Americans may need to wear masks for up to 18 months, Yale expert says

Health officials across the United States did an about-face on face coverings last week as pressure mounted from experts in the medical community. Now a top Yale University doctor is suggesting Americans should get used to the idea of wearing face masks well into next year to curtail COVID-19 spread.

After more than a month of consistent messaging from health organizations like the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), the U.S. Surgeon General and even President Donald Trump that face masks were unnecessary and ineffective at preventing coronavirus transmission, the CDC reversed its guidelines on April 3 and began suggesting that Americans should consider wearing face coverings in certain public settings.

Days earlier, President Trump insisted that if the guidance for mask-wearing were to become necessary, masks would only be needed for a short time. However, Dr. Shan Soe-Lin told AccuWeather she has a very different prognostication.

Dr. Shan Soe-Lin, pictured above, is a lecturer at Yale and the managing director of Pharos Global Health Advisors. (Image shared by Shan Soe-Lin)

"I think people are going to have to wear masks until there's a vaccine. I mean that to be completely blunt," Shan, a Yale University lecturer and an immunologist by training, said in an interview with AccuWeather. "I think the next best would be through the end of the epidemic. It definitely needs to be moving past peak."

Shan cautioned that the threat from the new coronavirus does not suddenly vanish with a peak in cases.

"The peak is not the magic end of it. That's just the top," she explained. "There's the whole downslope, too, that you need to ride and ensure that you're just not starting up another peak again."

An employee of cake shop prepares chocolate Easter bunnies with masks in Lykovrisi, northern Athens, on Wednesday, April 8, 2020. (AP Photo/Thanassis Stavrakis)

With experts predicting that a vaccine may be 12 to 18 months away, Shan's timeline differs dramatically from Trump's. She reasoned that the timeframe is necessary to ensure that people recognize that the COVID-19 threat will linger far longer than just the social distancing period.

"I don't think this threat is going to go away. It's hopefully going to manageable," Shan, who is also the managing director of Pharos Global Health Advisors in Boston, said. "Especially if we are able to rapidly increase testing and really strengthen contact tracing and keep people who are infected isolated."

The cultural differences between the U.S. and some east Asia countries when it comes to mask-wearing has been a crucial component of this debate, Shan said. In some Asian countries, Shan said, not wearing a mask when you're sick is seen as rude. Or as one person summed it up to The Wall Street Journal about mask-wearing in Hong Kong, "Not wearing masks in Hong Kong is like not wearing pants."

Comparatively, wearing a mask in the U.S. has drawn Shan plenty of uneasy glances from others in public, she told AccuWeather.

A little girl wears a scarf around her head as she lines up with her mother, looking to buy KN95 face masks outside Masataco, a taco shop in Whittier, Calif., Tuesday, April 7, 2020. Masataco has managed to sell thousands of face masks at cost, mostly first responders. Just days after recommending that people wear masks to prevent the spread of the coronavirus, a county in Southern California went a step further and ordered all residents to cover their faces when leaving home as the number of infections and deaths continued to rise across California. (AP Photo/Damian Dovarganes)

Since the CDC's new guidelines were unveiled, Shan said she has seen more people around her Boston-area home adopt the mask-wearing policy, but she wants to see more.

"It still needs to come up a lot more, though, but I think the more people who adopt it, the less stigmatizing it will be," she said. "It's a big cultural thing to have to reverse here ... It's just not a norm that's done and it's a norm that needs to change in a really trying time."

If Shan's timeline of 12 to 18 months of mask-wearing proves necessary, she said that what she views as American pride around individualism may be a hurdle to widespread adoption.

"I think we're going to see here in the U.S. that states that are really slow to adopt some of these basic things are really going to pay for it in a couple weeks," Shan predicted.

A bicyclist wears a face mask as a statewide stay-at-home order remains in effect in an effort to reduce the spread of the new coronavirus Tuesday, April 7, 2020, in Denver. (AP Photo/David Zalubowski)

AccuWeather CEO and Founder Dr. Joel N. Myers said more specific parameters surrounding mask usage are necessary to help people understand the importance of the protective pieces.

"When somebody says you should wear a mask for 12-18 months, we should say, 'Wait a minute. It depends. If you're in New York City, yeah, probably so," Myers said, adding that he thought the same might not be necessary for those in sparsely populated areas.

Part of Shan's insistence on mask-wearing for both the infected and uninfected is to further reinforce the concept of social distancing. She said she feared warmer summer months pushing more people outside and into closer proximity.

Shan also pushed against the idea that masks will be more uncomfortable or difficult to wear once temperatures rise.

Tom Watson runs in Liberty Park while wearing a mask Monday, March 23, 2020, Salt Lake City. (AP Photo/Rick Bowmer)

"I'm more worried that people aren't going to maintain social distancing," Shan said, adding that she wears her mask when going out for a run.

"I can't say that it would be worse [to wear] in the summer. I think the greater threat with nicer weather is just people going outside more. I think the other thing that people need to really understand is that masks don't make you invincible. There is no 100 percent safe way to go outside, even with hand-washing, masks and social distance," she cautioned.

That sentiment is similar to what some of the country's top health officials have said since the CDC reversed its stance on masks. "The most important thing is the social distancing and washing your hands," Dr. Deborah Birx, who heads up the White House Coronavirus Task Force, said last week. "We don't want people to get an artificial sense of protection, because they're behind a mask."

Shan said social distancing is crucial at this time. "That's why everyone really, really needs to be staying at home."

Regardless of an area's setting, population density or infection rate, a widespread, unified and cohesive nationwide approach on mask-wearing will also be key to slowing COVID-19, Shan said.

"The virus doesn't respect state borders so those of us in states that are doing better can't be smug," Shan said. "You know there's going to be little brush fires that can come from slower states and ignite new epidemics and in our states. No one is safe."

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