CDC is considering revising its outdoor mask guidance. Here's what health experts say.

Health

Yahoo News 22 April, 2021 - 11:44am 55 views

On Thursday, the director of the Centers for Disease Control and Prevention told "TODAY" the agency is considering revising its mask guidance.

“We’ll be looking at the outdoor masking question, but also in the context of the fact that we still have people who are dying of Covid-19,” Dr. Rochelle Walensky said.

Already in states where mask orders are still in effect, there are moves to loosen restrictions for outdoors. North Carolina Gov. Roy Cooper hopes to lift restrictions, including an outdoor mask mandate, by June 1. New York City Mayor Bill de Blasio is considering a change to outdoor mask guidance by June. Connecticut will lift mask requirements for outside in mid-May, along with transitioning indoor mask rules from mandate to guidance.

Some health experts are increasingly calling for mask restrictions to be eased for outdoor activities.

“We know that the virus largely spreads indoors and there's very little transmission outdoors, except in some very specific circumstances,” Dr. Ashish Jha, dean of the Brown University School of Public Health, said. “At this point in the pandemic, with more than half of Americans vaccinated, it's pretty reasonable to start thinking about peeling back outdoor mask mandates.”

Masks should be used during large outdoor gatherings where people are close together for a prolonged period of time, such as a rally or sports events in packed arenas, he said. But passing someone on a street or going for a run without a mask is a very low-risk situation.

“Requiring everybody walking down the street to wear one is probably not needed,” Jha said.

A review paper published in The Journal of Infectious Diseases by researchers at the University of California, San Francisco, found that less than 10 percent of transmission occurs outdoors and the odds of spreading the virus indoors were 19 times higher.

However, experts at Northwestern University argue keeping masks on when you're outside — even after you're vaccinated — is not only a "social courtesy,” but also helps "model the behavior" for children, who can't yet get the shot.

According to current CDC guidance, “masks may not be necessary when you are outside by yourself away from others, or with people who live in your household.”

Health experts hope the CDC will more clearly outline high-risk situations when masks are truly needed.

Kristin Nelson, an assistant professor of epidemiology at the Emory University Rollins School of Public Health, said that while it was reasonable to include outdoor mask mandates up until now, she would like to see them be one of the first restrictions lifted as more of the population gets vaccinated and case counts start to fall.

“I think those mass mandates in outdoor spaces should probably be the first to go,” she said. “We really need to focus on places we know are at high risk for a transmission like large gatherings and closed spaces with poor ventilation.”

Homing in on the importance of indoor masking and helping people understand when it's safe to take off the mask may actually increase compliance, Jha said.

“Then you can really emphasize where it's not safe and get people to [wear their mask],” he said.

The rate of community transmission is an important factor for loosening rules. In places where it's lower, it may be an appropriate time to start lifting requirements.

Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health, cautioned that setting a strict threshold to lift mandates isn’t advisable and that mask mandate metrics are subject to new and emerging science.

“If you're vaccinated and if there's low rates of community transmission, it's definitely reasonable to not worry about wearing masks [outdoors]” she said.

But when in a crowded situation, even if outdoors, it's safer to keep the mask on, Rimoin said.

Yahoo poll: Is it time Singapore did away with the mask mandate outdoors?

Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital, said wearing masks outdoors gained momentum when “we were in the height of surges, when there was not a huge amount of insight into how transmission was occurring.” As we’ve gathered more data, Brownstein said “the bulk of all transmission events are taking place indoors and outdoor transmission is very low.” When you are alone outside or with your household, you may not need to mask up, although you’ll want to keep your mask handy, experts suggest.

