if by this time next year we saw a strain that needs a new vaccine, for who knows what will the various vaccines do to the evolution of the virus..

    2. Walter

      That may or may not be a reasonable approach; you cannot make a blanket judgement. It will depend on the continuing rate of infections in your area. If it falls to zero, and you are vaccinated, there is zero reason to wear a mask.

      1. RepubAnon

        Things could be worse – it could be the Nipah Virus. 50% mortality rate with a long incubation period.

        Stopping the next one: What could the next pandemic be?

        The Covid-19 pandemic took much of the world by surprise. But not everyone. For years, epidemiologists and other experts have warned that we have been setting ourselves up for a global pandemic.

        Most of the diseases experts worry about originate in animals. In fact, 75% of newly emerging diseases are zoonotic. Covid-19 – thought to have originated in pangolins sold at wet markets in China – was no different. But like Covid-19, zoonotic diseases are becoming riskier to humans because of our own actions. Our effect on the climate, encroachment on wildlife habitats and global travel have helped circulate animal-borne diseases. Combined with urbanisation, overpopulation and global trade, we’ve set up an ideal scenario for more pandemics to come.

  3. Blended

    I can’t claim ownership of this statement, but I think its relevant here: “When you combine science and politics, you get politics.”

    The mask issue may be based in science, but has become so wrapped up in politics as to be useless. The historical and continuing flip-flopping by the politicians in question exacerbates the problem.

    Politics sucks. And I am really starting to think is truly the root of all evil.

      1. Louis Fyne

        based on incompetence. in the early days Fauci going on national TV saying that masks don’t work…when all of Asia was masking up at the same time.

        the science was crystal clear even at that time that masks, done properly, , work

    1. Carla

      The bible was right about at least one thing: money is the root of all evil. Money owns politics, corrupts science, kills the environment and destroys people.

  4. Pym of Nantucket

    We have a lot of “damming half the river” activities which arise from our incorrect belief that all effects aggregate linearly and therefore we think any effort is good and contributes equally to a beneficial outcome. In reality, many effects do not bring benefit until you get close to completion because the impacts are non linear. Putting a dam across even 90% of the river will have very little effect.

    I feel like there is a religious feel to a lot of our reaction: something terrible is afoot so something, anything should be done. Maybe some hail Marys or a bit of fasting will do it?

    We have more or less decided that keeping kids out of school will be a disaster for society. That one salient decision, which I support, basically negates a huge amount of busy body curfews and rules we are putting in place: an army of people who are very socially and physically active, don’t follow rules, have poor hygiene and are essentially immune to covid mobilize each day and move in millions of different directs and interact for six hours, then return to be with the susceptible people awaiting them.

    Who are we kidding here and why are we so amazingly impervious to seeing this obvious gaping hole in our control efforts?

    1. ChiGal in Carolina

      The most recent episode of the podcast On the Media investigates how the narrative that schools are safe became the consensus on the back of flawed data.

      Short and highly recommended.

  5. Jon Claerbout

    Do all masks steam up your glasses? All the ones I’ve found do, especially when I’m biking.

    1. Travis Bickle

      The volume of air you’re cycling as you cycle has GOT to be far, far larger than the filtration capacity of any mask. Not that I know what I’m talking about, but notice how any mask will have its seal totally broken by any sort of intense exhale.

      Along these lines, one of the shade-of-gray things that seems impossible for people to keep balanced in their heads around is how safe one can be in completely open air, especially if you are cycling along at 15-20 mph. The problem is that there is still some viral dispersion from the guy ahead of you, or to your rear if its you that’s shedding. But at whatever point good research is available on the intensity of the load being passed along, I bet it’s trivial.

      Surgical, ear-looped masks, BTW, usually have a bit of wire at the top, which if fitted correctly largely preclude fogging during relatively passive activities.

    2. juno mas

      Not all masks steam up your glasses. Look at the photo at the top of this post. The woman is wearing a mask that has a pliable metal band over the nose and cheekbone area. It is underneath the mask material. (Right- click the photo to “view” it outside the article. Zoom it until you can see the mask very close up.) This pliable band allows her to shape the mask to her face for a close fit. This type of close fit eliminates the “fogged glasses” effect AND makes the mask more effective.

      Look for masks with this design element.

      1. furies

        I’ve been making ‘origami’ masks…with that metal strip at the top.

