CDC relaxes mask guidance, raising questions
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Last week, the CDC relaxed its masking guidance to say that fully vaccinated Americans do not need to wear masks or socially distance indoors.
CDC Director Rochelle P. Walensky, MD, MPH, explained that the updated guidance was in response to a recent sharp decrease in cases and mounting real-world evidence about the effectiveness of COVID-19 vaccines.
Source: Adobe Stock.
Walensky told ABC News on Sunday that that the guidance for unvaccinated Americans has not changed.
“The guidance ... is about individuals and what individuals are at risk [for] if they are not vaccinated. If they are vaccinated, they are safe. If they are not vaccinated, they are not safe [and] they should still be wearing a mask — or, better yet, get vaccinated,” Walensky said. “This is not permission for widespread removal of masks.”
We asked experts if they have any concerns or questions about the newly relaxed guidance.
Amesh A. Adalja, MD
Some people have expressed concern that the unvaccinated will dishonestly claim to be vaccinated in order to not comply with mask guidance. However, I think it’s important to remember that many of those people have not been complying since the beginning of the pandemic, so it really won’t, in my opinion, have a major impact. The critical issue, however, is that public health authorities cannot sacrifice the well-being of the vaccinated — whom the virus treats very differently — to the unvaccinated.
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Adalja is a senior scholar at the Johns Hopkins Center for Health Security.
Peter Chin-Hong, MD
I have fielded a million questions from the community like this: “How on earth would you know whether someone next to you is vaccinated or not?”
Unlike countries like Israel, there will be no green-pass, QR codes or immunity passports to determine whether unmasked individuals (especially in crowded indoor settings during tourist-heavy months when travelers come from all over the country — and the world) are vaccinated. Because of this, it is difficult to imagine how this by itself will be an incentive for individuals to get vaccinated.
But perhaps my biggest concern as an infectious disease doctor has to do with this question: What do we tell our immunocompromised patients who may not have had a response to immunization? For now, not much has changed for them in terms of masking up, at least for now while we await further data — and guidance.
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Chin-Hong is an Infectious Disease News Editorial Board Member and professor of medicine and director of the transplant infectious disease program at the University of California, San Francisco.
Carlos del Rio, MD
While I am really encouraged by the changes and agree with lifting masking and social distancing requirements for fully vaccinated persons, the devil is in the details. Implementation is hard because we really don’t know who is vaccinated and who is not, and we have only 37% of the population fully vaccinated. I wished the CDC had added something like: “It is still appropriate to continue masking in places where unvaccinated and vaccinated people are mixing indoors, such as schools, grocery stores, etc.;” or: “Once you achieve X% fully vaccinated, then masking is not required.” I think that one could potentially use data from the CDC COVID-19 tracker and use the “level of community transmission” combined with the percentage of population vaccinated in a community to make recommendations. Something like this may be useful:
- blue (245 counties are at this level now) and/or greater than 50% of the population with at least one dose (18 states here now): no masking or social distancing required;
- yellow (1,003 counties are here now) and/or 40% to 50% of population with at least one dose (24 states here now): masks recommended indoors, no social distancing required;
- orange (1,035 counties are here now) and/or less than 40% of the population with at least one dose (16 states here now): masks required indoors, social distancing recommended; and
- red (936 counties are here now): masks and social distancing required.
For more information:
del Rio is an Infectious Disease News Editorial Board Member and distinguished professor of medicine and executive associate dean at Emory University School of Medicine.
Monica Gandhi, MD, MPH
I like the new CDC guidance that masks are no longer required by vaccinated individuals based on prior guidance that face masks protect the wearer for unvaccinated individuals, along with a host of new studies that COVID-19 vaccines are highly effective and massively reduce the chance of transmission. Although each state will now decide for itself whether to proceed with CDC guidance or wait until a certain metric has been reached to remove mask mandates simultaneously for everyone, the momentous nature of the new CDC guidance cannot be overstated. The guidance may help motivate those on the fence to get vaccinated. and certainly signals a return toward normalcy with the astounding effectiveness of the vaccines.
For more information:
Gandhi is a professor of medicine and associate chief of the division of HIV, infectious disease and global medicine at the University of California, San Francisco.
Linsey C. Marr, PhD
The new guidance came a little earlier than I expected. I thought it would be prudent to wait until everyone who is willing (ages 12 and up) has had an opportunity to be fully vaccinated, around July 1. Nevertheless, the combination of highly effective vaccines, lower case numbers and ever-increasing numbers of vaccinated people means that the risk for severe illness for vaccinated people is extremely low. However, this does not mean that we should drop all precautions. Good ventilation and filtration remain key to controlling virus levels in the air and minimizing the risk for transmission, particularly when large numbers of people mix indoors for long periods of time. Unvaccinated people should continue to wear masks to reduce their chance of getting infected and transmitting the disease, and anyone should feel comfortable wearing a mask any time. Not only does a mask help with COVID-19, but it also helps with other respiratory viruses, particulate air pollution and pollen allergies.
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Marr is the Charles P. Lunsford Professor of Civil and Environmental Engineering at Virginia Tech University.
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