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MINNEAPOLIS — It was shortly after 4 p.m. Tuesday, and all chatter ceased in the roll-call room for the Fourth Police Precinct in North Minneapolis. Everyone’s attention was glued to the television on the wall. Then came the verdict: Derek Chauvin was guilty on all counts, including murder, for killing George Floyd last May. The station house stayed silent, the officers processing what the verdict meant after a year of tension and conflict, said Inspector Charles Adams, the precinct’s commanding officer. “It was just like, wow,” Adams said. Sign up for The Morning newsletter from the New York Times For him, it was a relief — he felt that Chauvin had been wrong and that his actions, kneeling on Floyd’s neck for more than nine minutes, cast a negative light on policing. But the verdict did little to end months of upheaval and anxiety in his profession. “So much is being thrown at us as law enforcement officials,” Adams said. “We’re unsure how we’re going to police in the future.” Police chiefs and unions across the country condemned Chauvin’s actions and applauded the jury's verdict, but not always with the same zeal or for the same reasons. Some said they hoped it would restore faith in the criminal justice system. Others said it would help keep the peace. And still others indicated that it would clear the way for “honest discussion” about policing. The feelings of rank-and-file officers were more complicated: a mix of relief, resentment at being vilified alongside Chauvin and unsettling thoughts of themselves in his shoes. “They’re thinking, ‘Man, I’ve got to think long and hard before I get out of my car and get into something I don’t have to get into,’ ” said Jim Pasco, the executive director of the national Fraternal Order of Police. In the Minneapolis station house, Adams heard of remarks from a few rank-and-file officers who believed the defense’s argument that drugs killed Floyd and that Chauvin had followed his training. “Some just think he got a raw deal,” Adams said. “But there’s a lot of them who think he was guilty, too.” The full extent of the fallout for Chauvin will be known June 16, when he is scheduled to be sentenced. He is being held alone in a cell in a maximum-security prison in Oak Park Heights, Minnesota, a Twin Cities suburb. He is allowed out for exercise for only an hour each day. Even then, he is kept away from other inmates. Prison officials said Chauvin was being kept in solitary for his own safety. Outside the Twin Cities, in rural communities where “Back the Blue” banners hang in storefronts, Chauvin’s trial at times seemed a world away. There, largely white police departments patrol largely white communities, and residents are often friends or relatives of law enforcement officers. In Gilbert, Minnesota, a community of about 2,000 three hours north of Minneapolis, Ty Techar, the police chief, said he watched only about an hour of the trial and 30 seconds of the body-camera footage. While he said that what Chauvin did would be unacceptable in his department, he stopped short of saying he agreed with the verdict. “For me to sit here and make a judgment on whether he got a fair trial, I don’t know all the evidence,” he said. “I haven’t looked at it closely enough.” He added: “Is it second-degree murder or manslaughter? I don’t know much about the case.” Police unions historically have been the staunchest defenders of officers, even those accused of wrongdoing. They did not defend Chauvin, but some used the verdict as an occasion to criticize public figures who have scrutinized the police. The Police Officers Federation of Minneapolis said in a statement that it wanted “to reach out to the community and still express our deep remorse for their pain” and that “there are no winners in this case.” “We need the political pandering to stop and the race-baiting of elected officials to stop,” the statement said. “In addition, we need to stop the divisive comments and we all need to do better to create a Minneapolis we all love.” Police and union officials have argued that the consistent pressure some community members and elected leaders place on law enforcement can be a detriment. In Minneapolis, there are several efforts to significantly downsize the Police Department and create a new public safety division. The governor of Minnesota has come out in support of a bill to limit police traffic stops for minor infractions. The Justice Department on Wednesday announced a broad civil rights investigation into the Minneapolis Police Department. Adams said that several officers were now hesitant to perform even some of the most basic duties like traffic stops, worrying that such situations might escalate and get them in trouble. In New York, a union leader seemed to play on such anxieties. “It is hard to imagine a tougher time to be a member of the law enforcement profession,” Ed Mullins, the president of the Sergeants Benevolent Association, wrote in a letter after the verdict was announced. He warned members that their every action was being recorded and that “scores of attorneys” were eager to sue them. “Our elected officials are complicit in perpetuating the myth that we are the enemy,” he added. Attitudes like that, activists said, speak to the resistance of law enforcement to be held accountable and allow police abuses to continue. Some police officials said the backlash to Chauvin’s actions actually provided an opportunity to improve. “I think it takes us a step closer toward reform,” said Michael S. Harrison, Baltimore’s police commissioner. “It doesn’t make it harder to do our jobs. It makes it where we have to train better, and use best practices and we have to do our job the right way.” The guilty verdict was a significant reminder for officers to stay within their training, said Rick Smith, the police chief in Kansas City, Missouri. “I think officers understand that going outside the norms leads to potential issues,” he said. “And this one highlighted that in the hundredth degree across the nation.” Adams said he believed that the judicial process ultimately helped the profession regain some of its credibility. Nine current and retired members of the Minneapolis Police Department testified against Chauvin at trial, including the police chief. That testimony, Adams said, showed the public that Chauvin was not representative of the Minneapolis police. The prosecution’s assertion during closing arguments that its case was against Chauvin, not the police, also helped, he said. After Chief Medaria Arradondo testified that Chauvin acted outside of department policy, Adams said he texted him to say he was proud to belong to his staff. This article originally appeared in The New York Times. © 2021 The New York Times Company

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Do we still need to wear a mask outdoors?

