As masking restrictions continue to drop worldwide, the choice to mask now comes down to our personal responsibility and risk tolerance. However, with many individuals now preferring to only mask in medium and high-risk environments, it can be hard to know when the best times to mask are. 

Earlier in the pandemic, different organisations and governments put out media detailing the highest-risk locations to catch COVID-19. While these lists are far from new, they are a great way to visualise the most dangerous settings - especially in comparison to less dangerous settings.

The graph we want to share today was created by the Texas Medical Association. While this is only one of many graphs of this kind, it’s one of the most thorough and, therefore, a good reference to have on hand.

So, what constitutes a high-risk situation? Well, the most dangerous situations are going to bars, large religious gatherings (500 people), sports stadiums and large concerts/musical festivals. There is a higher chance of COVID-19 transmission in these locations than anywhere else, and masking in these situations is a must.

Slightly lower on the risk graph but still considered high-risk are activities such as going to a movie theatre, amusement park, gym, and eating at a buffet. Similar to the highest-risk settings, each of these settings involves many people in an indoor (or confined outdoor0 environment. 

Considered moderate-high-risk activities include shaking hands, playing football and basketball, travelling by plane, attending a wedding or funeral, eating in an indoor restaurant and going to a hair salon or barbershop. In this risk group, we have a few interesting situations: playing sports and flying.

The sports listed are contact sports, and despite taking palace outside (in the case of football), there is a significant amount of close contact with other players. For this reason, both football and basketball are considered moderate-high-risk, whereas sports such as tennis wouldn’t be.

Secondly, it’s interesting to see flying included as it has been largely publicised that flying is safe. While it’s true that flying itself isn’t high risk, the issues come during boarding, taxiing, and takeoff when the air circulation systems are not active. We recommend reading the recently written article on plane air quality for more information on this.

At the moderate risk level, we begin to see activities such as swimming in public pools, working in an office building, shopping at a mall, going to the beach, and having dinner at someone else’s house. Interestingly, some activities involve only a few people involved in these situations. However, they are still considered moderate-risk due to the close contact and length of the contact.

In the second lowest category, moderate-low-risk, activities such as eating in an outdoor restaurant, walking in a busy downtown, playing golf, waiting in a doctor’s waiting room, going to a museum and grocery shopping appear.

While these are considered moderate-low risk situations, it’s important to remember that it largely comes down to the number of people in a confined space. For example, while doctor’s waiting rooms are considered moderate-low-risk by the Texas Medical Association, I’ve seen carbon dioxide levels as high as 3200ppm in a small waiting room with around 12 people.

Since carbon dioxide can act as a proxy for COVID-19 transmission in these settings, this is a worrying sign and shows that my chances of contracting COVID-19 in this situation are around 8x higher than if I was outdoors or in another low-risk environment.

That brings us to low-risk environments. According to the Texas Medical Association, these activities include going camping, playing tennis, pumping gas, going to a restaurant to get takeout, and opening the mail. While not mentioned on the list, it’s also worth saying that some previously mentioned activities can be low-risk if there is a low number of people.

For example, although visiting the beach on a busy day is considered moderate risk, the risk level drops if there are only a few people spread out along the beach. This can also go the other way, as I mentioned earlier, where a doctor’s waiting room (or waiting rooms in general) can be significantly higher risk depending on the people present and the room size.

Notably, public transport is missing from this list. If it were added, it would likely sit at moderate-high or high-risk, as the chances of transmission are very high. Not only are there often many people inside public transport, but the spaces are also confined with minimal airflow. We recommend masking if you plan to use such transport methods.

Unfortunately, although mask mandates are dropping worldwide, COVID-19 is still out there, and, in some areas, cases are at all-time highs. It’s important to not forget about the ongoing pandemic and to judge the risk of certain settings. While it’s important to live our lives and not totally isolate ourselves, it’s also important to wear a mask and take precautions when needed.