        I tried many other designs and was always struggling with my glasses fogging, but stumbled onto the origami masks on etsy, found the pattern on youtube and I was off…

        4 layers; silk, 2 quilting cotton and one filter holder out of flannel, so 5 layers with a filter. I’m getting custom orders as they are discovered locally. Maybe not n95 but pretty darn good.

        1. juno mas

          Three cheers for the “Makers” in the world. Glad to see a non-corporate designer becoming successful with discerning observation and creative “making”.

          Hip, Hip,. . .

        2. ChiGal in Carolina

          this is the kind I wear, but I always get the ones with removable nose wire because I found some sold separately on Etsy that are 5” long which provides a much better fit than the 3”ers most masks come premade with.

          Bravo to you for being so enterprising and if you wish to expand your reach I would be delighted to order from you if you can make yours removable.

          NC mutual support!

    3. Anthony G Stegman

      I struggle with the same problem, especially during winter months. When I grocery shop I have to remove my glasses so I can see what I am doing. Outdoors I take off the mask unless I find myself in a crowded environment in which case i get the heck out of Dodge as quickly as possible.

      I’ve seen some homemade contraptions using a small sponge on the bridge of the nose that is supposed to absorb the moisture in exhalations. They didn’t seem ready for prime time, however.

      I think you are safe foregoing a mask when out bike riding, unless you ride in a peloton as many cyclists in my neck of the woods do, though rarely are any wearing a mask.

    4. Keith

      If you are biking, I am assuming you are outdoors. If so, you do not need to bother with the mask. Masking is an indoor issue. That being said, if the mask is fogging up your glasses, then there is not a good seal, similar to bearded people,, so anything you hope to trap is escaping.

    5. Bittercup

      Consider a silicone mask with a KN95 liner. I happen to have this one (but there are multiple other styles out there like this or this) and it completely eliminated the glasses fogging up issue for me. The silicone molds well against my face (provided the straps are appropriately tight), creating a bit of a suction cup effect, which is what you’d want to avoid air leaks anyway.

      1. verifyfirst

        I cannot recommend the O2 Curve–I tried it, and it had huge moisture build up after just 20 minute walk around the park–like shake out the water when you get home level of moisture.

    6. Arizona Slim

      I’m with you on that one. I ride, I breathe heavily, and my glasses look like I just got caught in a thick fog.

      ISO: A solution!

      1. General Jinjur

        The anti fog solutions for sale don’t work? I haven’t tried them yet but recently bought some spray on and wipe on anti-fogging solution for glasses.

    7. DrEvans

      Another option: A YouTube ER doctor recommended buying motorcycle glasses, since they are anti-fog and provide more protection. I bought a clear anti-fog regular pair for ~$5 on Amazon that is adjustable and comfortable with soft rubber above the ear.
      They also have plenty of over-the-glasses safety and/or motorcycle goggles or glasses that have UV protection, anti-fog & scratch with options of tinted and/or polarized. Link below: I found a decent priced USA-made Honeywell UVEX OTG, anti-fog/scratch, UV-protected safety glasses with good reviews, meeting industry standards available in clear or tinted for $10.99:


      1. DrEvans

        Award winner coming soon called Floe Mask:

        Go Sun Devils!! My parents moved here in the 70’s for ASU grad school and then my sister & I went as undergrads in the 90’s.
        An ASU team beat out >70 countries and almost 1,000 teams for their unique bifurcation mask that is not only anti-fog, but has a filtration system similar to an N95. AND took home the $500,000 prize! Not available yet, but they are looking for a local supplier and a manufacturer. Article link:

  6. Mikel

    “Vaccines can provide two levels of protection. The measles vaccine prevents viruses from causing infection, so vaccinated people don’t spread the infection or develop symptoms.

    Most other vaccines — including flu shots — prevent people from becoming sick but not from becoming infected or passing the virus to others, said Dr. Paul Offit, who advises the National Institutes of Health and Food and Drug Administration on covid vaccines.”

    Think there might need to be a different names for things that prevent infection and things that don’t???

    1. Fern

      I believe that vaccines that prevent you from infecting others would be called “sterilizing” vaccines.

    2. campbeln

      Agreed. Too many think this is a silver bullet, when the tests on the first round were only to confirm (some measure of) lessened symptoms, NOT immunity nor inability to transmit.

