To Mask—Or Not to Mask?

With most mandates now rescinded, Bergen residents must decide on their own whether to use face coverings—and where. Here’s some expert advice. By Leslie Garisto Pfaff

The entry doors to the Bergen Town Center bear the words “Please mask up.” On a recent early summer afternoon, however, only about one in five shoppers appeared to have heeded that request. In the center’s Target store, though, more than half of shoppers were masked. That mixed verdict may reflect the state of masking in general, some two-and-a-half years into the COVID-19 pandemic—at least in our corner of northern New Jersey. With government mandates no longer in place, the decision to mask has largely become a personal one, with the major exceptions of hospitals and prisons, doctors’ offices and other healthcare institutions.

Inside that Target, Teaneck resident Miosoti Francisco is masked. “I wear it everywhere I go,” she says, “because I know COVID is still with us.” Veronica Oh, on the other hand, who’s here from Manhattan’s Upper West Side, is combing the aisles unmasked. She recovered from a bout with COVID about a month ago, she explains, “so I feel like I’m kind of immune to it.” She does, however, put on a mask when she’s in crowded, closed-in spaces like the New York City subway. And if she feels a cough or a case of the sniffles coming on, she’ll don a mask for the safety and peace of mind of those around her.

Maybe they’re both right. The small print below the Town Center’s request to mask up offers a caveat: “Face masks should be worn in compliance with CDC regulations.” And if you go to the “Mask Guidance” page of the website of the Centers for Disease Control and Prevention, the advice you’re given appears to be somewhat equivocal: In

large print, it advises: “Wear a mask when there is a lot of COVID in your community.” But it doesn’t explain, on that page at least, what “a lot” might mean. In smaller print, it also says we should “wear a mask in public places when there are a lot of people around,” again leaving “a lot” unexplained.

“I know this is confusing, but whether or not to mask has become an individual decision in most instances,” notes Suraj Saggar, D.O., chief of Infectious Disease at Holy Name Medical Center in Teaneck— something that recent conversations with a group of Bergen County residents make abundantly clear. Their stated reasons for masking—or not masking—or only sometimes masking suggest that residents tend to be making those decisions based not on mere whim but according to their perceptions of, and tolerance for, individual risks. You may see yourself in one or more of their personal stories.

The Everywhere Masker. Hackensack resident Caryl Blank has been stringent about masking ever since the first mandates were put in place. She’s over 65 and knows that her age puts her in a high-risk category. “I wear a mask whenever I’m in public except when seated at a restaurant, and that’s not often,” she says. Several months ago, a friend invited her out to dinner, and when they got to the restaurant, Blank began to feel uneasy. “The tables were really close together,” she remembers. A few days later, she tested positive for COVID and was sick for more than three weeks. “I’d be happy if everyone had to wear masks in public now,” she says.

The Crowd-Averse Masker. Like Oh, Mina-Jacqueline Au of Edgewater doesn’t regularly mask unless she finds herself in an indoor space that’s extremely crowded. Ironically, one of her reasons for not masking in most places is that she suffered a bad case of COVID in December and still has residual breathing problems, which are exacerbated by wearing a mask. She does, however, run a women’s wellness and aesthetic clinic and requires that her staff (including herself) wear masks during patient hours. “It is still a fact that people are getting COVID,” she says, “so in a professional setting, masking is the right thing to do.”

The Other-Directed Sometime Maskers.

Dumont resident Guy Zimbra masks at the supermarket and is especially careful to wear a mask when spending time with his 92-year-old grandmother, who suffers from dementia and whose advanced age places her at a high risk of contracting a severe case of coronavirus. On the other hand, Hackensack-based comedian and actor Lee O. Valentin doesn’t generally mask in public unless he has symptoms possibly indicative of COVID, such as a cough or runny nose. “I understand the mask is to protect others who are at a higher risk or immunocompromised,” he says. “I don’t want to be the cause for someone else’s suffering.”

The (Mostly) No-Masker. Robert Rossi of North Bergen is a medical sales rep whose work takes him to hospitals throughout New York and New Jersey, where masks are mandatory. Outside of work, however, he no longer masks up. He was vaccinated twice and boosted once and feels his vaccination history confers sufficient immunity; though he is over 65, he’s in good health and without other risk factors. “Vaccines,” he says, “prevent serious illness from the virus in most people.”