CNN 22 April, 2021 - 03:10pm

Updated 3:44 PM ET, Thu April 22, 2021

Utah Sen. Mike Lee questions CDC mask-wearing guidelines for children

Deseret News 22 April, 2021 - 01:43pm

Some congressional Republicans, led by Utah Sen. Mike Lee and Missouri Rep. Jason Smith, want the Centers for Disease Control and Prevention to explain why children as young as age 2 should wear a face mask to reduce the spread of COVID-19.

In a letter Thursday to CDC Director Dr. Rochelle Walensky, the group of 30 House and Senate lawmakers say the recommendations have had serious consequences for some people.

“Multiple parents of young children have been removed from flights, and in some instances, permanently banned, from future travel on the airline they were flying due to their toddler’s refusal to wear a mask,” according to the letter. “These unfortunate events have occurred despite the parents’ best attempts to have their child cooperate with the mask requirement, which is a struggle millions of parents have faced this past year.”

Compliance has proved almost impossible for parents of children with disabilities, resulting in increased social isolation and negative mental health consequences, the letter says.

Stories of passengers getting kicked off flights because their child wasn’t wearing a face mask have garnered national attention in recent weeks.

Airlines have required all passengers to wear face coverings since last May. In January, President Joe Biden required all airports, commercial airplanes, trains, intercity buses and other forms of public transportation to comply with CDC guidelines on mask wearing. The CDC issued a corresponding mandate that only exempted children under the age of 2.

In Utah, some groups have urged parents to send their children to school without face coverings since a new law lifted the statewide mask mandate on April 10. The law, however, keeps the mask mandate for K-12 students in place through June 15.

The CDC recommends children age 2 and older wear a mask when in public and when around people they don’t live with to slow the spread of COVID-19. Medical experts say mask wearing for babies and toddlers could make it harder for them to breathe and increases the risk of suffocation.

The public health agency recognizes that mask wearing might not be possible in every situation and that it poses challenges for children with cognitive, intellectual, developmental, sensory and behavioral disorders.

In the letter, Lee and the other lawmakers argue that CDC’s guidelines are among the most stringent in the world. They say children in Switzerland under age 12 don’t have to wear masks, while kids in France and the United Kingdom under age 11 are exempt. In Italy, children under age 6 aren’t required to wear face coverings.

“The significantly lower age requirement for mask wearing in the United States raises questions about the susceptibility of young children to COVID-19, the rate at which they transmit the disease, and their developmental ability to comply with mask requirements,” according to the letter.

The GOP lawmakers say there is evidence showing a lower likelihood of young children contracting and spreading COVID-19. They cite studies in the letter that say children transmit the virus but not as often as adults, especially in younger age groups.

“Within the United States, children younger than age 5 account for approximately 6% of the population but only 2% of total coronavirus cases,” the letter says.

The letter asks the CDC to show the scientific studies it relied on to set mask-wearing guidelines for children, if it’s tracking the latest research on COVID-19 transmission among children and whether it’s willing to modify and update its current recommendations.

Is it still necessary to wear masks outdoors? CDC 'looking at' revising mask guidance

TODAY 22 April, 2021 - 01:24pm

On Thursday, the director of the Centers for Disease Control and Prevention told TODAY the agency is considering revising its mask guidance.

“We’ll be looking at the outdoor masking question, but also in the context of the fact that we still have people who are dying of COVID-19,” Dr. Rochelle Walensky said.

Some health experts are increasingly calling for mask restrictions to be eased for outdoor activities.

