Birx: Wear a Mask ‘Even with Family’

Confusing advice is unlikely to be heeded.

Dr. Deborah Birx, who is coordinating the US Federal Government’s response to the pandemic, is mixing some confusing advice in with a reminder to keep our guard up.

CNN (“The US just topped 6 million coronavirus cases in about 7 months. What happens next is up to you, Birx says“):

Many Americans are fed up with this pandemic, and some have let their guard down – especially when spending time with friends or family.

But that’s the opposite of what needs to happen, said White House coronavirus task force coordinator Dr. Deborah Birx.

“We know we can’t always be perfect. We know that we’ll put this message out about private gatherings and something will happen and you’ll realize you have been in a situation, you’ve been around people, you didn’t have your mask on,” Birx said.”

That is the time to make sure you’re protecting others in your household and around you by wearing a mask when you’re around them, even if they’re family.”

Birx urged Americans to take personal responsibility, especially if they want to help keep economies open.”Right now, we gain freedom through wearing our masks and socially distancing,” she said.

The general advice is sensible and comports with my understanding. While I’ve slowly taken more risk in going out over the weeks that Virginia has phased out the lockdown, I’m still wearing my mask when out in public and trying to practice social distancing. We started back up at school last week and we’re taking prudent measures there as well.

But the notion that we’re supposed to wear a mask “even with family” is confusing. I’ve searched a bit and have been unable to find a transcript of her full remarks, including on the State Department website. One hopes and presumes she means family members who aren’t part of one’s household but it’s not being reported that way in the press.

It’s bad enough that we’re getting awful messaging from the President and that he’s pressuring even the CDC to issue unhelpful guidelines. But Birx seems to be trying to do the right thing here. She needs to make sure her messaging is crystal clear.

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James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College. He's a former Army officer and Desert Storm veteran. Views expressed here are his own. Follow James on Twitter @DrJJoyner.


  1. Kathy says:

    If you live in a household where several family members go out often, regardless of reason, they should all wear masks around each other or practice distancing. If only one person goes out often, they should also either wear masks or distance from the rest.

    That’s just common sense.

  2. James Joyner says:

    @Kathy: That’s certainly not what they have been messaging since March and it’s really unrealistic. Unless members of a family are going to forgo physical intimacy, or even having meals together, they’re going to get each other sick. Even the Chinese didn’t ask asymptomatic people living in the same household to mask up–they just isolated those known to be infected from the others.

  3. Jen says:

    I assume this means non-shared household family. That’s where I’m seeing the most gatherings happening that have the potential to be spreading events. People are desperate to get back to normal and think that if they just gather with family, all will be okay.

    There are multiple issues but one is people seem to struggle with even the lexicon that has arisen around covid. “Quarantine” has a very specific meaning; you aren’t supposed to interact with anyone outside of your household. But people have interpreted it as “safer at home,” to include outside forays to the grocery store and whatnot. This becomes problematic when people are tested and instructed to “quarantine” pending test results.

    People think that because they’ve “been good,” that it’s okay to gather at weddings and such. This is particularly the mindset in rural areas, but as that wedding in Maine shows, it only takes one person. One.

  4. KM says:

    @James Joyner:

    That’s certainly not what they have been messaging since March and it’s really unrealistic.

    Well, back in March they didn’t realize how insane and /or gullible people would be and that wearing a mask would become political. Using March as a benchmark is unfair because we really didn’t understand (a) how bad this was going to get and (b) how crazy the populace was.

    As for unrealistic, I take it you’ve never known a family who has an an immunocomprised member. My aunt with the double-lung transplant wears her mask around EVERYONE, including family if they are home and we are expected to do the same. I have a large family with many that are essential workers (nurses and grocery stores workers) who are prime candidates for bringing home COVID even if they are careful. We’ve already had one elderly great-aunt get infected – thank god it was mild but we had to send her away to a county holding area because she couldn’t isolate with the rest of us. I hate my mask but I’m not allowed into the house without it if my aunt’s home….. and she’s home damn near 24/7. I’ve been enduring construction at home since June to set up a place for isolation for the regularly exposed while the rest of us who work from home can go mask-free. I’m essentially having to double our living space because this $&*%%&$^$&$ disease keeping getting perpetuated by people who don’t understand transmission vectors.