The Enthusiastic Masker. Patricia Nixon of Hackensack is in the minority when it comes to her spirited embrace of the face mask. An allergy sufferer, she finds that masking helps keep her symptoms at bay; it also protects her from what she calls “wisps of moisture from those around me”—a particular problem for people of short stature, like Nixon. “I know a lot of people can’t wait to be free of masks for good,” she says, “but I can’t see myself going back.”

MAKING AN INFORMED DECISION

So how do you decide whether to mask and where? BERGEN turned to the Bergen County Health Department and Dr. Saggar for advice:

• Be mindful of rates of transmission.

“COVID rates did fall in the region,” says Dr. Saggar, “but they’ve plateaued and could rise again.” The CDC’s COVID Data Tracker allows you to determine the rate of county transmission along with a designation of the risk (“low,” “medium” or “high”) that represents. It also offers recommendations (as opposed to mandates, at this time) for masking and other measures. In early July, for example, Bergen’s weekly rate of transmission was 278.48 cases per 100,000 people, which is considered medium. At that level, the CDC recommends that people with possible COVID symptoms or a positive test mask up in public spaces and that all residents wear masks on public transportation. It also suggests that those “at high risk for severe illness” wear a mask in indoor public spaces. • Consider your individual risk. If you’ve been vaccinated and boosted and have no specific risk factors such as advanced age or a compromised immune system, your risk of being hospitalized or dying from COVID is low. Ask yourself, Dr. Saggar advises, “whether you feel that the negatives of wearing a mask outweigh the positives.” Those positives, of course, include a lower risk of contracting COVID, which, even when not deadly, can be highly uncomfortable and can lead to long COVID, in which viral symptoms persist after a negative test.

Conditions that put you at higher risk, says Saggar, “include being very old or very young, being unvaccinated, having an autoimmune disorder, taking medication that suppresses your immune system or suffering from a serious illness like cancer.” Michael Pagan, a spokesperson for the Bergen County Health Department, recommends that “those at high risk for severe disease talk to their health care provider about whether they need to wear a mask and take other precautions.”

As stated, the CDC advises everyone to mask up on public transportation, though it’s not a mandate. “Personally,” says Saggar, “I would consider masking if you’re taking mass transit and are in close quarters with numerous people.” He and his family also mask when flying. • Consider others you could infect. If you believe you’re at low risk but live or interact regularly with those at higher risk—elderly parents, say, or anyone who’s immunocompromised—masking in indoor public spaces is a way to protect them. “That’s why we still wear masks in healthcare settings,” says Saggar. “I may not be worried about myself, but I don’t want to pass COVID along to a patient.”

WILL MANDATES RETURN?

Pagan notes that “as new variants continue to emerge, the CDC may recommend universal masking if there is a surge in cases causing severity in illness and/ or an increase in hospitalizations.” Experts believe that could happen when temperatures drop in the fall and winter and people begin to congregate indoors in greater numbers. Omicron’s new variants, BA.4 and BA.5, are a particular concern, as they’re both highly contagious and extremely adept at dodging antibodies— which means that even fully vaxxed folks are at risk of so-called breakthrough infections. While Saggar doesn’t foresee a return to the lockdowns of 2020, he stresses that “we have to understand that COVID isn’t done with us, and we need to be flexible where masking is concerned.”

But will we be? Saggar notes that “the whole concept of masking has become politicized,” with some people basing their decisions on political affiliation rather than solid science. And there’s long been a concern in the healthcare community that people might not be willing to return to masking after spending months or years mask-free.

Still, most of the Bergen residents we spoke with say they’d mask up again if mandates were to return. And while there’s no guarantee that COVID rates won’t rise again, we can perhaps take comfort from the fact that new vaccines, engineered to protect against Omicron, will be rolled out in the fall, just in time for that potential surge.

“That’s why we still wear masks in healthcare settings. I may not be worried about myself, but I don’t want to pass COVID along to a patient.”

—Suraj Saggar, D.O., chief of Infectious Disease, Holy Name Medical Center