Even though mask wearing slows the spread and potentially reduces the severity of COVID-19, the CDC recognizes that there are certain situations in which wearing a mask might not be the best idea. Unfortunately, their mask wearing guidelines are so abhorrently written that they seem to suggest that people with certain non-medical excuses opt out of wearing a mask.
According to the CDC, masks should not be worn by:
Children younger than 2 years old
This is understandable.
Anyone who has trouble breathing
This is misleading, because the CDC later goes on to say that people with asthma should indeed wear masks, and people with lung conditions should consult their doctor and opt for virtual activities if their doctor says that they shouldn't wear a mask.
Anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance
This makes sense.
Wearing masks may be difficult for some people with sensory, cognitive, or behavioral issues. If they are unable to wear a mask properly or cannot tolerate a mask, they should not wear one, and adaptations and alternatives should be considered
No wonder people think they can use an "exemption" to protest wearing a mask. This guidance from the CDC likely refers to people with severe and incapacitating sensory, cognitive, or behavioral issues. Unfortunately, if we take it as written, the CDC is basically telling people without medical conditions that if they don't like how a mask feels, or if the mask makes them want to throw a nice, big, grown-up tantrum, they simply shouldn't wear it.
The CDC later clarifies that if you are able to wear a mask and remove it on your own, you should be wearing one -- but it does not clarify the severity of behavioral issues that would fall under the "don't wear a mask" umbrella.
They go on to say that outdoor workers should "[p]rioritize wearing masks when in close contact with other people, like during group travel or shift meetings, and remove masks when social distancing is maintained."
It is worth noting that the mask-wearing guidance regarding outdoor workers must not be applied to indoor workers. The guidance for outdoor workers is intended to be a safety measure for people whose masks could get caught in construction equipment, or for people at risk of heat-related illnesses.
According to a scientific brief published by the CDC in October 2020:
There are several well-documented examples in which SARS-CoV-2 appears to have been transmitted over long distances or times. These transmission events appear uncommon and have typically involved the presence of an infectious person producing respiratory droplets for an extended time (>30 minutes to multiple hours) in an enclosed space. Enough virus was present in the space to cause infections in people who were more than 6 feet away or who passed through that space soon after the infectious person had left.
This is interesting, because the CDC says it's alright to remove masks when eating indoors, regardless of how many people are in the restaurant or building.
CDC recommends wearing a mask while dining in a restaurant except when actively eating or drinking.
In other words, their guidance to remove masks when eating indoors contradicts their own scientific brief regarding airborne transmission in indoor spaces from more than 6 feet away. Clearly, you can't eat with a mask on, but the CDC opted to issue this guidance instead of suggesting avoiding indoor dining.
The CDC also tells us that runners, bicycle riders, and anyone else doing high-intensity activities can opt out. "Masks should be used in public settings, but if you are unable to wear a mask because of difficulty breathing during high intensity activities, choose a location with greater ventilation and air exchange (for instance, outdoors versus indoors) and where you can keep at least 6 feet from others during the activity."
This should not be interpreted as "I can run near other people and shake off my sweat-covered hair as I run by without a mask." No, you may not do that. According to the CDC, you may take off your mask and do high-intensity exercise outdoors, far away from other people -- NOT near other people.
You are not exempt from wearing a mask in the gym, if your gym is even open.
The CDC's mask wearing guidance consistently contradicts itself, and leaves plenty of room for misinterpretation and rule-bending by people without medical conditions.
For example, the CDC suggests that people doing high-intensity activities should not wear masks if the mask would impede their breathing. Then, they say that wearing a mask does not impede breathing at all, nor does it increase carbon dioxide levels in the body.
A cloth mask does not provide an airtight fit across the face. The CO2 completely escapes into the air through and around the sides of the cloth mask when you breathe out or talk. CO2 is small enough to easily pass through any cloth mask material. In contrast, the virus that causes COVID-19 is much larger than CO2, so it cannot pass as easily through a properly designed and properly worn cloth mask.
Even N95s don't increase CO2 retention, according to Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital. “There is no risk of hypercapnia (CO2 retention) in healthy adults who use face coverings, including medical and cloth face masks, as well as N95s," the doctor told Healthline. "Carbon dioxide molecules freely diffuse through the masks, allowing normal gas exchange while breathing.”
The key here is the word healthy. The CDC's guidelines for people with breathing difficulties are likely intended to apply to people with serious lung diseases whose doctors have advised them not to wear a mask.
The guidance regarding people with behavioral difficulties should not be misinterpreted, either. According to the CDC:
Appropriate and consistent use of masks may be challenging for some children and for people of any age with certain disabilities, including cognitive, intellectual, developmental, sensory, and behavioral disorders.
Does this mean that an adult who does not have a medical condition but behaves badly is exempt from wearing a mask? No. The CDC suggests the following:
When deciding if children and people with certain disabilities should wear a mask, determine if they can: use a mask correctly; avoid frequent touching of the mask and their face; limit sucking, drooling, or having excess saliva on the mask; remove the mask without assistance.
In other words, if you are able to use a mask correctly, and if you are able to remove it without assistance, you are likely not exempt from wearing a mask, no matter how bad your behavior is. And if you are exempt, according to the CDC, you should be making adaptations or accommodations so that you can still wear a mask where laws and policies require it. Otherwise, the CDC says you should stay home and opt for virtual activities instead of in-person activities. It is worth noting that the CDC suggests that people who can't wear masks stay home, not the other way around.
Unfortunately, while the CDC acknowledges that almost everyone should be wearing masks, their guidelines leave much room for interpretation and for mask evasion.
Here's a simple checklist if you're unsure whether you're exempt from wearing a mask:
- Are you under 2 years old?
- Are you physically unable to wear a mask due to a medical condition?
- Are you physically unable to remove a mask by yourself due to a medical condition?
- Do you have a severe medical condition because of which your doctor informed you that wearing a mask could be detrimental to your health? (Remember: asthma, according to the CDC, is not a qualifying medical condition.)
- Are you an outdoor worker for whom wearing a mask could put you in physical danger due to the equipment you work with, or due to the risk of heat-related illnesses? (Remember: if this applies to you, it only applies while you are working, not while you're at the supermarket after your shift.)
- Do you have a medical condition that causes sensory, cognitive, or bevioral difficulties, because of which wearing a mask causes you severe discomfort and/or puts your safety (or others' safety) at risk?
None of the guidance from the CDC is intended to apply to people without medical conditions who simply do not want to wear masks. Not wanting to wear a mask is not an excuse, no matter how poorly written the CDC's guidelines are.
Mask up. Stay safe.
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