With vaccine distribution steadily increasing across the United States many people are hopeful about regaining a sense of normalcy. However, the Centers for Disease Control and Prevention (CDC) maintains that COVID safety precautions are still recommended, even after full vaccination.

Daniel Horn, MD, Director of Population Health and Quality within the Division of General Internal Medicine at Massachusetts General Hospital, has been on the front lines since the first surge.

In this Q&A, he shares what he has seen, what clinicians have learned over the past year and the importance of being vigilant as we move forward.

What is your role and how did it change during the first surge?

I’m a primary care doctor in the Internal Medicine Associates and the Director of Population Health and Quality for the Division of General Medicine. I run a lot of our disease management and population health initiatives for primary care at Mass General.

In the first surge I was focused on the rapid implementation of telehealth tools to help ensure that ambulatory and primary care could be sustained. After the dust settled on the first surge, I have mostly been back to focusing on my previous job, which is quite a full one.

Based on where we were last year, what have you seen change?

I recently finished a week of inpatient service, caring for mostly COVID patients, and it does feel like a world of improvement compared to early on. I think we have much more confidence in both infection control protocols and what feels like a more reliable supply of PPE.

We have tools in our armamentarium in the inpatient setting, and now with emerging data about monoclonal antibodies in the outpatient setting, and this felt like a week where patients who were hospitalized with COVID did well.

We can now use these tools early on in the disease for patients at moderate to high risk of developing complications. Antibody therapy looks promising in reducing hospitalizations from COVID-19, hopefully that can be scaled and implemented. Further upstream from that is the vaccination campaign where the faster we can go, the better.

Can you explain why we need to continue to be vigilant with mask wearing and physical distancing?

The vast majority of the population remains unvaccinated and therefore–by leaps and bounds—masking is still the way to go.

There has been some recent questions about whether there is added benefit from double masking, but I think the most important way to double mask is “I wear a mask and you wear a mask.” When we both cover our noses and mouths we dramatically reduce our risk of COVID transmission.

The combination of growing numbers of people who have been vaccinated, plus continued masking should hopefully lead to dramatic reduction in cases over time as long as we all remain vigilant.

As time passes, I expect public health and infection control officials will lay out clear messaging for when it is safe to unmask and where and when we need to continue masking. But we are quite a ways off from that.

What is the significance of President Biden’s 100-Day Mask Mandate?

What we’ve learned from communicating during the pandemic is the importance of sending a clear message, asking that people try to universally adopt this public health protective measure to help their loved ones, friends, colleagues and fellow humans continue to stay safe.

The 100-days number for masking is important along with the 100-day target for vaccine delivery because it is a clear and understandable message.

Undoubtedly, that timeline will be extended, but I think the most important message is, “Everyone, please do this together for a period of time and you’ll see a dramatic reduction in cases.”

What are best practices for limiting the spread while vaccination continues?

COVID-19 is a highly infectious virus and we continue to see it causing an unfortunate burden of the disability and death across our population, but particularly in vulnerable communities.

Until we reach a level of herd immunity through mass vaccination, which will take time and clearly is taking time, masking, hand-washing and social distancing remains our best defense.

COVID-19 Research at Mass General
Researchers and clinicians at Massachusetts General Hospital Research Institute are mobilizing to develop new strategies to diagnose, treat and prevent COVID-19. Learn more.