“We know that the virus largely spreads indoors and there's very little transmission outdoors, except in some very specific circumstances,” Dr. Ashish Jha, dean of the Brown University School of Public Health, said. “At this point in the pandemic, with more than half of Americans vaccinated, it's pretty reasonable to start thinking about peeling back outdoor mask mandates.”

Masks should be used during large outdoor gatherings where people are close together for a prolonged period of time, such as a rally or sports events in packed arenas, he said. But passing someone on a street or going for a run without a mask is a very low-risk situation.

“Requiring everybody walking down the street to wear one is probably not needed,” Jha said.

A review paper published in The Journal of Infectious Diseases by researchers at the University of California, San Francisco, found that less than 10% of transmission occurs outdoors and the odds of spreading the virus indoors were 19 times higher.

However, experts at Northwestern University argue keeping masks on when you're outside — even after you're vaccinated — is not only a "social courtesy,” but also helps "model the behavior" for children, who can't yet get the shot.

According to current CDC guidance, “masks may not be necessary when you are outside by yourself away from others, or with people who live in your household.”

Health experts hope the CDC will more clearly outline high-risk situations when masks are truly needed.

Kristin Nelson, an assistant professor of epidemiology at the Emory University Rollins School of Public Health, said that while it was reasonable to include outdoor mask mandates up until now, she would like to see them be one of the first restrictions lifted as more of the population gets vaccinated and case counts start to fall.

“I think those mass mandates in outdoor spaces should probably be the first to go,” she said. “We really need to focus on places we know are at high risk for a transmission like large gatherings and closed spaces with poor ventilation.”

Homing in on the importance of indoor masking and helping people understand when it's safe to take off the mask may actually increase compliance, Jha said.

“Then you can really emphasize where it's not safe and get people to (wear their mask),” he said.

The rate of community transmission is an important factor for loosening rules. In places where it's lower, it may be an appropriate time to start lifting requirements.

Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health, cautioned that setting a strict threshold to lift mandates isn’t advisable and that mask mandate metrics are subject to new and emerging science.

“If you're vaccinated and if there's low rates of community transmission, it's definitely reasonable to not worry about wearing masks (outdoors),” she said.

But when in a crowded situation, even if outdoors, it's safer to keep the mask on, Rimoin said.

Akshay Syal is a medical fellow with the NBC News Health and Medical Unit.

Republicans Demand CDC Explain Why 2-Year-Olds Should Wear Masks

The Federalist 22 April, 2021 - 11:52am

A group of more than two dozen congressional Republicans demanded answers from the Centers for Disease Control and Prevention (CDC) on Thursday as to why children aged 2 and older must wear face masks despite overwhelming evidence they possess extremely low risk from coronavirus infection.

Children, 32 lawmakers from both chambers wrote in a letter to CDC Director Rochelle Walensky spearheaded by Utah Sen. Mike Lee, account for less than 2 percent of all coronavirus cases and present low risk of spreading infection, according to the scientific literature. The CDC, however, more than 12 months into the pandemic, still says children as young as 2 years old should wear a face mask. These recommendations carry a heavy weight, influencing state, federal, and corporate guidelines.

“The implementation of these recommendations has had serious consequences for some Americans,” lawmakers wrote, including airplane removal and placement of parents on airline blacklists. “These unfortunate events have occurred despite the parents’ best attempts to have their child cooperate with the mask requirement, which is a struggle millions of parents have faced this year.”

Earlier today my family endure the most horrific & dehumanizing treatment onboard @WestJet plane. My wife was threatening to be arrested & forcibly removed unless my daughters, 3 yrs & 19 months would wear a mask. While my 3yrs wore her mask, the 19 months old was hysterical. pic.twitter.com/MHnaTnKgCU

— Safwan Choudhry (@SafwanChoudhry) September 9, 2020

Compliance for children with disabilities meanwhile, “has proved almost impossible, resulting in increased social isolation and negative mental health consequences.”

The U.S. requirement that nearly all children wear masks stands out as a global outlier. Swiss children under the age of 12 are exempt from mask mandates, while children under the age of 11 in France and Great Britain also remain mask free.

Republicans even highlighted comments from National Institutes of Health Director Anthony Fauci, who said, “If you look at the data, the spread among children and from children is not really very big at all, not like one would have suspected.”

