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How new mask rules may impact immunocompromised individuals and children with disabilities

Zackary Drucker
The Gender Spectrum Collection
A genderqueer patient walking down a hospital hallway, pre-pandemic.

On Wednesday, new guidelines provided by the Centers for Disease Control and Prevention were put into action by New York State, allowing vaccinated individuals to access some public spaces without masking. But many have asked: what does this mean for immunocompromised individuals and people with disabilities?

WBFO reached out to Dr. Dennis Z. Kuo, the division chief of general pediatrics at the UB Jacobs School of Medicine & Biomedical Sciences. He specializes in health systems and the care of children with disabilities. He shared what he feels the implications of this new guidance are, along with what everyone should consider when making decisions about masking. 

"I do have some concern that the way that this guidance is being interpreted, not how it's written, but how it's being interpreted, is potentially putting individuals with disabilities at risk," said Kuo.

Kuo pointed out a point many have made in discourse on social media - there may be some confusion about what this announcement actually means.

"There were some at the individual and at the public health level, that may be interpreting this as we've made tremendous strides, and we don't need to take those precautions that have worked. And there's certainly a balance we need to strike with, we need to get out, we need to get our kids in school, we need to get our businesses reopened, fully reopened, we're not talking partial, we need to get back to that level of activity."

He goes on to argue that these policies and practices that are created in reopening need to keep people with disabilities in mind. 

"We have to do it [reopen] in ways that are continue to be safe, and continue to protect the rights of all of those who deserve that level of protection, and can utilize these businesses and utilize these public spaces and return to school. And that's what we need to do," Kuo said.

He also expressed that mask mandates protect everyone - not just people at higher risk.

"If we loosen the mask mandates from a public health receptive to soon we may jeopardize the ability of everybody to be able to do that [reopen, return to school]. And I think that, in turn may be counterproductive for for us, for the public."

Individual Risk vs Collective Impact

Kuo says that while the individual risk of COVID to vaccinated individuals may be low, it is much higher for our systems and people who can’t or haven’t gotten vaccinated, or may not have amounted an immune response due to a health condition or medical treatment.

On an individual level, it [the CDC guidance] makes sense, because individuals who get the vaccine in general have a very, very high response to it," said Kuo. "It is recognizing that if you know you're vaccinated, then the risk for you to get sick from this and passed on to other people is very, very small it's very negligible."

But some people with allergies to the vaccines' ingredients might not be able to get vaccinated. And, as The New York Times reports, some people who are immunocompromised may not mount the same immune response as immunocompetent individuals. Some people are immunocompromised due to medications that suppress the immune system, such as treatments for autoimmune disease, cancer and organ transplant. Some people are born with immune systems that don't work as well. 

"The thing is that what happens on the individual level, what happens at the public health level, ideally, they would harmonize but they don't always harmonize," said Kuo. "Even though the individual risk is still very, very low when you're vaccinated, the risk to the general public and the risk to our systems and our schools, and our hospitals, and our businesses is actually still quite elevated in Western New York. Because there's still a lot of virus circulating out there."

Erie County is still "very high risk"

Right now, Erie County is a “very high risk” area of transmission for unvaccinated individuals, according to the New York Times COVID-19 tracker. He suggests that public health policy should take into account those who are at most risk.

"Disability is one of the areas where I think we need to do more discussion about health equity, you know, individuals with disabilities have just as much rights to be in public spaces, as anyone else, individual with disabilities have the right to have an education just as much as anyone else.”

"And when we're talking about public health policy, and we're talking about, you know, protecting and supporting the rights of individuals with disabilities, you know, I feel strongly that you really need to design your, your public health protocols around those who are most vulnerable."

Children still can't get vaccinated - and their eyes are on the adults

Kuo says that adults making decisions about their own mask wearing should consider what impact that may have on children in their lives. He explained that for some children, it may have taken more time to adjust to mask wearing than others. 

"There were children that we've had to spend a lot of time really helping them understand the importance of wearing a mask and for some kids, it's a months long process for especially if you know there are some kids with developmental disabilities," Kuo said. "We really need to support mask wearing so they can be in school and go into public spaces.”

He explained that in this moment, it is important for adults to consider the behaviors they may be modeling for children, many of which who cannot yet be vaccinated and who may have taken longer to adjust to mask wearing. Currently, only children 12 and up can receive the vaccine. Masks are also still required in schools in New York State, including for vaccinated individuals.

"They [children] watch what we do. You know, they absolutely watch what we do and for the protection and for the culture of supporting these kids and their families, it is important for parents and teachers and folks to continue wearing masks around them so that they understand the importance of protecting themselves and wearing masks.”

Kuo also emphasized that all of these factors are things people should consider when making decisions about masking. Kuo recommends that everyone who can get vaccinated should get vaccinated and suggests that at times where the virus is circulating at great rates, it is a good idea to mask and follow COVID precautions to protect everyone. 

Emyle Watkins is an investigative journalist covering disability for WBFO.
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