Don’t argue, just talk to your doctor

With the new CDC mask guidance igniting yet another branch of the COVID-19 culture wars to emerge (ie. the folks now exclaiming “I thought you trusted science, why are you still wearing a mask if you’re fully vaccinated?!” and on the other side, “Great, now anti-vaxxers will just lie and say they’re vaccinated, putting us all at risk!”) let’s just take a moment to reflect on the context of this advice.

Here’s my armchair take on the CDC’s mask guidance and our state’s re-opening plans. Let me just say, I’m not qualified to refute any advice given by our top epidemiologists, but this is my perspective. I’d be interested to hear others.

The CDC and the government in general is primarily interested in protecting the populous. They are making risk/benefit calculations weighing many factors, basically everything Americans have been fighting about in the mask and vaccine culture wars. They’re thinking broadly about how to stop the spread of a devastating disease, and how to produce the least suffering and best outcomes among the most residents of this country.

The guidance about fully vaccinated people being able to resume life without masks makes sense in this context. The percentage of people who may get a breakthrough case of COVID-19 would not significantly contribute to community spread and therefore the cost benefit analysis comes out positively on the side of unmasking and returning to life pre-pandemic for fully vaccinated people.

What the CDC and government authorities are not speaking to is individual risk profiles. Take for example if you live with an elderly relative or a severely immune-compromised spouse. Even if you yourself are vaccinated, you might decide that your risk of passing a breakthrough case to your vulnerable family and one of them dying is too high, so you keep masking in public. This seems to be well within reason, IMO.

Now say you live with a fully vaccinated non-vulnerable household, the chances of a breakthrough case having devastating health effects on you and your household are very low. The amount of virus in your body in a breakthrough case will be small, and your antibodies will be hard at work, as will the antibodies in the people in your household. Additionally, the chances of your potential breakthrough case resulting in a significant increase in a public outbreak are small. Your vaccinated status in combination with the vaccinated status of many around you results in broken chains of transmission.

I think the best thing people can do is talk to their primary care doctor(s) and see what they think of your personal and household risk profile. I’ll trust the CDC and expert epidemiologists to think through the public health implications that apply to 328 million, and I’ll take responsibility for thinking through my personal risk profile and consult my doctor to make the best decisions for myself and my household.

Edited to add: When I wrote the above, I failed to factor in compassion. I was only focused on reason and explanation of the CDC guidance. If we factor in compassion, and we definitely should, we might think about how our fully vaccinated maskless life could affect other individuals, in particular walking around in the world asymptomatically spreading virus, we might inadvertently harm someone who is vulnerable. Therefore, we might consult both our doctor, and our hearts before venturing out without our mask.