Advanced Covid FAQ
Covid primarily spreads through airborne aerosols, which are not effectively blocked by cloth or surgical masks (or poorly-fitting N95s, for that matter). Both the CDC and the American Medical Association agree that a well-fitting high-filtration mask (KN95/N95/KF94) is necessary to protect both yourself and others from the highly contagious Omicron variant. While cloth and surgical masks may have been useful against earlier covid variants, they are especially insufficient against Omicron. Unfortunately, even though the CDC and the AMA agree on this point, public health messaging has not caught up, and as a result many people are still using outdated masks.
Additionally, the unfortunate reality is that many high-filtration masks are counterfeit, and do not provide the filtration that they claim. In order to protect yourself and others, it's important to wear a vetted KN95/N95/KF94 from a reliable source, with no exhalation vent.
The good news (!) is that authentic, quality & affordable high-filtration masks are now readily available from sources such as Project N95 -- with lots of options to help you get the best possible fit.
One-way masking is much better than no masking at all, but it is also much less effective than two-way masking -- which means that it is insufficient to protect high-risk people in an era of extremely contagious covid variants.
Risk of infection from any given covid exposure is a function of both masking (on both ends) and exposure time. Let's estimate that a non-fit-tested N95 mask blocks 90% of infectious viral particles, and that you can get infected with covid after 2 minutes of unmasked exposure (likely true with Omicron). That would mean that, with one-way masking, a masked, vulnerable person is at risk of infection after just 20 minutes of exposure to an unmasked contagious person. With two-way masking, the vulnerable person would be safe for 200 minutes, or 3.3 hours.
Anecdotally, in an empirical demonstration of the above calculus, the authors of this page know of multiple cases of people getting infected with the Omicron variant despite wearing well-fitted N95 masks.
Check out the extremely helpful mask listings at Project N95.
We've got good news for you! There are now lots and lots of options for KN95/N95/KF94 masks of various styles and fits, and there's a lot you can do to seek out a mask that's as comfortable for you as possible. Project N95 is one great resource. Masks that are lauded for being especially comfortable and well-fitting include the Flo Mask, Envomask, Aura N95, and Kimberly-Clark duckbill N95. It may also help you to adjust the mask straps with extra loops or knots, in order to get a good fit.
Beyond this, it's important to remember that, while no one particularly likes the physical sensation of wearing masks, the physical experience of covid and/or Long Covid -- for you, or for someone that you unknowingly transmit to while unmasked -- is likely to be far worse. While comfort is, indeed, a real need, safety and protection from serious long-term health problems and death are more fundamental needs; pikuach nefesh, or saving a life, is an important Jewish value that supersedes comfort. Even in secular society, we often do things that are somewhat uncomfortable (like wearing seatbelts, life preservers, or condoms) in order to protect ourselves and/or others.
With that said, a few people truly cannot wear masks because of particular issues like major sensory sensitivities, migraines, etc. If this is you, we recommend that you first try different mask options, as recommended above, to see if anything can work. If, truly, nothing works, then you're experiencing a disability issue and this qualifies as an access conflict; see below for more (LINK).
These feelings are understandable, but we'd like to offer a reframe. Masking is an act of love -- a sign that the person wearing the mask is deeply considering the needs of others, especially the high-risk people who have been most impacted by this pandemic and undergone the most isolation and trauma. Masking also is an incredible tool that, when done well, enables people to gather together in relative safety, thus alleviating isolation. You can make masking your own by seeking out comfortable -- perhaps even stylish and colorful -- masks that fit you well. It's understandable that masks may feel associated with the trauma of the early pandemic, but -- just as people learned to practice safer sex with condoms to combat AIDS -- we can integrate masks into our regular routine.
A negative rapid test means that it is very unlikely that you have covid and are extremely contagious -- but it does NOT rule out the possibility that you have covid and are moderately contagious, as evidenced by the significant covid spread at the 2022 White House Correspondents' Dinner, which required proof of a negative same-day rapid test.
A PCR test is more sensitive than a rapid test, and if you test negative with a PCR, you are highly unlikely to spread covid in the hours immediately after the test. However, PCR results usually take 1-3 days to come back from the lab; by the time you get them, they tell you about your status in the past, not the present.
Both rapid tests and PCR tests can be useful covid mitigation measures, but they should be layered with other measures, like ventilation and masking.
We have a great workaround to share! It turns out that one of the best ways to get high-quality rapid tests in bulk is to order them from Europe, where they are sold much more cheaply than in the US. We can attest from personal experience that this link is reliable and that, even with shipping costs, the tests are extremely affordable.
Actually, YES! Three brands of rapid at-home PCR tests are currently available: Cue, Detect, and Lucira.
The one catch is that these tests are pricey. However, we want to share this information because we think that rapid PCR tests are a strong possible solution to certain types of situations that can arise in Jewish communal life -- like, for instance, an individual service leader needing to remain unmasked so that hard-of-hearing people can read their lips.
To quote the People's CDC:
"We now know that social distancing is not enough to protect people from COVID – the CDC recommendation for social distancing of 6 feet was based on early confusion about how the virus moves in air. While it is true that large virus-containing droplets do fall to the floor on average within about 6 feet from an infected person, they can be projected much further. Later it became clear that much smaller droplets, called aerosols, are produced just by breathing (and more are produced by talking, laughing or singing). The aerosols are so lightweight that they don’t fall to the ground. Rather, they can float in the air for hours, unless diluted with outside air or trapped in a filter. In addition, a 2021 study showed that the smallest aerosols contain the greatest amount of viruses. That makes both filtration and dilution with fresh air more important than ever."
To this we would add that -- given that the highest amount of aerosols are produced by singing -- shul (or any other place with communal singing) is an especially high-risk environment, which necessitates a special focus on covid protection measures, including ventilation and filtration of air.
Covid risk can, unfortunately, still be significant in outdoor settings, as explained by epidemiologist Theresa Chapple in this June 2022 episode of the Death Panel public health podcast (
https://www.deathpanel.net/transcripts/outdoor-transmission-theresa-chapple?format=amp) - as well as numerous other sources.
Covid aerosols move like smoke - if you’ve experienced the smell of cigarette smoke in outdoor settings, then you have direct experience of the ways that invisible aerosols move and sometimes create a significant impact, even when not indoors.
From a harm reduction standpoint, outdoors is significantly safer from Covid transmission than indoors -- this matters! At the same time, N95 masks and rapid tests are still useful tools (and potentially crucial ones, depending on the wind conditions and the degree of Covid safety needed by participants in the space) when outdoors.
Distancing does have a much greater impact outdoors than indoors - so designating a “masks off” area at a significant distance from a “masks required” area can be one option, as needed.