    The sad truth is it’s “unrealistic” because we’re selfish and simply don’t want to be inconvenienced. The Chinese expected the populace to mask up or isolate; in a society where you cannot expect a good percentage to do either, wearing a mask around family that could be bringing home plague makes horrifying sense. Yeah, families get each other sick but James, if that sickness was pneumonic plague or Ebola, I bet you’d be reconsidering wear a mask around infected kin. We are being way too caviler about something we don’t really understand and has a pretty high death rate, solely because we don’t like how much of our lives it has the potential to disrupt.

  5. CSK says:

    Please don’t tell me we’re supposed to wear a mask when–let’s be blunt here–sharing a bed or engaging in sexual intercourse with our spouses. They are family members, are they not?

  6. Tyrell says:

    That could get awkward with married couples when it comes to certain activities.
    I guess she is also against snuggling and spooning.

  7. James Joyner says:


    As for unrealistic, I take it you’ve never known a family who has an an immunocomprised member. My aunt with the double-lung transplant wears her mask around EVERYONE, including family if they are home and we are expected to do the same.

    Obviously, in unusual circumstances, we need to take unusual precautions. But that doesn’t seem to be what Birx is suggesting.

    Yeah, families get each other sick but James, if that sickness was pneumonic plague or Ebola, I bet you’d be reconsidering wear a mask around infected kin.

    Again, my presumption is that Birx was talking about normal circumstances: a family with no one showing any symptoms of COVID. Again, it’s obvious that someone presumed to be infected should be treated differently.

  8. Mister Bluster says:

    That could get awkward with married couples when it comes to certain activities.

    Yeah, like standing next to each other at the kitchen sink doing the dishes.
    “You wash, I’ll dry.”
    “Just hope I don’t drop the good china when you toss it to me six feet away!”

    “Wait! What? You don’t have to be married to do that?”

  9. CSK says:

    Birx really does need to explain precisely what she means by “family.” Are the parents of small children, all of whom have been living together in quarantine since March, suddenly supposed to mask up and socially distance themselves from their toddlers? (As well as each other.) Will a three-year-old happily accept no more hugs from Mommy and Daddy? What about bath time? And bed time? And getting dressed? Hard to do all of that from six feet away.

    This lack of clarity is exactly the sort of thing that bewilders and then infuriates people.

    And…of course special precautions should be taken around people with compromised immune systems. But again…were these the people to whom Birx was referring?

  10. CSK says:

    Okay, NPR is reporting Birx’s comments this way:
    “Whether it’s a wedding, whether it’s a funeral, whether it’s a birthday party, whether it’s just a Sunday afternoon dinner where we brought our family from across the city and we’re sitting in the backyard, if you don’t have a mask on and someone is within six feet, virus spread can and will occur.”

    That makes more sense given that she seems to be speaking of extended rather than immediate family. Still, you can’t eat Sunday dinner while masked. And she appears to be suggesting that you can be outside and still need to stay masked and six feet away from others.

  11. Tyrell says:

    @Mister Bluster: Certainly if a family member or friend has a serious sickness, or weak from something like cancer treatments that would be advisable. As far as a normal, regular family, that’s close to the Howard Hughes level on the germophobe scale.
    At her house she probably makes them clean the toilet seat with a pressure washer!

  12. Scott says:

    This is exactly what happened to my son’s in-law who live in the Rio Grande Valley. They had a large Father’s Day get together and a bunch came down with COVID. Traced it back to one of the cousins from San Antonio who got it from his trainer. Several ended up in the hospital. Fortunately, none died.

    Yes, it can get tiresome but people need reminding that there is still contagion out there and need to be cognizant where everyone has been and act accordingly. Even if there is family.

    My wife is back to work at her Elementary School and we are still cautious and conscientious about contact, cleaning, disinfecting and other risk reduction measures. Knock on wood.

  13. Monala says:

    From Vanity Fair, via LGM:

    [Senior fellow at Stanford University’s Hoover Institution and Trump’s new pandemic adviser Scott] Atlas reportedly meets with Trump on a near-daily basis, more than any other health official, and is “advocating [herd immunity] policies that appeal to Trump’s desire to move past the pandemic and get the economy going.”