      Mix in the Biden (and now Trump) approach to shove more doses into an already mismanaged pipeline while ignoring the hold-back for second doses… and we’ll have a sub-optimal administration of a sub-optimal “vaccine” to people who’ll think they’re bulletproof.

      My opinion, these first round vaccines are going to make things worse, especially in the environment of heightened transmissiblity of the UK variant.

      Stay safe, all.

    1. Barry

      This is probably still germane WHO 2019 guidelines on pandemics research to the effectiveness of masks in spread of influenza. Ten RCTs were included in meta-analysis, and there was no evidence that face masks are effective in reducing transmission of laboratory-confirmed influenza.

  7. John Zelnicker

    @Jon Claerbout
    January 15, 2021 at 10:49 am

    Fogging is a sign that you are not wearing the mask correctly.

    The top of the mask needs to be high up on your nose, under the lenses, almost to the bridge piece. Most masks have a metal band that you can form to the shape of your nose for a better fit. Mold it to fit your nose, just under the bridge area.

    Doing this has eliminated my problem with fogging.

    Edit: Meant to be an answer to the Jon Claerbout post above.

  8. Pavel

    I worry about the psychological effects (particularly among children) of ongoing mask-wearing by parents and other family members. Facial expressions are critical in understanding speech and emotions. I believe that being able to see a mother’s face is important for infants in learning how to speak.

    I passed a schoolyard the other day and there were half a dozen kids running around with masks on. People are wearing masks walking alone down empty roads whilst (where I am) there is interior dining so people can be in a closed space without a mask in the company of strangers for 60 minutes. How does that make sense?

    As noted above, there is a wide variation in the quality of masks and how they are worn.

    Can someone tell me: if I am a reasonably healthy person and am exposed to a small viral load of covid, would I be better off maskless [when I am not close to others] and breathing fresh air in and out, or “recycling” air from my infected respiratory passages?

    I am not anti-mask, just wondering how and when they should be worn for maximum effect. People wearing crappy cloth bandanas tied loosely around their face all the time doesn’t really help IMO. It might be better to insist on high-quality masks worn properly in the situations where it really matters.

    Sigh. What a mess.

    1. CanChemist

      My understanding is that you’re always better off with a fresh, correctly fitted mask if you’re going to be near other people. It needs to be donned/doffed correctly with proper hygiene, and not reused afterwards until washed. It also needs to be exchanged if it gets too moist or if you have any other concerns. I’m finding I change them every 2-3h.

      If you’re talking about walking into a doctor’s office and mask contamination afterwards, then yes, I exchange it after I leave, as soon as I can safely do so.

    2. Pym of Nantucket

      Excellent point. Most mask wearing is a waste. However, since we don’t want people to have to decide for themselves, we just tell people to do some token coverage. At the ski hill I go they make people wrap a knit wool scarf around their face or they cannot get on the lift in the outdoor wind. It’s like a Monty Python skit, but everyone is doing it.

      So here’s the problem with saying “every little bit helps”. A wool scarf in an outdoor wind may reduce covid transmission risk by one one billionth and indeed is not hindering BUT, when we tell people to do futile things out of faith, they become frustrated and see that the regulations are not getting to the core source of transmission. It’s like our recycling of bottles taking hours of individual effort so they can be shipped to China and burned. Eventually doing stupid token things depletes people’s patience.

      At first politicians hate to do anything ahead of the curve, then they hate to do nothing behind the curve. We are in stage two, especially after the Trump shaming enacted by Facebook and Twitter. We are in the religious compliance mode but I simply don’t think we want to go to where Taiwan is in this regard. The kind of control needed will require a greater level of fear (everyone is getting it now and discovering it isn’t deadly at all: problem), and a greater restriction of freedom. Even if we wanted that I doubt we could pull it off.

      A long time ago we should have been honest that this is a geriatric condition and put our resources there. Seniors living in disgraceful conditions should have been the focus from day one and we could have done something about that. Now it looks like we are going to ride this out while waving our arms a lot. Vaccines will turn into a rolling mandatory vaccine service with new updates like software patches that you need to get a passport. Maybe they will distribute your passport on the Google Play store…

      1. a different chris

        >everyone is getting it now and discovering it isn’t deadly at all: problem

        My best friend’s brother died. Where TF do you get this stuff?

