April 29, 2021

The new CDC guidelines, which relax the need for masks, particularly in outdoor settings, are great. But they have led to quite a bit of confusion—especially for individuals with compromised immune systems like myeloma patients. 

Can myeloma patients safely follow these new COVID-19 guidelines? Yes, but with added caution.

Important details of new CDC guidelines 

The guidelines include an excellent diagram called “Choosing Safer Activities.” For the fully vaccinated, it is safe to go without a mask when engaging in outdoor activities, attending small outdoor gatherings, and visiting a restaurant with an outdoor patio area with friends from multiple households. However, these activities still require masks for the unvaccinated.

A key point for myeloma patients to understand is that even if you are fully vaccinated, your antibody levels can be lower than necessary to provide full protection. As I noted in last week’s blog, data are still limited, but myeloma patients on active treatment clearly have suboptimal antibody responses. Lower responses were also noted for patients with smoldering myeloma.

The bottom line for myeloma patients—even those fully vaccinated—is that wearing a mask is still a good idea if you are interacting with people with uncertain vaccination or health status.

Where masks are still required 

According to the CDC guidelines, masks are still required across the board for crowded outdoor events as well as all indoor activities. For myeloma patients this means that any in-person meeting held indoors needs to be carefully reviewed and discussed. Important points to consider:

• Who previously used the meeting space? 
• What are local guidelines based upon local community levels of COVID-19? 
• How good is the room’s ventilation? 
• Is there sufficient room to maintain the needed social distancing? 
• If in doubt, indoor meetings should still be avoided. 

Good news 

The much greater freedom outdoors is really a welcome change! Walking, running, biking with members of your household do not require a mask — which is wonderful. Obviously, if community levels of infection are high, be careful if you encounter unknown individuals during outside activities. It is an excellent idea to have a mask with you in case a risky situation emerges unexpectedly. 

But it is also fine to get together with small groups of family members or friends who are fully vaccinated without masks. This is something we have all really missed.

Current status 

In the U.S., we are slowly coming out of the pandemic. Right now, more than 82% of people over 65 have received at least one vaccination. Thus, risks of new COVID-19 infections are largely from younger people still not vaccinated or who have not been previously infected with COVID-19. Unfortunately, fewer vaccinations outside the U.S. have led to continuing high levels of new infections. Until the global pandemic is under control, the world cannot return to normal. Routine business and travel are just not possible. 

Let’s hope the situation improves as we enter the middle part of the year. In the meantime, we will get through this together, especially if we continue to reach out and sustain our social connections and, for myeloma patients, continue getting the best myeloma care possible. 

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Dr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.