CDC significantly eases pandemic mask guidelines
Aiming to stay ahead of a country racing to declare the pandemic over, the U.S. Centers for Disease Control and Prevention on Friday announced far-reaching changes in the way it gauges the status of the pandemic and recommends public health measures such as masking indoors.
The impact of the CDC’s move was immediate and sweeping: Under its new framework, indoor masking is no longer recommended for counties where 72% of Americans live. Students in those counties would no longer be urged to cover their noses and mouths while inside school facilities.
In the 63% of counties currently deemed at low or moderate COVID-19 risk, the decision to don a mask in public spaces would be an entirely personal one.
Los Angeles County, the most populous in the country, falls into the riskiest of the three new “COVID-19 Community Levels” outlined by the CDC. So are San Diego and Imperial counties, most of the San Joaquin Valley and the majority of California’s rural north.
But most of L.A.’s neighbors — Orange, Riverside, Ventura, Santa Barbara and San Bernardino counties — are one step down in the medium category of risk, and most of the San Francisco Bay Area is in the low-risk tier.
In devising its new assessment of community risk, the CDC opted to stop counting new infections and focused instead on whether local healthcare systems are in danger of being overwhelmed with severely ill COVID-19 patients. That, in turn, is a warning sign that COVID-19 deaths are about to rise, another vital sign for the CDC.
The CDC has eased its guidance on when people should wear masks in public indoor settings, but still recommends them in L.A. County.
“We’re in a strong place today,” said Dr. Rochelle Walensky, the CDC director. “We must focus our metrics beyond just cases in the community and direct our efforts toward protecting our people at high risk of severe illness.”
Many Americans, including people with compromised immune systems and medical conditions that make them vulnerable to severe cases of COVID-19, will opt to continue wearing masks and take other measures to protect themselves, Walensky said. The new system will help them see where masking makes the most sense while freeing healthy people to go about their business, she added.
As the Omicron variant infects record numbers of people, many in Southern California say they are no longer willing to hide from a virus that has already killed 800,000 Americans.
The new framework also defuses a growing political problem: The CDC’s masking advice was at odds with Americans’ growing weariness with safety measures, and with the widespread perception that the worst of the pandemic is over.
In recent weeks, even governors in some of the nation’s most pandemic-vigilant states have declared their intent to roll back emergency public-health measures, including mask mandates.
Dr. Marcus Plescia, chief medical officer for the Assn. of State and Territorial Health Officials, called the new CDC system a big win for Americans seeking clear guidance on how to live safely in a world where the coronavirus remains in wide circulation and illnesses could surge suddenly.
“They’re really trying to be responsive to the idea that people need a bit of a respite,” he said. “We need to scale back these public health measures, but still provide some indicators of when you really can’t scale back any further.”
The new paradigm radically altered the national pandemic map. On Friday morning, 95% of U.S. counties were classified as having “high” or “substantial” levels of coronavirus transmission, and indoor masking was recommended in in all of them. By Friday afternoon, nearly two-thirds of counties were deemed safe enough to make masking optional.
Much of New York, Massachusetts, Maryland, Illinois, Wisconsin and South Dakota are colored green on CDC’s new map, indicating low COVID-19 risk. But California, Oregon, Montana, Kentucky, West Virginia, North Carolina, Tennessee, Florida and Maine had broad swaths of orange, indicating their hospital systems remained at risk of being overwhelmed with COVID-19 patients.
“It’s clear that the country as a whole is transitioning from pandemic to a state in which the virus is endemic,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “But we also have a very large country, and we’re not all doing it at the same pace. This lets the folks at the front of the line move a bit faster than those at back of the line.”
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By signaling that even the CDC is willing to ease up, the new approach may accelerate unmasking in the places least likely to be ready for it, Schaffner said.
He called the agency’s revised measure sensible, but warned that the CDC must prepare communities to return to public health measures if necessary.
“Once we’ve flipped the switch to off we need to remember there’s a big world out there and if there’s a new variant, I’m afraid we may have to flip that switch back on,” Schaffner said.
“That will be very hard,” he acknowledged. “Most Americans want to put COVID in the rear view mirror.”
For much of the past two years, CDC’s risk levels were based on a combination of new infections and the percentage of positive tests in the prior week. The new “COVID-19 Community Levels” are computed using a mix of local hospital capacity and the number of COVID-19 patients admitted to hospitals. Walensky said these measurements will be refined over time with data from wastewater surveillance networks and other sources.
The new system acknowledges a number of new realities. New cases involving the Omicron variant have plummeted from their mid-January peak of 807,000 per day to roughly 75,000. COVID-19 deaths, which rose above 2,600 per day in early February, have declined by a more modest 38%. Those trends have meant fewer hospitals are close to reaching the limits of their capacity.
Meanwhile, the Biden administration’s focus on expanding the availability of rapid, at-home tests has made new infections harder for the federal government to track.
Experts at the Centers for Disease Control and Prevention have set aside herd immunity as a national target for ending the pandemic.
With more than 215 million Americans fully vaccinated and many millions previously infected Walensky suggested that a version of herd immunity has effectively been achieved. Among those with immune protection, infection with Omicron has generally resulted in mild symptoms at worst. Given this “widespread population immunity,” she said, “the overall risk of severe disease is now generally lower.”
At the same time, new COVID-19 medicines capable of preventing severe COVID-19 in high-risk patients are beginning to make their way into wide use. These antiviral drugs are expected to keep more of the newly infected from requiring hospitalization.
At the White House, Press Secretary Jen Psaki said changes like these have altered the pandemic landscape enough to warrant a new approach. At the same time, she urged caution in reopening the country.
“There are still people dying every day of COVID. There are still immunocompromised populations,” she said. “What we are trying to work towards is a period of time where COVID is not disrupting our daily lives.”
Times staff writer Anumita Kaur in Washington, D.C., contributed to this report.