      2. SteveW

        What are you talking sbout? “Don’t think we want to go where Taiwan is in this regard…” . Taiwan have not imposed restrictive measures on personal freedom. Schools have not been closed. Life is mostly normal. Economy keeps going. Citizens are simply more considerate and understanding. More masking. Social distance. Trusting their leaders. The GO is a renowned epidermologist. The key control has to do with international travel. Only hundreds of cases and handful of death in all. We all should be that kucky.
        Are you confusing Taiwan with Wuhan?

      3. Massinissa

        Look… Yes, most of the deaths are older people. No, that doesn’t mean younger people do not often still need hospital care. The hospitals are overburdened as it is. And with infections going up at an existential rate now, they could become overwhelmed within the next few months. This virus mostly kills old people, but it doesn’t only affect old people.

        And all of this is not even considering post-covid effects at all.

        1. Yves Smith Post author

          Of the people I know second hand who have died:

          1. Two older people at one aide’s church

          2. Three relatives of one aide’s SO, all under 40, two of those in Oho, one in Alabama

          3. The husband of the niece of one aide, 31.

          So my sample skews heavily to under 40. None with co-morbidities.

    3. t

      I am completely freaked out by people who have trouble with relating to people in masks. Seriously. I never knew ao many people were using all the parts of the face the people can control or noses or chins or whatever the heck they are looking at.

      This came up when comments were off.

      Kids don’t have this trouble. My effing animals don’t have this problem. Other people’s dogs are no less certain about me being pleased or annoyed.

      I guess some of you are the same people who don’t want to punch people who expect to have a serious conversation while they’re wearing sunglasses.

      Number one thing I learned.

      1. Pavel

        I’ll just speak for myself but I find it tremendously useful (and often charming or entertaining or edifying) when I can tell if someone is smiling or frowning or making other facial expressions with their mouth. I daresay more emotion is expressed that way than through the eyes (though the latter are also important).


      2. bulfinch

        Yes, exactly — all the bits below the eyes – the piehole and the nozzle and the chinny chin chin – they’re are all just extraneous and even tacky ornamentation; fleshy frippery that we could all take or leave.

        This is also why bank robbers — at least the really intelligent ones — only wear sunglasses to pull off a heist.

        1. JBird4049

          Speak for yourself. This hearing aid wearer sometimes has to lip read especially when someone insist on mumbling. SHOUTING does not really help much while enunciation does. The whole face also adds to that understanding. From the forehead to the lips. So now we have all these masks that can make it sound like mumbling and half of the face is hidden. My verbal comprehension has dropped strongly.

      3. CoryP

        Having to communicate with patients/customers at work through the triple sound barrier of mask-plexiglass-mask, I’ve been surprised at how much not lip-reading impairs my understanding. (It’s noticeable when for better or worse people temporarily pull them down). It’s hard to say if the sound muffling is the biggest problem, or if I’ve always relied on lips more than I realized.

        Also I find that my facial recognition is significantly impaired with the lower face covered. There is a definite beat between when I look at someone’s face, and when my brain identifies them — and many of these are people I see at least weekly.

        It is what it is and I’m not suggesting we change anything, but it’s been funny to experience how easily my visual/facial processing system gets tripped up.

        A coworker also suggested winter clothes and hats probably make identification even harder due to changes in silhouette.

  9. CanChemist

    Speaking of masks, if anyone is looking for more technical information especially about N95 types, 3M has some great resources here:


    Also, fit is really important. We are noticing at work that we’re seeing 3 main fits… “regular” which would be most masks and fits either gender. “small” which tends to be smaller faces, usually the smaller women, and “high cheekbones / flatter face” also called ‘asian fit’ by some manufacturers, which requires a much longer nosepiece to fit correctly.

    If your mask fogs your glasses it’s not fitted correctly.

    In terms of straps, for smaller heads it does work better to position the top elastic much higher on the head. If you have longer hair you can make a bun in the middle of the back of the head, and hook the elastic on top of that for extra security.

  10. Anthony G Stegman

    The costs of high quality masks is an issue for many people. Some approach $20 per for double layered cloth masks. This is not workable in the United States where we have millions of people living a hand to mouth existence. Joe Biden’s budget plans must include money to make available free to all high quality masks. They should be handed out like candy.

    1. Keith

      Most stores offer a free mask at the entrance of their shop (well, at least the big box stores). As for the mask, I do not really see price being that big of an issue. I got mine, a gaitor, when masking became required in WA state, which was several months ago. It is still fine and I use it regularly. Masks are like jackets, buy one, take minimal care and it will last.

