How to think about masks, testing and holiday gatherings amid omicron spike

On Friday, the state Department of Public Health reported the highest single-day number of new, confirmed COVID-19 cases since early January. The seven-day average positivity rate in Massachusetts reached 5.77%.

With the emergence of the highly transmissible omicron variant of the coronavirus as the Christmas and New Year holidays are upon us, it is becoming increasingly difficult to navigate the pandemic.

Shan Soe-Lin, the managing director of Boston nonprofit Pharo Global Health Advisors who holds a doctorate in experimental medicine from McGill and a masters of public health from Harvard, joined WBUR's Weekend Edition to discuss.

How well are masks working with the new coronavirus variant? 

"Masks are still one of the most important things that we could do to protect ourselves against coronavirus. Unfortunately, with the very high transmissibility of omicron and delta, everyone should be wearing the very best mask possible. So I don't think cloth masks are going to cut it anymore. KN95s and even KF94 masks (the Korean paper version) are readily available now compared to last year. People should really be wearing the best one they can. If you don't have access to either of those, then a surgical mask doubled up with a cloth one is better. And if you only have a cloth mask, then wear that. But really, everyone should be doing the best they can at wearing the strongest mask they could find."

"Everyone should be doing the best they can at wearing the strongest mask they could find."

When and where do you think people should be wearing masks now? 

"In my opinion, it would be helpful if state and local governments would accept the fact that coronavirus is not over yet. It's never been over. It's just been going in waves. Relaxing and reinstating mask mandates is just very confusing for everyone and also ineffective because people don't stay put or stay in one place every day.

"Given the very extreme threat from omicron and delta, everyone should be wearing masks indoors, period, in any public spaces. Also, if anyone's gathering indoors with people they don't know or haven't been able to test, then also I would say that people should be wearing masks indoors or in their own homes. That's probably extreme, and people won't like hearing that, but that's the best way to keep yourself safe."

Gov. Baker has said he is not imposing a statewide mask mandate for indoor public spaces in Massachusetts. What do you think about that?

"I think that's terribly wrong. Masks are cheap. They're widely available now for everybody, and there's just overwhelming evidence that show that they work. But unfortunately, they only work if everyone does it and leaving it up to individual cities and towns ... is ridiculous. He's failing as a leader. His job as governor of Massachusetts is to make sure that all of us are safe. ... [Masking is] just the least that we can do for each other, for yourself just to keep everyone safe."

How should we be thinking about holiday get-togethers this year?

"I don't have an optimistic message. People can't have their cake and eat it too. We're still in a war with coronavirus, and right now it's winning. I understand, too, that people need to live their lives. This is really not quite the same as the holiday season last year in 2020 now that we have vaccines available to us. So when thinking about gathering with loved ones and friends, the first thing I would think about is, you know, is it worth the risk? And how do I make the risk that exists as low as possible?

"This is probably the most dangerous time in some ways for us in Massachusetts with the rising case counts."

"I would strongly recommend that people not socialize with unvaccinated people indoors. If you have to do that, then I would suggest being outside as much as possible. And if you have to get together in larger groups ... our family has been testing everyone with rapid tests before before letting them in — [including] all of our vaccinated, fully boosted, friends and family. And even when we're inside, we try to spread out as much as possible and I keep the windows open and also have HEPA filters. So that might be a little extreme, [and] that may not be possible for everybody. But realize that the threat is real. This is probably the most dangerous time in some ways for us in Massachusetts with the rising case counts. ... A holiday really isn't worth getting terribly sick or losing a loved one to something that was otherwise preventable."

How important are boosters?

"I think everyone should know that boosters are far more important now than it was even realized maybe a month or two ago when boosters started becoming more widely available. Two shots [or one of the J&J] just aren't enough in the face of omicron now, and also what we now know about vaccine protection waning. It's important to know that there's still somewhat positive data that if you've had two shots, it's probably mostly OK to keep you out of the hospital. But, you know, a booster is much more effective in reducing the severity of illness further."

If you had to sum up one message for folks who do plan to gather in some way, what would that be?

"My key message to everybody would be that this is possibly the most dangerous time in the course of the pandemic to get COVID. With the incredible transmissibility of omicron, everyone should realize they're probably going to be exposed. And if you're going to be exposed, the safest way to do that is with [a booster shot] and a mask on your face."