As COVID-19 rates plummeted, the Biden administration on Friday relaxed its recommendations for indoor masks for about 70 percent of Americans, including most schoolchildren — a shift that could hasten the end of mask mandates in the United States.
Before Friday, more than 96 percent of U.S. counties were considered “substantial” or “high” transmission areas, where the Centers for Disease Control and Prevention recommended masking in most indoor settings.
Now, only 37.3 percent of counties fall into that category, according to Greta Massetti, an epidemiologist on the CDC’s COVID-19 Response Incident Management Team. In the coming weeks, that number will continue to fall as the U.S. winter Omicron wave recedes.
At the same time, the CDC also announced that it will no longer recommend universal masks in all schools, regardless of COVID rates. Instead, the agency will now recommend universal school masks only in communities where it believes COVID rates necessitate masking in all public areas.
“We want to give people a break from things like wearing masks when our levels are low,” CDC director Rochelle Walensky said at a news conference. “We are stronger as a nation today, with more tools to protect ourselves and our communities from COVID-19, such as vaccinations, boosters, wider access to testing, availability of quality masks, accessibility to new treatments and improved ventilation.”
Friday’s announcement didn’t change thinking about the effectiveness of indoor masking, as studies continue to show that the plays a role in minimizing spread and disease during a peak† Rather, the new guidance came as part of: a broader update to the way the CDC defines high, medium, and low levels of COVID risk.
Previously, CDC guidelines pushed for universal masking indoors in areas of “substantial” or “high” transmission, based primarily on the number of local cases detected each week. When those thresholds were first established in November 2020they reflected the latest science.
But as both testing and immunity increased — and as the extremely contagious but less severe variant of the Omicron coronavirus mild infections became much more common — raw caseloads became a less accurate measure of risk. As a result, cities like Los Angeles, which have adhered to the CDC’s old guidelines, have required residents to wear masks longer — and until the positivity rate across the province falls much lower – than would have been necessary in 2020before anyone was vaccinated.
To address this issue and keep pace with the changing nature of the pandemic, the CDC will now also evaluate “factors that reflect disease severity, including hospitalizations and hospital capacity” when measuring risk, Walensky explained. — which will then “inform the CDC recommendations on prevention measures such as masking.”
“As the virus continues to circulate in our communities,” Walensky added, “we need to focus our statistics on more than just cases in the communities, and focus our efforts on protecting people at high risk for serious illnesses.” [in order to] prevent COVID-19 from overwhelming our hospitals and healthcare system.” The CDC will urge “high”-risk counties — as opposed to “medium” (currently 39.6 percent of counties) or “low” (23 percent) — to mandate masks indoors.
The impact will be immediate: a sharp drop in the proportion of US counties where the agency recommends indoor masking (as well as for all schools in those counties).
On Friday, Walensky warned that “none of us knows what the future holds for us and for this virus,” adding that “we need to be prepared… [masks] again if it gets worse in the future.” SARS-CoV-2 is much more flexible and unpredictable than scientists had anticipated, with many worrying that as long as billions of people worldwide remain unvaccinated, more evasive — and potentially more virulent — variants could easily emerge.
Meanwhile, an estimated 7 million Americans are immunocompromised, no children under 5 have been vaccinated, and “Long COVID” looms as a real concern†
Walensky acknowledged these threats and was clear. “Remember, there are still people who are at higher risk,” she said. “Everyone is certainly welcome to wear a mask at any time if they feel safer wearing a mask.”
But the question for the future is whether America will ever mandate face coverings again — especially in light of studies showingas Massetti put it on Friday, that “people who wear high-quality masks” [such as N95s, KN95s and KF94s] are well protected, even if others around you are not masking.”
For months, many Americans – particularly residents of the country’s reddest regions – no need to mask† Some resist masks even longer, and governors like Florida presidential hopeful Ron DeSantis have gone so far as to ban local mask requirements.
By contrast, liberal leaders have largely sided with public health experts by recognizing that indoor masking can help limit infections and disease.
But while Omicron cases have plummeted in recent weeks, Democratic governors from California to New York have also decided to lift their own indoor mask mandates — signaling that such requirements could be gone for good this time.
“We are moving beyond the crisis phase to a phase where we will work to deal with this virus,” said California Governor Gavin Newsom, a Democrat, said last week. “People are looking forward to turning the page.”
Ever cautious, the CDC is certainly not leading away from mask mandates. But with its new guidelines, the agency could mark the beginning of the end. Unless things get really bad in the future, Friday may be remembered as the moment when masking in the US officially became less of a collective obligation and more of an individual choice.