      1. ChiGal in Carolina

        But gaiters have been shown to be minimally effective per articles linked on this site even in just the past few days. There has been data available on this for months.

        I think this—“compliance” that is ineffective due to confusing guidance and unavailability of affordable options—is what is being discussed on this thread.

        1. Katiebird

          The suggestion in the tweet quoted in the post that nylon hose over a mask makes the mask more effective made me wonder if wearing a gaiter over a mask would improve the effectiveness of both mask/gaiter?

          I’ve been wearing disposable paper masks but wouldn’t mind adding the gaiter to bind the edges.

          1. ChiGal in Carolina

            my guess is it’s probably better to use a stocking, as many gaiters are more loosely woven (part of the problem with them) and meant to go over the face and neck, which stocking are not, hence they will be more tightly stretched and truly mash the surgical mask against the face.

            also, those masks being disposable are not very kind to the planet–apparently there is concern about the enormous amount of plastic waste being generated since the masks are not actually paper but some sort of polypropylene.

            to up my game for the second variant, I think I will check into the mask Bittercup linked to above. I am so rarely around other people anyway…

  11. Rock Hard

    So reading through this, this sounds exactly like where we were a year ago: “it’s just like the flu”. Only now there’s a vaccine, so…

    IDK where I stand on this. I used to make fun of the Japanese tourists walking around in their masks, but with the influenza numbers off radically this year, maybe those tourists were onto something.

      1. BillC

        Interesting, Pym. Not just in Nantucket! This same belief (“paid to chart them as Covid”) is circulating here in Italy. Can you share any documentation supporting this assertion?

      2. RockHard

        Ehhhh… I was sick with some unknown virus right after Thanksgiving and they ordered both a COVID and a flu swab. Both negative. Probably more productive places to put your energy than making up things.

      3. Yves Smith Post author

        This is false. Hospitals run tests, or didn’t you know that? IM Doc pointed out that no patient of his this year had tested positive for the flu, which had him flummoxed.

        Your disinformation is a violation of our site Policies. You are no longer welcome here.

        1. Pym of Nantucket

          You are correct and my comment is not correct. I read an article this fall saying that Covid deaths are being mis-reported. I went back and saw it does not apply to flu. Furthermore I did some reading just now on the drop in flu in New Zealand where there effectively is no Covid which is quite definitive evidence.

  12. Matthew

    Anyone who thinks that a large section of the public will continue to socially distance and wear masks after a significant number of them are vaccinated, especially those at low risk and the young generally, are fooling themselves. Human beings are social creatures, this pod stuff is going out the window and there will be a big division between those with different risk profiles and perceptions, and no amount of public health messaging is going to do anything about it.

  13. Rick

    A couple of links on difference between surgical and procedure below.

    Main difference seems to be protection against fluids – the surgical is more resistant.

    Also, here’s an interesting link on actual testing. I have made some of their design rubber snuggers and they work very well.

    Fix the mask.

    From Canada.

    Another look.

  14. Ignacio

    Very well said. To remove the masks wait until herd immunity is achieved. And it can be risky even then If you have not been infected or vaccinated previously.

  15. Hana M

    This is the most depressing article I have read in months. I am elderly, living alone with no close relatives and few friends nearby. I have severe hearing loss and I depend on lip-reading to communicate. I have spent the last 11 months in a kind of involuntary isolation that has stripped me of much of my will to live. Not to see another live human being’s smile. Not to be able to exchange and understand a single word, not even the smallest chat with a check out clerk. Not to see the full face of any human just walking down the street. And now, no hope either?

    1. Ignacio

      Hi Hana,
      Living in isolation is indeed hard. This is not my case as we are four in my family. I have tried to keep contact, at least by messaging from time to time, with friends I know to live alone. I don’t think that a mask can be considered as a cause of isolation though it is more difficult to identify masked people. As smiling takes many muscles in the face you can really see masked people smiling through their eyes and their general attitude. The cause of our isolation is someone called SARS CoV 2 and masks are just another consequence and not precisely the worst. These days i barely see anyone except family members but when I meet someone I know I never miss the opportunity to have whatever conversation, even the shortest and stupidest of the conversations. I feel that I need it and sometimes this comes with interesting stuff.

