An Emergency Physician's Thoughts on the CDC's New Mask Guidelines

Michael Burg, MD
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For almost two years, I’ve not been sick. I didn’t catch a cold, avoided seasonal influenza, and dodged COVID-19. Now, thanks to immunization, I’m largely — but not completely — protected from a serious COVID-19 infection.

Not becoming seasonally sick with respiratory viral infections has been a luxury, one I’ve not enjoyed for the last 30+ years as an emergency physician. For whatever reason, thousands of my infected patients thought it acceptable to cough or sneeze directly into my face without even an attempt to cover their mouths and noses. Every winter, I got sick with a cold or two. Once or twice I got the “flu.” Truly a long series of miserable experiences.

That I’ve not been sick more recently is likely due to the public health measures to contain the coronavirus pandemic. Despite what many anti-science adherents believe, hand washing, masks worn properly, and physical distancing are well-proven infection control measures. By themselves, these measures helped prevent a horrible pandemic situation, plagued by delays, incompetence, and willful ignorance, from getting worse. It is truly hard to comprehend that our grim outcomes in this country could have been even more cataclysmic. Thankfully, all that seems to be fading into the distance.

Immunizations are still a more powerful tool for infection control. Even with 30 to 40% of eligible Americans un-immunized, coronavirus infection metrics continue to improve. Imagine where we’d be as a nation if all eligible Americans were fully immunized!

Now the CDC has issued new guidelines for mask-wearing. As of May 16, 2021, their guidance states:*

If you are fully vaccinated, you can resume activities that you did prior to the pandemic.
Fully vaccinated people can resume activities without wearing a mask or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.
If you haven’t been vaccinated yet, find a vaccine.

Please note: there is nothing here stating we’re to behave as though the pandemic is ending.

So how are we to behave given this new advice?

This is my plan from now on. You don’t have to agree with it, but I would urge you to develop one for yourself and your family. It is entirely possible and likely that new and dangerous pathogens will continue to emerge. Think back to how the world looked in 2019. Contrast that with the world of March 2020 and beyond. We live in interesting, dangerous, and potentially lethal times.

  • I plan to continue all public health measures currently in place. Masking is first and foremost, but I’ll also continue social distancing where possible, and good hand washing.
  • I will travel with caution while masked.
  • I will urge un-immunized or partially-immunized people to receive the full protection afforded by immunization.
  • Given that approximately 1/3 of eligible Americans remain un-immunized, I will politely ask that unmasked individuals in close public spaces wear masks. (I tried this today as six unmasked people entered a hotel elevator with me. All masked without protest when asked politely to do so.)

My decision — as a fully immunized person — to continue mask-wearing is a personal preference. I know that I don’t HAVE TO. Over the years, pre-pandemic, I’ve noticed many masked individuals in public, especially while traveling or in busy cities. Now, mask-wearing for me, while I’m in crowded public spaces or those spaces with the potential for high contact, seems prudent. I’ll adjust my behavior from now on as new information becomes available and as my experience deepens.

As always, I remain open to learning new helpful and evidence-based information designed to help me and all of us successfully navigate the coronavirus pandemic.

Please feel free to share your thoughts and opinions. We’re all in this together.

Final thoughts

I can wear glasses, a hat, and shoes all day even though I’m more comfortable without them. Surely I can do the same with a mask that might save my life or prevent serious illness.


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San Luis Obispo, CA

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