COVID-19, Mask-Optional Policy, and Monkeypox: How to Stay Safe?

Along with easing protection measures for COVID-19, like mask-free air travel, people wonder about their safety and question whether they need to take the fourth COVID-19 vaccine. Should we still wear masks on the plane despite the new optional-mask policy? Is monkeypox a new threat?

From now on, we're in a stage where wearing masks whenever possible and in crowded environments makes sense.

PissedConsumer spoke with Dr. Karen Jubanyik, an Associate Professor and an emergency physician at Yale University School of Medicine. In this video, Dr. Jubanyik explains the current situation with COVID-19 and monkeypox, who needs the fourth dose of vaccine, and what can help you stay protected when traveling. 

• What is the COVID-19 situation now?
• How do masks and vaccinations help?
• What does the mask-optional policy mean?
• Who needs to take the 4th COVID vaccine?
• What is monkeypox and how is it transmitted?
• Health tips to stay safe during travel

How Did the Situation with the COVID-19 Change Over the Past Two Years?

Dr. Jubanyik: My name is Dr. Karen Jubanyik, and I am an emergency physician at Yale University School of Medicine. I work in the emergency department.

Michael: Karen, thank you for joining us today. My name is Michael, and I'm with PissedConsumer. How did the situation with the pandemic change over the last two years?

Dr. Jubanyik: We were in the thick of it. We started to have the first cases in Connecticut soon after New York, which was pretty early in the pandemic. We started seeing patients who had COVID in March. Although we had multiple peaks… 

…our biggest peak in the number of sick patients was April of 2020. 

There wasn't a whole lot known, no vaccinations, limited PPE, and little known about effective treatments at that time. We received a lot of scary information that had come from China and Italy in terms of their survival statistics.

How Do Masks and Vaccinations Help?

Michael: How much did masks and vaccinations help?

Dr. Jubanyik: Vaccinations were an incredible help in terms of decreasing the spread. People were able to open up businesses and schools. Everybody heralded the doctors, but it was the nurses, the people who worked in nursing homes, in the post office, in grocery stores, and those who drove our school and city buses. It was a whole army of essential workers who could get back to work safely without worrying they were going to die. 

In the first waves, we had otherwise healthy people in New York City who worked in IT. They were essential to keeping the hospital up and running with the computers. People like that died; it wasn't just nurses and doctors. 

Everybody able to get vaccinated was a game changer.

What Does Mask-Optional Policy Mean?

Michael: On April 18, the Florida judge said we no longer need to wear masks on airplanes. What's your take on it?

Dr. Jubanyik: My take on that is that I would wear a mask. I would encourage people to wear masks on airplanes. There is one thing that's different with air travel, as opposed to rail or bus. On the train even ten years ago if I was sitting next to somebody coughing up along, I had to excuse myself, go two cars down and find another seat. I wouldn't want to sit next to somebody who was coughing. 

I didn't want to catch the flu. I didn't want to even catch a bad cold. I have flown once in two years, right before April 18th. Masks were required, but I felt good about that. The plane was full and I would not have been able to move my seat.

If the person next to me was coughing incessantly without a mask, I would feel very unprotected. So, if I was to fly tomorrow, I would wear an N95 mask, which is what I've done throughout the pandemic. 

I've taken care of very sick patients, coughing in a very small room with me. I've had to be in a room for a prolonged period of time doing procedures and talking to them and having end-of-life conversations with them, things like that. 

I didn't catch COVID because I know I had full PPE on. Still, before getting on a plane, during the plane flight, I would wear my mask and use Purell. 

I don't think that if the judge is telling me that I don't need to wear a mask means I can't wear a mask. 

Even before COVID, I did, when I took flights. I'm not a germophobe by any stretch of the imagination, but I used to bring a mask with me, not an N95, but a regular mask when I flew in the winter. Usually, I brought a few extra ones for the people around me if they wanted a mask. 

I take care of very sick patients. I take care of cancer and transplant patients. Yale New Haven Hospital is a major transplant center. I didn't feel like I could be cavalier about getting infections while traveling and inadvertently pass them on to my patients.

Who Needs to Take the Fourth Vaccine Dose?

Michael: Vaccination is recommended by CDC. Do we have to get a fourth dose of the vaccine? How often do we need to vaccinate? What are your recommendations?

Dr. Jubanyik: This is going to be individualized. We're still going to learn more about whether it's better to space out the vaccinations for six months or even more. There's some evidence that otherwise healthy people may not need to rush out and get the fourth vaccination, even if they indeed qualify. 

