Health experts differ on wearing masks outside

Infectious disease specialists have different answers for a simple question: Is it necessary to wear a mask outdoors?

Dr. Anthony Fauci, director of National Institute of Allergy and Infectious Diseases, says he wears a mask whenever he has to interact with people, indoors or outdoors.

“I wear a face covering outdoors,” said Dr. Fauci, a key member of the Trump administration’s coronavirus task force. “And even though when you go outdoors, there may not be anybody literally 20, 30, 40, 50 feet of you, unexpected things happen, like, when I go walking or jogging in the evening, I turn a corner and all of a sudden you’re very close to someone.

“So even though it’s easier to socially distance when you’re outdoors than when you’re sometimes in a room, just to be doubly safe, I wear it when I’m outdoors,” he said.

Indoors or outdoors, if a person is four or five feet away from someone who coughs, sneezes or just talks, there is still a risk of spreading COVID-19, Dr. Fauci said.

“I see that when one person has a mask on and another person without a mask on, it makes that person uncomfortable and they move aside,” he said. “So I think it’s good to have both the general feeling of being safe and the actual reality of being safe even though outside you have much more space I don’t think people should feel completely protected because they’re outdoors.”

However, Dr. Sandro Cinti said the risk of exposure depends much on time.

“So I think outdoor activities where you’re not in very crowded, face-to-face situations, you don’t need to wear a mask because I think an important thing to remember is that the infection rate is all about exposure times time,” said Dr. Cinti, a professor of infectious diseases at the University of Michigan, Ann Arbor.

“So it’s the amount of exposure and how long you’re exposed to somebody. And so when we’re outdoors, walking by somebody in the streets, we’re not going to be exposed. The exposure time isn’t enough,” he said.

Dr. Cinti noted that the risk could depend on the type of outdoor activity people are engaged in and whether they are maintaining physical distance.

He added that it’s OK to run and bike outside without a mask so long as it’s not in tight groups, but it wouldn’t be safe to participate in a marathon even with a mask on.

Walking past someone outside doesn’t pose as great a risk of transmission as playing volleyball on a beach where there’s close contact does, he said.

Several governors are requiring residents to wear face masks inside public places, but their orders do not clarify whether a mask should be worn outdoors.

Virginia Gov. Ralph Northam announced Tuesday everyone age 10 and older is required to wear face masks at indoor sites such as stores, personal care and grooming establishments, and food and beverage venues, beginning Friday. Last month, Maryland Gov. Larry Hogan signed an executive order mandating residents to wear face masks while indoors. Neither specifies whether masks are required outside.

“Outbreak investigations and epidemiologic studies indicate that the risk of SARS-CoV-2 transmission is highest when people spend time indoors for an extended time,” said Dr. Edward Belongia, director of the Center for Clinical Epidemiology and Population Health at the Marshfield Clinic Research Institute.

“There are many uncertainties about COVID transmission, but overall the risk of transmission appears to be low in outdoor settings where social distancing is maintained,” Dr. Belongia said. “It is important to emphasize that masks are not a substitute for social distancing, including both indoor and outdoor activities. People who engage in outdoor activities should continue to follow social distancing guidelines.”

Earlier in the pandemic, federal health officials did not recommend face coverings until studies showed a significant portion of individuals can spread the virus before showing symptoms.

Since the virus can transmit between people in close proximity through speaking, coughing or sneezing, even in the absence of symptoms, the Centers for Disease Control and Prevention recommend that individuals wear cloth face coverings in spaces where physical distancing is difficult to practice such as grocery stores and pharmacies.

Even with face masks, health experts stress maintaining 6 feet of distance to slow the spread of the virus. Cloth face coverings can help prevent people who don’t know they have the virus from passing it onto others, according to the CDC. It is important to recognize that there are asymptomatic people with COVID-19 who are shedding the virus and still a large proportion of the population who are at high risk for serious illness should they be exposed to the SARS-CoV-2 (the virus that causes COVID-19), said Dr. Henry Bernstein, a pediatrics professor with infectious disease expertise at the Zucker School of Medicine at Hofstra Northwell.

“We know that SARS-CoV-2 can be a mild disease for some, but they could still be shedding a certain amount of virus that could be devastating to certain individuals,” he said, adding it would be wise to wear a mask if coming into contact with people, especially those who don’t share the same living space, to decrease the chance of transmission.

“I think it’s appropriate to wear a mask outdoors if you’re going to come in contact potentially with another person,” Dr. Bernstein said. “Wearing a mask is protecting someone else I think we want to try to do whatever we can in order to prevent infection and keep our communities safe.”

The public is recommended to wear cloth face coverings and not surgical masks or N-95 respirators, which the CDC guidance says are critical supplies should be reserved for healthcare workers and other medical first responders.