“Our review of scientific literature on COVID-19 infections showed ‘evidence for significantly lower susceptibility to infection for children aged under 10 years compared to adults given the same exposure,’” lawmakers wrote, outlining another study that found children enjoy 56 percent lower probability of infection as opposed to adults after contact with another infected individual.

Given the data, Republicans demanded the CDC explain in detail, with the studies it examined, how it came to its conclusion for children as young as 2 to wear face masks, with a deadline for response set for May 6. Republicans are also inquiring whether the CDC is remaining up to date on the latest science related to childhood COVID-19 transmission.

Copyright © 2021 The Federalist, a wholly independent division of FDRLST Media, All Rights Reserved.

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Do We Still Need to Keep Wearing Masks Outdoors?

The New York Times 22 April, 2021 - 04:00am

Science shows that the risk of viral transmission outside is very low. The “two-out-of-three rule” can help you decide whether to mask up.

As more people get vaccinated and spring weather and sunshine beckon us outdoors, one question may be nagging at you: Do we still need to wear masks outside?

More than a year into pandemic life, many people remain confused about the risk of spending time outdoors around other people. A growing body of research shows that transmission of Covid-19 is far less likely outdoors than inside, and the risk will get even lower as more people get vaccinated and cases continue to decline. But many states have yet to lift strict outdoor mask mandates. In Massachusetts, for instance, outdoor masking is required at all times, even when nobody else is around.

Recently the online magazine Slate stirred controversy when it suggested an end to outdoor mask rules. The article won support from top public health experts and even The New England Journal of Medicine blog but prompted a fierce backlash from readers, who noted that while the risk of outdoor transmission may be low, it’s not zero.

“Shallow and selfish take,” wrote one reader on Twitter. “You have blood on your hands. You should feel ashamed,” posted another.

After a year in which many of us have learned to dutifully wear masks and look askance at anyone who does not, it’s understandable that people remain fearful when they cross paths with the unmasked. So how do you make the right decision about when to wear a mask outside?

Many virus and public health experts say the guidance hasn’t changed — spending time with others outside during the pandemic has always been safer than indoors. But whether a mask is needed outdoors depends on the circumstances, including local public health rules and whether you and the people you’re with are vaccinated. Brief encounters with an unmasked person passing you on the sidewalk or a hiking trail are very low risk, said Linsey Marr, a professor of civil and environmental engineering at Virginia Tech and one of the world’s leading experts on viral transmission. Viral particles quickly disperse in outdoor air, and the risk of inhaling aerosolized virus from a jogger or passers-by is negligible, she said. Even if a person coughs or sneezes outside as you walk by, the odds of you getting a large enough dose of virus to become infected remain low, she said.

“I think the guidelines should be based on science and practicality,” said Dr. Marr. “People only have so much bandwidth to think about precautions. I think we should focus on the areas that have highest risk of transmission, and give people a break when the risk is extremely low.”

Dr. Marr uses a simple two-out-of-three rule for deciding when to wear a mask in public spaces or when she doesn’t know everyone’s vaccination status. In these situations, she makes sure she’s meeting two out of three conditions: outdoors, distanced and masked. “If you’re outdoors, you either need to be distanced or masked,” she said. “If you’re not outdoors, you need to be distanced and masked. This is how I’ve been living for the past year. It all comes down to my two-out-of-three rule.”

If you stop to have an extended conversation with someone who isn’t vaccinated, masks are recommended. Even outdoors, your risk of breathing someone else’s air increases the longer and closer you stand to them. One of the few documented cases of outdoor transmission happened in China early in the pandemic, when a 27-year-old man stopped to chat outside with a friend who had just returned from Wuhan, where the virus originated. Seven days later, he had his first symptoms of Covid-19.

And masks are still advised if you find yourself in an outdoor crowd. Standing shoulder to shoulder with strangers during an outdoor concert or a protest could increase risk, particularly for the unvaccinated.

Recently while hiking without a mask, Dr. Marr said she still made an effort to keep her distance from large groups when the trail got crowded.

“If I was passing by a solo hiker it didn’t concern me,” said Dr. Marr. “But if I passed by a group of 10 hikers in a row, I stepped further off the path. The risk is still low, but at some point there could be a large enough pack of people that the risk could become appreciable.”

