CDC backtracks with new mask guidance

The Centers for Disease Control and Prevention (CDC) on Tuesday reversed guidance from just two months ago by saying fully vaccinated people should now mask up in certain areas, underscoring the growing threat posed by a new strain of the coronavirus.

In updated guidelines, the CDC advised fully vaccinated people to wear masks in “public, indoor settings” in parts of the country with “substantial” or “high” levels of transmission. Agency officials cited data showing vaccinated people can spread the delta variant, which recently became the dominant strain of COVID-19 in the U.S.

“This new science is worrisome and unfortunately warrants an update to our recommendations,” CDC Director Rochelle Walensky told reporters Tuesday.

The guidance also calls for all students, teachers and staff to wear masks, even if they’re vaccinated, to reduce potential spread.

The agency’s backpedaling for vaccinated adults sparked mixed reactions Tuesday, particularly since Americans have been told since mid-May that they can go maskless in almost all settings so long as they’ve had the COVID-19 vaccine.

Public health experts widely applauded the decision as the right move amid surging cases and with less than half of the U.S. population fully vaccinated.

Leana Wen, an emergency physician and public health professor at George Washington University, said the new guidance was “overdue,” and that the agency is “heeding the growing chorus of public health experts who have called for” revised recommendations.

“I’ve said all along that the CDC made a major mistake in issuing their guidance in the first place,” she said, referring to the May 13 announcement. “Many of us thought … that this was exactly the result that would occur.”

Nationwide, COVID-19 cases have climbed in recent weeks, with the average daily count more than doubling in the past two weeks and reaching five times its level from late June. The U.S. has also seen a rise in daily hospitalizations and deaths, with higher increases in certain areas.

The delta variant has quickly tightened its grip on the U.S., accounting for about 83 percent of all COVID-19 cases in the two-week period ending July 17. The strain made up just 3 percent of cases less than two months ago.

Isaac Weisfuse, an adjunct professor at Cornell University Public Health and a medical epidemiologist, said he thinks the delta variant was “the critical factor” in the CDC’s decision.

“I think they’re right in saying that they have to follow the science,” Weisfuse said. “Unfortunately, from a science perspective, we seem to be on a rollercoaster. And so what really fit well or reasonably well in May doesn’t necessarily fit reasonably well in July.”

In her announcement, Walensky noted that the CDC’s relaxation of mask recommendations for fully vaccinated people in May occurred when the alpha variant, which is not transmitted by vaccinated people, was dominant.

Federal health officials, including Walensky, have repeatedly labeled the recent surges as a “pandemic of the unvaccinated,” saying fully vaccinated people were much less at risk to develop serious illness from COVID-19.

Walensky said the U.S. is “still largely … in a pandemic of the unvaccinated,” adding that data shows the “vast majority” of severe disease, hospitalization and fatalities are occurring among unvaccinated people.

White House press secretary Jen Psaki said the White House and CDC are “sending a very clear message to the public, that in order to protect yourself, save your life, save the lives of those around, you need to get vaccinated.”

Just 49.1 percent of the U.S. population is fully vaccinated, leaving the unvaccinated, including every child under the age of 12, as well as immunocompromised people vulnerable to the virus.

The CDC on Tuesday stopped short of issuing an overarching recommendation for fully vaccinated people across the country to wear masks in all indoor public settings.

But Josh Liao, an associate professor of medicine at the University of Washington School of Medicine, cautioned that with a lag in data coming in, “there is a danger in trying to be too precise” in where the recommendations are active. 

“If you say only an area geographically where cases are rising, by the time you see the cases rising … it’s already spreading,” he said. 

Mask recommendations and mandates have gained traction in recent weeks, with Los Angeles County this month becoming the first major county to require masks indoors for all individuals regardless of vaccination status.

Announcements of vaccine requirements for certain state and health workers have also ramped up in the past few days.

Wen, a former Baltimore city health commissioner, said she thinks the CDC should go a step further by requesting proof of vaccination for many Americans so that fully vaccinated people can safely gather.

Walensky noted that the CDC does not have jurisdiction over recommending vaccine mandates for the federal workforce, military, schools and other employers, saying agency officials instead act as “technical advisers to the government.”

Some of the harshest criticism of the CDC’s new guidance came from congressional Republicans, with many slamming the updated recommendations as government overreach and a threat to the vaccination effort.

Sen. Mike Braun (R-Ind.) released a video calling for the federal government to allow local governments and businesses to make decisions on masks.

“There was no data to show that it worked with the oppressive, heavy-handed government approach to begin with,” he said in the video. “Be respectful of the disease, but exercise individual responsibility. That’s the key. No more mandates, masking, and things that didn’t work from the get-go unless it makes common sense to do so.”

Rep. Cathy McMorris Rodgers (Wash.), the top Republican on the House Energy and Commerce Committee, which has jurisdiction over federal health agencies, said the new guidance “deeply undermines vaccine confidence” and could harm children’s mental health and emotional and social development.

“Mask mandates for more command and control will not build trust — only resentment,” she said in a statement. “The Biden Administration should be leading with science, not shame and fear.”