    The idea behind herd immunity is that enough people become immune to COVID-19—either through mass vaccination or prior infection—that the disease slows its spread. But scientists are still racing to answer questions that make this strategy untenable, like how long immunity lasts and who is most vulnerable to infection. It’s also unclear how much of the population would need to be infected to achieve herd immunity, though the Post notes it may necessitate hundreds of thousands, if not millions, of deaths.

    Atlas has argued that the herd immunity approach would not lead to more deaths if the vulnerable are protected and said, in a July appearance on Fox News, “When younger, healthier people get the disease, they don’t have a problem with the disease. I’m not sure why that’s so difficult for everyone to acknowledge.”

    Infectious-disease experts contest both claims: more than 25,000 people younger than 65 have died of the virus in the United States, per the Post, and the high rate of obesity and heart disease in the U.S. means more people overall are vulnerable to it. Not to mention Atlas and Trump are pushing for a return to schools, which could put older people who don’t live in nursing homes at risk.

  14. Just nutha ignint cracker says:

    This comment thread is an example of why the saying “don’t complicate things” exists. And I thought I was the ignint cracker here. 🙁

    “When younger, healthier people get the disease, they don’t have a problem with the disease. I’m not sure why that’s so difficult for everyone to acknowledge.”

    Ummm… is it because that statement isn’t actually true? I get that your with the administration and have to lie as part of you job, but at least be believable. 🙁

  15. Joe says:

    I live across the street from – and walk my dog around – a large city park. It is a destination park with a lot of picnic facilities. Every weekend there are a number of large, extended family gatherings or even group gatherings, mostly with no apparent distancing and few if any masks. Much as I enjoy that particular aspect of the park, these days those gatherings gives me the heebie geebies.

  16. KM says:

    Social distancing is not going to happen with small children since they need care. However, if exposure is a concern then constant masking may be needed. Are the kids gonna like it? No but I bet they like having parents and grandparents more. The point is to minimize spread so if your child is going to school where COVID is a thing, then everyone at home gets to be masked 24/7 or as long as they can stand it. Frankly, the only reason it’s even gotten to this point is because we’re not doing it right outside the home so now it’s creeping inside. The inside of your home isn’t safer then the store or school if the people in your house are the ones going to the store or school. It really sucks but if until we have an effective treatment, this is our future.

    Besides, kids that age like dress-up. Play doctor or super-heroes or whatever it takes for the kids to understand masks inside are needed for a time. Maybe play Toxic (variation of Floor is Lava) – don’t touch that, it’s poison and you’re “dead” for a while. The way to avoid being “dead”? Wear protection aka the mask! It’s worked for me with the little ones so far – we change masks to different patterns to help with the game (plaid for kitchen protection, blue for bedrooms, etc). Longest I’ve gotten consistent usage from a small child? Little under 5hr in an epic game of Toxic House and Yard with the dog as SuperCarrier.

  17. Dave Schuler says:

    @James Joyner:

    That’s certainly not what they have been messaging since March and it’s really unrealistic.

    The messaging has largely been wrong since March. Such studies as have been done have mostly been in fairly intimate settings: hospitals and the home. Those studies have shown reductions in transmission.

    There’s less empirical evidence or systematic studies supporting the effectiveness of facemasks under circumstances with less contact. Mostly it’s being extrapolated.

    Much the same is true of the two meter social distancing guidelines. Historically, it’s been one meter but that was found to be inadequate in the case of SARS. So it was extended to two meters.

    Confusing? Yes. Impractical? Yes. But that’s the state of our knowledge.

  18. CSK says:

    Well, it will be a very touchy business explaining to very young children that if they don’t wear a mask, grandma or grandpa or mommy or daddy could die. And it would be their fault, would be the unspoken but nonetheless very clear message. To inflict that kind of emotional trauma on a child seems to me unspeakably cruel.

    In any event, Birx needs to issue very clear, very explicit guidelines. Absolutely nothing–and I mean nothing–should be left open to interpretation, because we both know what will happen in that case.

  19. Tyrell says:

    @Jen: At most gatherings, such as birthdays, holidays, anniversaries, cookouts, pool parties, and graduations people mingle, talk,
    play games, and have fun. It is not like they are very close to each other. Some may dance, but that is usually with people they have a close relationship with.
    Probably the biggest risk is Uncle Claude’s chili. Now that’s where you have to watch out.