    2. Hellothere

      A lot of people are alone right now and it’s a really rough ride. Some options to consider…

      – a lot of local communities are doing outreach with the elderly, to provide phone calls and/or visits outside to isolated people. Maybe there’s something in your area? Maybe even call your local umbrella volunteer organization and/or city government if there’s nothing obvious coming up?

      – Do you have a webcam and are you able to video chat with people? That at least allows you to talk to people without masks. Maybe friends/family can refer you to other people who are looking to chat and meet new people and would be interested to talk to you?

      – is your local deaf community able to help you find opportunities to socialize?

      – it may sound funny but have you considered online virtual communities that are ‘real time’. There’s the obvious gaming stuff, and not all of it is just angry teenage boys ;). Also there’s communities like Second Life that were used by a lot of older people and/or people with disabilities long before the pandemic hit, and where a lot of communication is still done by typing and not necessarily talking.

    3. annie

      i am terribly sorry to hear this. i’d like to say that i had a cochlear implant and it changed my ability to hear dramatically. medicare covered everything: operation, all the testing before and after, annual checkups, as well as the new devices one needs to use.

    4. Animalover

      Hana, Though many of us without family around may not rely on lip reading to communicate as you do, we are subject to a similar kind of loneliness that makes despair almost inevitable. Of course, being without phone contact due to hearing loss must be particularly isolating. Please forgive this question, as I really do not know…I wonder would it be possible for you to read the lips of someone speaking on a computer screen… I see my young friend and her children on Zoom, smiling faces, bodies turning upside down in their chairs, dancing and crying — and my day is made… I also find great comfort watching the birds collecting around their feeders and other wildlife who regularly visit. Of course, this doesn’t replace human connection, but it can be a comfort and helpful in staving off the worst loneliness… I don’t know where you live, but putting your bare feet on the ground may also bring you closer to the rhythm of the natural world. Such closeness to living energy has been shown to improve mood…. Please don’t be too disheartened. This difficult episode will pass.

    5. ChiGal in Carolina

      Hana, you articulate so poignantly your despair, my heart goes out to you. I don’t know if you have heard of polyvagal theory, which is the neuroscience behind what we have long known from attachment theory, that connection is vital for well-being. The suggestion above to do video calls is spot on.

      Making eye contact and smiling activates the “safe and social” brain and is something I do now with friends (back in Chicago) I previously talked to on the phone as I am completely isolated since my mom died in August. I have made exceptions for occasional masked and distanced walks with my very few friends here but probably the MIT article linked yesterday is my wake-up call not to even do that.

      I am a psychotherapist and have a doxy.me account which is how I see my clients. I just sign in and my friends do the same and it is like they are in the room with me. No time limits and it’s free. Of course, if you have Apple products you could also FaceTime on tablet or computer. If you are tech challenged it is well worth it to see if there is a way to get assistance in setting something up.

      I believe that doing daily or even every-other-day video calls with friends will revive your will to live.

    6. Arizona Slim

      My hearing loss isn’t very severe, but if you speak to me in person or on the phone, be prepared to spell things out with the aviation alphabet if I don’t understand what you’re saying. Or I’ll start this spelling process — “Did you mean A as in Alpha?”

      Next topic: Zoom meetings. I wear headphones, and guess what? For the first time since I don’t know when, I can HEAR what is being said! I don’t miss anything! Hooray!

      As for lip reading, I am the worst at it. Hence the aforementioned aviation alphabet.

    7. Sometimes Susan

      Oh Hana,
      I’m so very sorry to hear this. It’s extremely depressing as you describe even without the added burden of deafness. I agree with Dr. Roger W. Koops who wrote an article titled The Year of Disguises in AIER. Near the conclusion of his knowledgeable document he said, “The ‘Mask Mandate’ idea is a truly ridiculous, knee-jerk reaction and needs to be withdrawn and thrown in the waste bin of disastrous policy, along with lockdowns and school closures.”
      We can only hope cooler heads will prevail soon. I wish you well.

      1. Basil Pesto

        I an shocked, shocked that AIER runs opinion pieces that don’t for a moment even begin to consider the precautionary principle.

        Furthermore, his hypotheses are almost all countered by real world case studies. I’d even go so far as to say that Dr Koops doesn’t, in fact, have your best interests at heart :o ymmv

    8. Matthew

      I suggest you get the vaccine then take the mask off, get out of the house, and engage in some face to face human activities with new people. Volunteer, make some friends. You are not obligated to match the risk tolerance of the most cautious among us.

