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Between COVID, flu and RSV, should people mask up every fall and winter?

An illustration of shows four people lined up in colorful clothes with one hand on their hip. Two are wearing surgical masks, and two are not.
Given that COVID cases, as well as the flu, surge every fall and winter, should you consider seasonal masking? (Illustration: Getty Images)

This season, as the temperatures drop, viral infections are rising. As we face what medical experts are calling a tripledemic — the convergence of influenza, RSV and COVID — you may be wondering how to protect yourself from getting sick. But beyond that, given that COVID doesn’t seem to be going anywhere any time soon and flu season returns every fall and winter, should you consider seasonal masking? Here are some things doctors say you should consider.

‘Dangerous’ surges of respiratory viruses

When the pandemic hit in 2020 and strict measures were put in place to help stop the spread of COVID, doctors say all other respiratory viruses disappeared abruptly and almost completely. “We had cut off the normal ways for respiratory viruses to transmit,” Dr. Shira Doron, infectious diseases physician and hospital epidemiologist at Tufts Medical Center in Boston, tells Yahoo Life. “Of course, they weren't gone. We didn't render them extinct. Gradually, they are coming back, and they are coming back with a vengeance.”

Dr. Anna Sick-Samuels, assistant professor of pediatrics at the Johns Hopkins University School of Medicine, says the disruption of the pandemic has created a shift in the seasonal patterns of these viruses. “What is a little different this year is that the timing of all these viruses is overlapping with early waves of RSV and influenza,” Sick-Samuels tells Yahoo Life. “In prior years, we would typically see them more in succession. So that impact was more spread out.”

Although these respiratory viruses are showing up earlier than usual, Doron says the current numbers are not that different from years past. “We certainly aren't seeing more flu than we would normally see at its peak,” she explains. “That being said, if there's this much flu and RSV in November, it could become the worst season we've ever seen.”

All this is happening just as people are getting ready to spend more time indoors, whether at busy shopping malls and large holiday parties or in crowded airports. Some people wonder if it’s time to revisit those pandemic protections, including masking, which have been relaxed across the country.

Given the current swell of respiratory viruses, Doron says she is not a proponent of health authorities “ratcheting down on mandates and restrictions right now, masks or otherwise — because I do think that we are now seeing one of the most dangerous, unintended consequences of those measures, which is these reactive respiratory virus surges.”

Should you mask up every winter?

So, does protecting your health mean automatically masking up when the cold weather hits and as respiratory viruses rise? Not necessarily. Dr. Vandana Madhavan, director of advanced pediatrics at Mass General Brigham in Boston, tells Yahoo Life that “it doesn't have to be an all or nothing” decision. She says, “I've talked a lot during the pandemic about public health interventions being like a dimmer switch, not an on or off switch. But that dialing up or down doesn't have to be at a larger community level.”

Madhavan says it really comes down to what works best for you and your family, along with your age and health status. “Someone might say, ‘We really want to be able to see the grandparents over the holidays. Let's all wear a mask for a couple of weeks and really be mindful of what activities we do,’” she says. “Masks don't have to be an all or nothing, but they remain a really effective tool.”

However, Doron says not all respiratory viruses are transmitted in the same way. “A well-fitting, high-quality mask appears to protect against COVID, but it may be less protective against viruses that are more reliant on the contact mode of transmission.”

For example, although RSV is spread when an infected person coughs or sneezes, it can also be spread by touching a surface that has the virus on it and then touching your face, according to the Centers for Disease Control and Prevention. So stepping up your hand hygiene and avoiding exposure to people who are sick may be just as, if not more, effective than wearing a mask in this case, says Doron.

In general, healthy lifestyle habits can also help. “There's a lot of basic stuff that we probably haven't paid enough attention to throughout the pandemic that still applies here,” Doron says. “Your underlying health really matters a lot. And that's eating well and exercising and sleeping well and doing things that keep your stress level down. All of those things are just huge risk factors for severe disease.”

When to take more precautions

However, if you fall into a high-risk category, such as those who are immunocompromised or are in close contact with someone who is, doctors agree that you should use everything in your toolbox to avoid exposing yourself to viruses this season. Those most at risk include the elderly, people with heart or lung disease, patients undergoing cancer treatment and babies less than 6 months old.

For parents of very young children who are unable to wear masks, Madhaven says it’s important to be an advocate for your child’s health. “Parents should really feel empowered to ask not just, ‘Oh, is anyone sick?’ But, ‘Have you been around anyone sick recently?’ Because that person who is exposed to someone who's sick might have it very mild, but then could transmit it to a more vulnerable young child or older adult.”

If you still have concerns, Doron suggests talking to your doctor to help you assess your personal risk and determine what protections might work best for you. “One small silver lining to COVID-19 is that people have become more aware. Like, ‘Oh, let's think about ventilation, let's think about transmission risks, etc.,’” says Doron.

Madhavan agrees, saying that these are all lessons that are also applicable to other respiratory viruses. “I think, right now, everyone understands we're all in the same boat,” she says. “We're all trying to keep ourselves and our families healthy.”

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