  20. annette chapel says:

    @CSK: it doesn’t matter husband or wife if they go out of the house they can potentioally bring it back with them

  21. KM says:

    We manage to do it all the time in the hospital. You do it the same way you teach small children not to play with oxygen lines, people’s medication or why some kids can’t have peanut butter. You do it the same way you teach children why they need to take life-saving medication and why they need to keep the Epi-pen on them and not in the sandbox or the bus. Some thing’s are done for ours or other’s safety and you can hurt people if you mess with that protection. We do this because it keeps our loved ones safe – you protect Grandma like Grandma protects you. Yes, you can hurt them if you are not careful so let’s learn how to not do that, shall we? Masks are medical equipment so teach your children how to use them safely like you would an insulin shot or wheelchair.

    Kids are not dumb and they are pretty quick to make connections. If you tell them you will give Grandma Owies if you yank her oxygen line, the kid will understand at the very least the Owies part. Since it’s kinda important for the kid to not touch the lines, you can’t just hope they pick it up on their own before something gets disconnected. You know how kids tend to think divorce is their fault? Kids take on guilt like boats take on water; kids are noticing masks being worn out in public and can put two and two together. Something is different; something bad is happening that means we’re changing our behaviors. It’s more cruel to make a child realize afterwards they may have hurt a family member or friend then to sit them down and explain the consequences of living in a pandemic. Lying to them isn’t going to help and kids can be cruel to each other. How many are going to get bullied with “You killed your Grandma, no-mask!” on social media? When their classmates start getting sick or god forbid die, America’s kids are going to get a crash course in emotional trauma. Better to do it now in controlled circumstances then dealing with crying children asking where so-n-so went and if it was their fault.

  22. Jax says:

    @KM: That’s effing brilliant with changing the masks and playing the game with the dog as the SuperCarrier!

  23. Jen says:

    @Tyrell: If they are talking in an indoor space, they’ll catch covid. The link in my post is about a wedding in rural Maine that had 65 people attend (more than the 50 allowed). One presymptomatic person attended. ONE.

    More than 87 cases, including one death (so far), have been linked to that wedding.

    Your post is a precise picture of the thought process that is allowing the virus to spread.

  24. Just nutha ignint cracker says:

    @Jax: Must be confusing for the dog though when he romps up and everybody runs away in different directions. But maybe the dog figures out the game and plays, too. I don’t know. Never had pets because of allergies.

    But it is a genius idea.

  25. KM says:

    @Just nutha ignint cracker:
    We’ve actually trained her to play Hide and Seek – tell her “find x” and she runs around till your found. She’s a therapy dog in training so this is a good exercise for her as well as fun for the kids. Dog catches you without a mask, even if in passing? Oh no, you’re out for 10 mins. I’m trying to work cookies / snacks in as “medicine” but haven’t got the right mix of “still need to mask even if treated” down yet.

    Basically theres a huge game of Tag /floor is lava in my house when the kids are here. I play with the dog to every day so the training sticks. If nothing else, great lock down entertainment and sneaky life lessons. 🙂

  26. Gustopher says:

    Maybe her family is ugly and she would prefer it if they covered as much of their faces as possible?

  27. Not the IT Dept. says:

    It must be awful being a public health official or doctor in a country where so many people think they’re smarter than you and can do anything they want because they’re American and Founding Fathers and all those amendments and stuff. A look around at other countries with different cultures (including the one just north of us) shows that the message was “personal inconvenience in the short/medium term = better outcomes for everyone”. You know, that whole greater good thing. And it worked better than it did here, the nation that demands a participation trophy AND a cookie for almost everything it’s asked to do.

    Duty of a citizen? Responsibility as an adult? Get outta here! We’re Americans, dammit! Even if many more people are dying than elsewhere, at least they’re dying freely!

  28. Just nutha ignint cracker says:

    @Not the IT Dept.: And even better than that, people dying doesn’t cost me a thing. It’s totally free and doesn’t inconvenience me in the slightest. Why, people die every day and I never even notice it.

  29. Holly says:

    I just had a heart attack 4 days ago. My sister who is not social distancing with a mask came over last night. She texted today saying she has a cold and couldn’t get out of bed. Asked if I was feeling ok. I guess I’ll know in 2 to 14 days when I might see symptoms. I had pneumonia 2 years ago I don’t think I could live through COVID. Thanks everyone for downplaying this virus and probably killing me. My sister says “everyone dies”. Does everyone have to die right now? I really don’t want to.