  16. Cuibono

    Masks protect against any strain of the coronavirus, in spite of genetic mutations.

    this needs to be made stronger; MASKS SEEM TO PREVENT strains of MOST viral respiratory infections.
    Anyone looked at global flu data lately???

  17. Ignacio

    On masks recommendations. If for some reason you are going to spend some time in an enclosure with some many more, then put on not one but two layers of masks.

  18. Lex

    Our plan is to wear masks every time we’re in public, even after being vaccinated, until 70-80% of folks in the U.S. have also been vaccinated. Then wear a mask every time we go out every winter henceforth. We have entered ‘the era of mask-wearing’. If someone wants to take issue with that, I’ll simply tell them I’ve been exposed to someone who had the flu and the mask is for their protection. Continue hand washing throughout the year, using hand sanitizer, and maintaining social distancing.

    I’ll be very surprised when, if ever, we see those plastic barriers come down in the shops. Social trust between strangers is going to be difficult to reestablish.

  19. Katy

    I posted this in Links, but I’m reposting here for relevance.

    I have sewn a couple dozen masks since August, using many different patterns. In my experience, the best pattern is the Jesse Killian mask. You use a person’s actual face measurements. There are 18 size variations.

    Even with the multiple sizes, the mask still has to be individually tailored to fit right.

    YouTube Instructions

    I have been using one layer of tightly woven cotton and one layer of medium weight 100% silk, also tightly woven. I had to buy all of the fabric online because the sewing stores near me only stock quilting cotton fabric, which is too porous.

  20. Henry

    Until they publish data on the effectiveness of vaccines in preventing the spread of Covid amongst the general population all we have are the results from the ads and based on how well the rest of this pandemic has played out why would anyone question that? So I’ll continue to take Vit D, better published support for its effectiveness vs the vaccines at this point, and wear a proper fitting (leak tested as per 3M site instructions) N95 in situations that warrant it (enclosed spaces with lots of people and poor air circulation) and because I find for it to work properly the N95 is pretty damn uncomfortable, I switch to a surgical mask or something similar when around people in better ventilated areas with shorter exposure times. I thought these two links provide a good illustration to help judge the risks where masks can be effective.

    How Coronavirus spreads through the air.
    Mask clearing up the confusion

  21. Phil in KC

    Got my first Moderna shot ten days ago. What a relief! Second shot on Feb 2, so yes, around Valentine’s Day or shortly thereafter my antibodies to Covid should (SHOULD) be peaking.

    Nonetheless, I wear a mask and will continue to do so until such time as the word goes forth that is safe to be in a public area without one. First, I want to model good behavior. Second, the carrier factor is important to me, not wanting to have friends, or family, or anyone, really, catch Covid from me. Finally, I wear the mask because I don’t want to identify myself as one of the “lucky” ones to get the vaccine early (front-line health worker) and arouse envy, nor give anyone the idea that once vaccinated you can discard the mask with impunity. We get inoculated individually, but we are all in this together.

  22. freedomny

    One of my siblings who gets 2-3 colds a year hasn’t experienced one in the past 12 months.. She told me that even when this whole covid gets resolved (she has gotten the vaccination) she will continue to wear a mask at work and in high ppl density situations…

    1. tomatohead

      Your body needs bacteria so that the immune system can work properly. We can’t assume that avoiding colds is a “good” thing.

  23. Mikey Joe

    January 2020 the only people that I saw wearing masks were in Flushing, Queens, NY.
    How things have changed over the last year!

  24. tomatohead

    In other words – it will never be feasible to expect an entire global population to use masks in a way that actually stops the spread of virus, so we should stop forcing it and find another way.

    I have read plenty of RCTs. If you can’t replicate the real-world, then the findings are meaningless.

    1. Skip Intro

      This is not at all completely illogical! Just like crime, it is impossible to stop it, why even bother with police? Just because people can reduce transmission of a virus through the cumulative effect of a combination of small and imperfect measures, doesn’t mean they should bother to do that if it looks silly or feels inconvenient. Freedumb!

  25. drumlin woodchuckles

    If millions of Mask Rejectors start approaching mask wearers to cough on them, sneeze on them , etc.; then millions of mask wearers may all have to start carrying around millions of cans of bear spray to spray at the Militant Covid Spreaders if they get too physically close to the mask wearers.

    To make them resume keeping a safe distance away.

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