It's an individual discussion that's worth having with your doctor. I don't think there's a one-size-fits-all. Even immunosuppressed patients may be on medications like steroids that may help them if they have a mild case of COVID. 

If you have medical conditions, you likely have access to a provider, a specialist, or a primary care provider. It's worth a conversation with them because it isn't a one-size-fits-all and the data's emerging. 

I haven’t gotten my fourth vaccination because I don't particularly fall in a high-risk group and I got my third one with a good sense of immunity. I've been exposed multiple times to people who've had COVID and have not gotten it. My husband is a few years older and he chose to get his fourth vaccination after a discussion with his doctor. 

There are multiple right answers here. I think that the evidence is very clear that…

…everybody should strongly consider getting the first two doses as well as at least one booster unless there's a contraindication from their doctor.

Anybody who feels like they may have a contraindication should have a discussion with their doctor. You may find out that what you thought was a contraindication wasn't. 

The most common reason why I see non-vaccinated people sick with COVID in my emergency department here in Connecticut, which is a highly vaccinated state, are pregnant patients. 

There were a lot of questions about whether it was safe during pregnancy, and all the data has shown that it is safe and effective for almost everybody pregnant. Much safer than getting COVID while pregnant. Again, most people who are pregnant have access to an OB-GYN who they could ask further questions.

What Is Monkeypox and How Is It Transmitted?

Michael: The latest news about monkeypox came out. What's monkeypox and what's going on with it?

Dr. Jubanyik: Monkeypox is similar to smallpox, which was eradicated in the United States many years ago. Monkeypox is a virus and it got its name because it was discovered in a colony of monkeys that were being used for research purposes. Actually, it didn't start with the monkeys. 

It is thought that rodents are the original carrier of this virus, but monkeys can get infected. Humans and other animals can get infected. 

We have seen monkeypox in the United States back in 2003 about 70 people were infected through Prairie dogs that had gotten infected. They had been importing a rodent that then transmitted it to Prairie dogs and people who were buying these Prairie dogs got infected. There were no deaths in that outbreak of about 70 people in the United States.

Michael: How is this virus transmitted? Will masks make any difference, on the airplane in particular?

Dr. Jubanyik: The one thing that's a little different about monkeypox is that the virus can be transmitted through the air, but it's a heavier virus. It doesn't seem to linger in the air as long as the coronavirus, for example. You can expect some respiratory transmission. 

There's no doubt that PPE in the medical setting and a mask on an airplane will be helpful. It's typically transmitted by very close physical contact like kissing, sharing utensils, and bedding with people who have it and are in close household contact. 

Those would be the people at highest risk for transmission of the monkey virus, and those eating or touching infected animals. If one was to travel globally, it would be recommended not to sample what is called bush meat and to stay away from animals in other countries. If you're sharing sleeping quarters, make sure you're sleeping on clean bedding. 

Michael: Will a smallpox vaccine made in childhood protect against monkeypox? 

Dr. Jubanyik: There is a lot of cross-reactivity. The US government has a whole stockpile of smallpox vaccinations that would be able to be used in the event of monkeypox outbreaks. What we don't know is if somebody was vaccinated. So they stopped vaccinating people, I believe in about 1972 in the United States. We don’t know if those of us who were old enough to get vaccinated would still have enough immunity from that vaccination. 

There are some specific monkeypox vaccinations, but we don't have a huge stockpile of those in the US. 

We do have a huge stockpile of smallpox vaccinations that we have at the ready. Those are considered effective.

How Do Travelers Protect Themselves Against Monkeypox?

Michael: Are there any health recommendations for people who travel a lot? 

Dr. Jubanyik: I still limit travel. I do the meetings that I can by Zoom. As we're opening up more of the country, there is going to be a little bit more pressure in business situations to travel. 

There are a lot of people who've missed seeing their family and I would not discourage anybody from traveling for that reason, but certainly, for business, we've gotten a lot smarter. If you're having a one-hour meeting with somebody in California and you're in New York, I would have that meeting by Zoom. 

I would limit my unnecessary travel, but I wouldn't be afraid to go visit family, and I would wear a mask. 

I would encourage children to wear masks on planes and trains as well. Keep your social distance when you can in the airport, use your Purell, and wipe down your seat trays with some wipes when you first get to your seat. That will help protect you both from COVID, monkeypox, and other common things. 

We're seeing a lot of flu now because we haven't had much flu. Usually, it would be pretty late in the year to see real influenza, but we're seeing a decent amount of influenza. People can get very sick, and especially immunocompromised people can even die from influenza. From now on, we're in a stage where wearing masks whenever possible and in crowded environments makes sense.

Michael: Dr. Jubanyik, thank you very much. Thank you for your time.

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