Break out your collection of face masks: on Tuesday, the Centers for Disease Control and Prevention (CDC) released updated guidelines recommending that many fully vaccinated people once again wear masks indoors. This reverses the agency’s announcement nearly three months ago that those who had received their full dose of Covid vaccine could ditch their masks in most settings, both inside and outside. The policy shift follows a surge in Covid-19 cases as the Delta variant of the novel coronavirus spreads rapidly among those who are not vaccinated.
What many find perplexing isn’t this reversal; it’s why the May 13th announcement was made in the first place, given that the country was nowhere near anything resembling herd immunity or the vaccination rates necessary to take a step like that. Technically, the CDC never said that everyone could stop wearing masks — just those who are fully vaccinated.
But operating within the confines of the honor system was never going to work — especially considering the overlap in people who choose not to be vaccinated with those who believe that mask mandates infringe on their constitutional rights. The CDC’s policy reversal also raises the question of whether the Delta variant would have been able to gain such a stronghold in the U.S., causing a significant increase in Covid-19 cases.
Of course, this isn’t the first time masking guidelines have changed, and, like the previous instances, the CDC says that their decision was based on the evolving science. This time, new data from recent outbreak investigations demonstrate that in the rare breakthrough Covid-19 cases among vaccinated people, those infected with the Delta variant may be contagious and spread the virus to others, and have a similar amount of the virus as those who are unvaccinated and become infected.
This stands in contrast to those who experienced breakthrough infections caused by the original strain of SARS-CoV-2, who were not thought to have the ability to transmit the virus to others, CDC Director Dr. Rochelle P. Walensky explained in a press briefing. “This new science is worrisome, and unfortunately, warrants an update to our recommendations,” she said.
As far as specifics, the CDC’s updated guidelines recommend that vaccinated people who live in areas with substantial and high transmission rates go back to wearing masks in indoor public spaces, along with vaccinated individuals with vulnerable people in their households. The CDC is also pressing for universal masking in schools — including all teachers, staff members, students, and visitors — whether or not people have been fully vaccinated.
Lastly, the CDC requested that community leaders in areas of substantial and high transmission encourage vaccination and universal masking to prevent further outbreaks. “Vaccinating more Americans now is more urgent than ever,” Walensky said. “The highest spread of cases and severe outcomes is happening in places with low vaccination rates, and among unvaccinated people.”
And despite the new evidence that vaccinated individuals with breakthrough infections may be capable of spreading the virus to others, Walensky said that those who are vaccinated “continue to represent a very small amount of transmission occurring around the country.” That is thanks, in large part, to the protection offered by the existing Covid-19 vaccines, which, she said, provides an estimated sevenfold reduction of the risk of a symptomatic breakthrough infection caused by the Delta variant by sevenfold, and a twentyfold reduction in hospitalizations and deaths.
Responding to a question about why masking guidance should be changed for the benefit of the unvaccinated, Walensky said that in addition to protecting people who are unable to receive the Covid vaccine (like children) and those who are immunocompromised, with the amount of virus circulating right now, the largest concern among public health officials is the “potential mutations away we are from a very transmissible virus that has the potential to evade our vaccines, in terms of how it protects us from severe disease and death.”
With regards to today’s announcement and policy reversal, Walensky said that it was not a decision the CDC made lightly.
“Not only are people tired, they’re frustrated,” Walensky said in her concluding remarks of the briefing. “We have mental health challenges in this country. We have a lot of continued sickness and death in this country. Our health systems are, in some places, being overrun from what is preventable. And I know, in the context of all of that, it is not a welcomed piece of news that masking is going to be a part of people’s lives who have already been vaccinated.”