Experts say CDC's guidance on wearing masks on public transportation 'should increase compliance'

The Centers for Disease Control and Prevention has issued interim guidance urging people to wear masks while taking public transportation. The guidance, which was quietly released on Monday, gives very specific information and recommendations on everything from the importance of wearing masks to what transportation operators should do if someone refuses to wear one.

“Given how interconnected most transportation systems are across the nation and the world, local transmission can grow quickly into interstate and international transmission when infected persons travel on public conveyances without wearing a mask and with others who are not wearing masks,” the guidance says, before noting that “appropriately worn masks reduce the spread of COVID-19 — particularly given the evidence of pre-symptomatic and asymptomatic transmission of the virus that causes COVID-19.”

West Reading, PA - September 14: A BARTA (Berks Area Regional Transportation Authority) bus with the message "No Masks No Ride" displayed on it's digital sign, drives West in the 600 block of Penn Ave in West Reading Monday afternoon September 14, 2020. Masks are required as a precaution against the spread of Coronavirus / COVID-19. (Photo by Ben Hasty/MediaNews Group/Reading Eagle via Getty Images)
The CDC urges people to wear masks on public transportation to prevent the spread of COVID-19. (Photo by Ben Hasty/MediaNews Group/Reading Eagle via Getty Images)

What do the guidelines say?

The CDC’s recommendation can be summed up this way: Everyone — including operators and passengers— should wear a mask on public transportation, whether it’s an airplane, ship, ferry, train, subway, bus, taxi or ride share. The CDC also states that masks should be worn in boarding locations, such as airports, bus or ferry terminals, train stations and seaports.

The CDC specifically states in the recommendation that operators “should refuse boarding to anyone not wearing a mask and require all people on board, whether passengers or employees, to wear masks for the duration of travel.” There are a few exceptions, though. Per the CDC, people may be unmasked during the following situations:

  • For brief periods while eating, drinking or taking medication

  • If unconscious, incapacitated, unable to be awakened or otherwise unable to remove the mask without assistance

  • When it’s necessary to temporarily remove the mask to verify a person’s identity such as during Transportation Security Administration screening or when asked to do so by the ticket or gate agent or any law enforcement official

The CDC also says that people may be exempted from wearing a mask if they meet the following criteria:

  • They’re a child under the age of 2

  • They have written instructions from a licensed medical provider to not wear a mask

  • They have a disability, mental health condition or sensory sensitivity that prevents them from wearing a mask

  • They’re hearing-impaired or communicating with someone who is hearing-impaired when the ability to see the mouth is essential for communication

  • When wearing a mask would create a risk to workplace health, safety or job duty as determined by the relevant workplace safety guidelines or federal regulations

  • They’re operating or essential to operating transportation for whom wearing a mask would interfere with that person’s ability to safely operate the vehicle

The CDC even offers very specific guidance for what transportation officials should do to increase mask compliance. These include:

  • Provide information to people purchasing tickets and again at boarding on the need to wear a mask

  • Only allow people wearing proper masks to board

  • Monitor passengers for compliance

  • Disembark anyone who doesn’t comply at the earliest opportunity

  • Have masks available for people who do not have a mask, if possible

CDC spokesman Scott Pauley tells Yahoo Life, “CDC is providing this guidance to further support state and local health authorities, transportation partners, and conveyance operators who have implemented requirements for passenger masks to support passenger safety, maintain a safe and operating transportation system, mitigate further introduction and spread of COVID-19, and help safely re-open America’s economy.”

Still, there are theories as to why the CDC decided to release the recommendations now. “People are starting to do more things now, including going places, and contact is increasing over time,” Dr. Amesh A. Adalja, senior scholar at the Johns Hopkins Center for Health Security, tells Yahoo Life. “As pandemic fatigue is increasing, it’s a time to really emphasize these simple measures.”

The holidays are also approaching. “We tend to see a lot of travel then — Thanksgiving is typically the highest travel day of the year — and that increases risk of infection,” Dr. Peter Winkelstein, executive director of the Institute for Healthcare Informatics at the University at Buffalo, tells Yahoo Life.

It’s also just getting colder, which means more people will be indoors, and riding a bike, jogging or walking might be more difficult in increasingly inclement weather. “Outdoors is definitely safer for preventing the spread of COVID-19,” Winkelstein says. “When you’re sitting on an airplane or a bus, you don’t have the safety of being outdoors and don’t have as much ventilation. Masks become doubly important.”

The guidance comes on the heels of a series of disturbing reports about mask compliance on public transportation. Earlier this week, a maskless woman on an EasyJet flight between Ireland and Scotland was captured on video deliberately coughing and spitting on passengers. “You need to get a life. Everybody dies, you know that?” she said. In June, a passenger was booted off an American Airlines flight for refusing to wear a mask. There have been reports of many other similar instances as well.

Will these new guidelines make travel safer?

While the CDC has already recommended that people wear masks in situations where social distancing isn’t possible, Adalja says that these new guidelines help “provide more clarity” on the issue. “It gives guidance to the carriers so they can have more uniform rules and have the backing of the CDC for their decision-making process,” he says. “That hopefully should increase compliance and help make their policies more robust.”

Altercations with passengers about wearing masks “has verged on the violent,” Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Yahoo Life. “This guidance should help.”

“Everything we can do to socially normalize mask wearing is important,” Schaffner says.

Overall, Adalja says, he expects that this guidance will help make public transportation safer during the pandemic. “I think this will help,” he says. “The more people follow this guidance, the less likely everyone is to get sick when they travel.”

For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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