Making sense of new mask guidelines

May 21, 2021
woman taking off her mask under the new mask guidelines
When should someone wear a mask and when does someone not need to wear a mask? UCHealth expert explains the new mask guidelines from the CDC. Photo: Getty Images.

While people who are fully vaccinated against COVID-19 no longer need to wear masks in many settings, masks are absolutely necessary for everyone in hospitals, health care clinics, airplanes and other places where vulnerable people are gathering, according to one of the top infectious disease experts in Colorado.

“If you are entering a health care facility, you need to wear a mask. If you are going to the airport and getting on a plane, you will be required to wear a mask,” said Dr. Michelle Barron, senior medical director of infection prevention and control for UCHealth and a professor of medicine and infectious diseases at the University of Colorado School of Medicine on the Anschutz Medical Campus.

Unless current state guidance changes, children who are finishing their school years with at least some in-person learning also must keep wearing face masks since children under age 12 can’t get COVID-19 vaccines yet.

And people who are immunocompromised or those who live with people who are dealing with cancer treatments or other health conditions that suppress immune responses should also keep wearing masks. People with compromised immune systems need an extra layer of protection since they are unlikely to have the same level of protection as those without immunosuppression.

Headshot of Dr. Michelle Barron. She describes what's safe after getting vaccines.
Dr. Michelle Barron. She helps explain the new mask guidelines. Photo by Cyrus McCrimmon for UCHealth.

While it’s wonderful that the percentage of people who are fully vaccinated continues to climb, the pandemic is not over yet, Barron said.

“People are still getting sick and dying. You need to use common sense to assess your risk,” she said.

“If you or someone you love or live with has an underlying condition that affects your immune system, you have a layer of protection from the vaccine, but it’s not going to be 95% effective,” Barron said. (Barron, herself, suffered the devastating loss of her aunt and uncle. Click here to read more.)

“Being vaccinated is our ticket out of this pandemic, but vaccines don’t mean that everyone can go around without masks,” Barron said.

Barron strongly encourages people to keep wearing masks in crowded indoor settings and to continue being considerate about vulnerable people in the community.

“It’s like a newborn baby. You don’t expose the baby to 50 million people because the baby doesn’t have a fully developed immune system. You have to protect the baby,” she said.

New guidance from the U.S. Centers for Disease Control and Prevention (CDC) allows fully vaccinated people to stop wearing masks much of the time.

That’s because the newest research has found that the vaccines that prevent COVID-19 are remarkably effective. They are working as well in the real world — even in high-risk environments like hospitals and prisons — as they did during clinical trials. During the trials, the new COVID-19 vaccines were up to 95% effective in preventing critical illness and hospitalizations.

The news about vaccine efficacy is excellent, Barron said.

But the CDC guidance also sparked a great deal of confusion. To help you better understand the new mask guidance and better navigate your world, we spoke with Barron to get answers to all of your questions.

What exactly does the CDC state in its new mask guidelines?

Here’s the new guidance for settings outside of hospitals and health care facilities:

  • “Fully vaccinated people no longer need to wear a mask or physically distance in any setting, except where required by federal, state, local, tribal or territorial laws, rules and regulations, including local business and workplace guidance,” experts at the CDC said on May 13.
  • Indoor and outdoor activities pose minimal risk to fully vaccinated people.
  • Fully vaccinated people have a reduced risk of transmitting SARS-CoV-2 (the virus that causes COVID-19) to unvaccinated people.
  • Fully vaccinated people should still get tested if experiencing COVID-19 symptoms.
  • Fully vaccinated people should not visit private or public settings if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms.

Do I need to wear a mask at a hospital or health clinic?

Yes, absolutely.

“The new CDC (mask) guidelines do not apply to health care facilities,” Barron said.

According to CDC experts: “Staff, patients, residents and visitors should continue to wear masks as recommended in all health care facilities.”

Click here to see CDC recommendations for health care facilities.

Why is it necessary to keep wearing a mask in a hospital or health clinic?

“People who are coming into hospitals are sick. Some may not have received their vaccines yet. They are vulnerable and you don’t want to transmit an infection to those individuals,” Barron said.

“Hospital workers are there to protect our patients. If there’s any potential risk for us to transmit something to our patients, then we need to mitigate that risk,” she said. “People who are sick don’t have a choice about coming into the hospital unlike people going to restaurants or concerts who have the option to go or not go.”

If I’m taking a trip, should I wear a mask?

Yes. “If you are going on an airplane, federal law requires you to wear a mask,” Barron said.

Wearing masks in airports and on airplanes is not only the law. It’s a great idea because these settings are very crowded. And, it’s impossible to know how many people on the flight are fully vaccinated.

Remind me again, what does it mean to be ‘fully vaccinated’?

