Immunocompromised travellers like me should have ‘masked carriages’ available to us

For those of us who still need to be cautious, there has to be a practical way to coexist with those who no longer wish to wear masks on public transport

People enter and exit a New York City subway car in New York, New York, USA, 21 April 2022 (EPA)

I received the news alert as I was pulling out my N95, about to board the Long Island Rail Road back to Manhattan. New York’s public transit was joining the many other train systems throughout the country that have already relaxed their own local mask mandates.

There is no turning back from here, and for many that is understandably welcome news. For those of us still cautious, however, there needs to be a way to more comfortably coexist, particularly within dense cities where many rely on public transportation. A creative solution that has not yet been tested would be to create micro mandates for specific masked cars.

This idea eliminates any remaining pretense that a universal mask mandate will ever again be enforceable or desired. Instead, it focuses on the possibility that passengers can self-select into cars according to how Covid cautious they are. Similar to the quiet cars Amtrak has long offered, “masked cars” would offer a predictable system that can be consistent across trains in various cities, and across distinct train lines within them.

One potential starting point would be to have the first and last cars require masking. This creates an immediate safer space for folks who remain vigilant. It also gives conductors an easier way to measure mask demand. If those end cars fill, they can scale it up and add one more in each direction. If they’re consistently far below capacity, consider eliminating one.

This solution acknowledges that not all of us can relax. An estimated 3% of Americans are moderately to severely immunocompromised. Many more are slightly so, and more still live or work with someone who is. While many of us look completely healthy when we board, appearances can be deceiving. Depending on where I am in my chemo cycle for metastatic breast cancer, my count of neutrophils, a type of white blood cell that helps fight infections, fluctuates between mildly and moderately immunocompromised.

While I personally remain masked, my anxiety had skyrocketed on trains long before this week’s announcement as I have increasingly found myself out of sync with many unmasked strangers. It is impossible to distance. I have no idea whether they have been vaccinated and boosted, and even if they have, breakthrough cases have skyrocketed. It is reasonable to assume that those who are unmasked on trains are unmasked elsewhere, thereby increasing potential exposure.

Those of us masking often feel anxious and vulnerable when unmasked folks sit near us. Those who board unmasked are less than thrilled when folks like me, already settled into seats carefully selected with safety in mind, inquire whether they would consider masking.

No one wants to be having these conversations anymore. In addition to feeling unsafe, they are exhausting. Covid fatigue is widespread. Of the 35,000 decisions we each make every day, whether or not we stay put on a train should not have to be among them. People shuffle on and off at every station. With each reset, I am often once again deciding what to do, scanning the car for a new seat.

Humans are not wired to embrace uncertainty. We have already lived with far more of it than we are used to during the past few years. Some sources of uncertainty, like when a new variant occurs, we cannot control. Others, like the level of comfort we feel on a train, we can greatly mitigate. Creating a micro mandate supports certainty for riders on both sides of the mask debate.

The time to try this new approach is now. Trains are a public good, particularly in cities like New York, Boston, DC, London and Paris where residents and tourists alike depend so heavily on them. Introducing masked cars could help me and so many others continue to move throughout our cities with both physical safety and peace of mind. To cancerland and beyond.