Walking your dog, riding a bike, hiking on a trail or picnicking with members of your household or vaccinated friends are all activities where the risk for virus exposure is negligible. In these kinds of situations, you can keep a mask on hand in your pocket, in case you find yourself in a crowd or need to go indoors.

“I think it’s a bit too much to ask people to put the mask on when they go out for a walk or jogging or cycling,” said Dr. Muge Cevik, a clinical lecturer of infectious disease and medical virology at the University of St. Andrews School of Medicine in Scotland, where outdoor masking has never been required. “We’re in a different stage of the pandemic. I think outdoor masks should not have been mandated at all. It’s not where the infection and transmission occurs.”

“Let me go for my run, maskless. Mask in pocket,” tweeted Dr. Nahid Bhadelia, an infectious diseases physician and the medical director of the special pathogens unit at Boston Medical Center. “Given how conservative I have been on my opinions all year, this should tell you how low risk is, in general, for outdoors transmission for contact over short periods — and lower still after vaccination. Keep the masks on you for when you are stationary in a crowd and headed indoors.”

To understand just how low the risk of outdoor transmission is, researchers in Italy used mathematical models to calculate the amount of time it would take for a person to become infected outdoors in Milan. They imagined a grim scenario in which 10 percent of the population was infected with Covid-19. Their calculations showed that if a person avoided crowds, it would take, on average, 31.5 days of continuous outdoor exposure to inhale a dose of virus sufficient to transmit infection.

“The results are that this risk is negligible in outdoor air if crowds and direct contact among people are avoided,” said Daniele Contini, senior author of the study and an aerosol scientist at the Institute of Atmospheric Sciences and Climate in Lecce, Italy.

Even as more-infectious virus variants circulate, the physics of viral transmission outdoors haven’t changed, and the risk of getting infected outdoors is still low, say virus experts. Pay attention to the rates of infection in your community. If case counts are surging, your risk of encountering an infected person goes up.

Dr. Cevik notes that debates about outdoor masking and articles showing photos of crowded beaches during the pandemic have left people with the wrong impression that parks and beaches are unsafe, and distracted from the much higher risks of indoor transmission. Often it’s the indoor activities associated with outdoor fun — like traveling unmasked in a subway or car to go hiking, or dropping into a pub after spending time at the beach — that pose the highest risk. “People hold barbecues outdoors, but then they spend time indoors chatting in the kitchen,” said Dr. Cevik.

As more people get vaccinated, decisions about going maskless outdoors will get easier. While no vaccine offers 100 percent protection, the rate of breakthrough infections so far has been exceedingly low. The U.S. Centers for Disease Control and Prevention recently reported just 5,800 cases of breakthrough infections among 75 million vaccinated people. And the C.D.C. has said vaccinated friends and family members can safely spend time together, without masks.

But it’s OK to keep wearing your mask outdoors if you prefer it. After a year of taking pandemic precautions, it may be hard for people to adjust to less restrictive behaviors. Sarit A. Golub, a psychology professor at Hunter College of the City University of New York, said it’s important for both the media and public health officials to communicate the reasons people can modify some behaviors, like outdoor masking.

“In the coming months, ‘normal life’ will begin to become safer, but I worry that some people won’t be willing or able to relax pandemic restrictions in ways that makes sense,” Dr. Golub said. “I worry that folks have internalized the fear messaging without understanding the reasons behind specific behavioral recommendations, and therefore, the reasons that they can be modified as circumstances change.”

Gregg Gonsalves, assistant professor of epidemiology at the Yale School of Public Health, said he recently was with a group of parents, including many vaccinated physicians, who met in a New Haven park to celebrate a child’s first birthday. “We’re all just standing around, everybody was masked, and then we started asking, ‘When’s the time we can be outside and take off our masks?’” Dr. Gonsalves said. “If people are vaccinated and you’re outdoors, masks are probably superfluous at this point.”

But Dr. Gonsalves said he understands why some people may be reluctant to give up their masks outdoors. “Some of this is Covid hangover,” he said. “We’ve been so traumatized by all of this. I think we need to have a little bit of compassion for the people having trouble letting go.”

After a year of pandemic, wearing masks outdoors is up for debate

The Philadelphia Inquirer 22 April, 2021 - 04:00am

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