Back in the spring, the Centers for Disease Control and Prevention (CDC) advised that people fully vaccinated against COVID-19 could safely resume activities without wearing a mask or physically distancing.
Now, though, the agency’s expert physicians and scientists are changing course, urging immunized people to wear masks indoors in public if they live in areas with high or substantial rates of SARS-CoV-2 transmission.
The CDC also is recommending that children, teachers and staffers in K–12 schools across the nation wear masks in the coming school year, regardless of COVID-19 vaccination status. This brings the agency’s recommendations in line with those of the American Academy of Pediatrics. The AMA strongly supports the scientifically driven changes.
With some confusion around the latest CDC mask guidance, these two public health experts took time to share what to tell patients about the change:
- Megan Srinivas, MD, MPH, an infectious diseases specialist and translational health policy research fellow at the University of North Carolina at Chapel Hill.
- Andrea Garcia, MPH, AMA director of science, medicine and public health.
Science is evolving
“CDC—when they announced their guidance a few months ago—noted that as we get new information, we can expect the guidance will shift,” Garcia said during an episode of the “AMA COVID-19 Update” about the updated CDC guidelines for masking. “What we are seeing here is the CDC has new information based on an outbreak in Massachusetts, and that new information is resulting in a shift in the guidance.”
“They're going back to the masking because of the science and science evolves,” said Dr. Srinivas, an AMA member. “It's not that they're just making things up—it's that they get more evidence and that's where they make these decisions.”
“The fact that the CDC has been willing to change based on the science—and share that science—is a huge sign of the transparency that they're using because that's a huge issue,” said Dr. Srinivas.
COVID-19 cases are on the rise
“The CDC website—specifically the CDC COVID Data Tracker—has a county-level map where people can see the transmission level in their area,” Garcia explained. “If you fall into one of those red or orange categories, those are areas of known concern and that is where CDC is recommending that individuals mask up in indoor public settings.”
More than 90% of U.S. states or other jurisdictions community transmission in the “substantial” or “high” categories.
“We're seeing substantial transmission in all 50 states, so people should continue to watch that map, which I understand is updated daily, and see if their area falls into one of those areas,” she added. “And if it isn't now, it certainly could be soon given what we're seeing.”
Learn more from the AMA about why the CDC is again turning to masks to help stop COVID-19.
Delta variant transmission is high
“If we don't get high enough vaccination rates in our communities, we start to see these variants evolve. And that’s what happened with the Delta variant,” Dr. Srinivas explained. “At the time the CDC initially made their announcement in early May about vaccinated people not needing to wear masks in public, the dominant strain here was really the Alpha variant—the variant that emerged out of the U.K., so the B.1.1.7.”
But the Delta variant has been shown to be more transmissible than other COVID-19 variants and “that’s the other issue why we went back to masking, which is really just because of the transmission and trying to get things driven down,” she said. “So even though you are protected—if you’re vaccinated—from having severe disease, you’re still at risk to being contagious to other people, which then could drive higher transmission rates and newer variants to evolve.”
Discover what doctors wish patients knew about the dangerous Delta variant.
It's about stopping the spread
“Our initial test and quarantine theories … are based on the fact that not only are you trying to protect the individual, but you’re trying to really stop the spread at the community level in order to protect the community overall,” Dr. Srinivas explained. “And when we see that people who are vaccinated can spread this disease as readily as others, we have to do what we can to control that spread.
“Which means reintroducing masking in crowded places, in indoor spaces, places that are high risk for transmission and also really reintroducing quarantine for people who test positive for the Delta variant as well, because they can—once again—expose others and spread that disease,” she added.
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