People are considered “fully vaccinated” two weeks after receiving their second dose of a vaccine, like Pfizer or Moderna, or two weeks after receiving single-dose vaccines like Johnson & Johnson.

Who can stop wearing masks most of the time?

“If you’re fully vaccinated and you live in a household where everybody else has been vaccinated and all these people that you live with have the ability to fully respond if they get an infection, (no one in the household) needs to wear masks,” Barron said.

“If you’re beyond the two-week window (after getting your second dose) and you’re healthy and are able to have an appropriate response to the vaccine, you can do almost anything within reason.”

Am I safer outdoors? Do I need a mask outside?

No, you don’t need a mask in most outdoor settings. You are much safer outside. The virus has never spread easily outdoors. Unless you are clustered in a very crowded setting outdoors, it’s fine not to wear a mask in outdoor settings.

What’s going on with kids? If I have children under age 12, should I keep wearing a mask? Do kids need to keep wearing masks?

Parents of younger children should keep protecting them. If parents of younger children are in crowded indoor settings, they should keep wearing masks so they don’t bring an infection to their children. In addition, it’s essential for children to keep wearing masks in crowded indoor settings.

Over the last month, Barron said children ages 9 to 12 had the highest rate of infections.

For children and teens ages 12 and older, vaccines now are free and easy to get through walk-in vaccine clinics. Click here to learn how to get vaccines and click here to learn about vaccines for kids and teens ages 12 and older.

What if I’m fully vaccinated but I’m not comfortable taking off my mask yet?

Many people feel more comfortable continuing to wear masks in crowded settings like grocery stores, hair salons and gyms.

“If you are uncomfortable removing your mask, use your own judgment. You don’t have to take it off,” Barron said.

Would you work out in a gym without a mask?

No. “I would probably still wear a mask in a gym.”

When you get your hair done, will you keep wearing a mask?

Yes. Barron knows that both she and her hairdresser are fully vaccinated. Still, the setting is crowded and it’s impossible to know how many other stylists and clients have been fully vaccinated.

So, she and her hairdresser are continuing to wear masks.

“I definitely worry more about indoor activities,” she said.

Should you wear a mask at an outdoor concert?

It depends on the circumstances and setting.

Barron is planning to enjoy her first concert soon at Red Rocks Amphitheater. She’s thrilled to hear musicians from the Colorado Symphony perform live again. Managers for both Red Rocks and the symphony have excellent COVID-19 safety protocols, Barron said.

Still, if Barron is in a crowded setting outdoors, she’s planning to wear a mask.

“Some of this is related to how much risk you are willing to take,” Barron said. “My level of concern is going to be higher than most because I don’t want to get sick or infect any of my patients.”

Are you dining indoors in restaurants without wearing a mask?

Yes. “I would go to a restaurant with other vaccinated people,” Barron said.

Even so, she wants to be certain that restaurant managers are following all protocols and that servers are wearing masks.

“I might put my mask on when I’m close to the server or when I go to the bathroom,” Barron said.

Is it safe to skip wearing masks in crowded offices?

Once again, the protocols depend upon the specific circumstances, Barron said.

“You have to be very conscious of the air handling systems in your building. There also are questions about how comfortable you are with your office mates and whether they have been vaccinated or not,” Barron said. “Some people may have reasons why they couldn’t get the vaccine. Perhaps they’re going through chemotherapy and their doctor told them to delay the vaccine so they could get the full benefit of it once they completed chemotherapy.”

If you work in a crowded setting and you have no way of knowing if your co-workers are fully vaccinated, then it’s probably wise to keep wearing a mask, Barron said.

Should children and teachers keep wearing masks in schools?

Since most children are not yet fully vaccinated, masks are essential in most schools.

Barron is hopeful that most children will be able to get vaccinated by the fall.

Be sure to follow guidance from your local health officials and your school district. If you have any concerns, err on the side of safety and keep wearing a mask. Until the pandemic is over, masks help greatly in reducing the spread of infection, Barron said.

What’s the best way to stay safe?

Barron recommends keeping a close eye on local infection rates in your community.

“If your community has high vaccination rates and positivity rates of less than 5% (meaning fewer than 5% of people who are getting tested for COVID-19 are testing positive), then you can feel more comfortable being out and about,” Barron said.

About the author

Katie Kerwin McCrimmon is a proud Coloradan. She attended Colorado College thanks to a merit scholarship from the Boettcher Foundation and worked as a park ranger in Rocky Mountain National Park during summers in college.

Katie is a dedicated storyteller who loves getting to know UCHealth patients and providers and sharing their inspiring stories.

Katie spent years working as an award-winning journalist at the Rocky Mountain News and at an online health policy news site before joining UCHealth in 2017.

Katie and her husband, Cyrus — a Pulitzer Prize-winning photographer — have three adult children and love spending time in the Colorado mountains and traveling around the world.