To mask or not mask? Omicron's decline reinvigorates debate

Several states are easing their masking rules in schools and public places as COVID-19 infections slow while the CDC maintains its guidance, with agency chief Rochelle Walensky, MD, noting "now is not the moment" for changes.

Dr. Walensky shared her comments with Reuters Feb. 8 after officials in California, Connecticut, Delaware, New Jersey and Oregon said they plan to roll back indoor mask mandates for K-12 public schools and other indoor spaces in the coming weeks. "We have and continue to recommend masking in areas of high and substantial transmission — that is essentially everywhere in the country in public indoor settings," she said. The CDC's COVID-19 transmission map showed 99 percent of U.S. counties had high community transmission as of Feb. 7. 

Here are six latest developments and things to know about masking in the U.S. as of Feb. 9: 

1. Six states have introduced changes to their mask rules: California, Connecticut, Delaware, New Jersey, New York and Oregon. 

2. The governors in California, Delaware and Oregon have all set expiration dates for statewide indoor mask mandates. In New York, a rule requiring businesses to ask customers for proof of vaccination or require masks expired Feb. 9. A separate mandate requiring masks be worn in New York schools is set to expire in a few weeks, though it's not yet clear whether that will be dropped or extended. Connecticut, Delaware and New Jersey have also set dates for when school-based mask mandates will expire. "This is not a declaration of victory as much as an acknowledgement that we can responsibly live with this thing," New Jersey Gov. Phil Murphy said after announcing students and school employees will no longer have to wear a mask as of March 7. 

3. The six states proposing changes are led by Democratic governors, which adds another wrinkle to the country's patchworked approach to masking guidance throughout the pandemic. The political party control of states has come to be one imperfect framework to interpret variation in masking rules. Many Democratic governors enforced the strictest masking mandates, while their Republican counterparts lifted mandates, did not issue them or in some instances, such as Texas and Florida, banned them.

4. Changes to masking rules at this point in the pandemic may not be as eagerly embraced as they were in May 2021 given Americans' collective memory of the delta variant. Scott Gottlieb, MD, former FDA commissioner, told CNBC he expects some pushback over changes to masking. "There is this sort of perception that the reason we had a delta surge last summer was because the CDC came out and said you didn't need to wear masks anymore. The two things were unrelated," he said. "At the point in which the CDC last spring said we don't need to wear masks anymore, delta wasn't even on the horizon. But there is this perception that has been formed that, but for the CDC's actions, we wouldn't have had the delta surge, which isn't true. But I think that's going to create a narrative that creates some pushback on lifting these provisions." 

5. Mask mandates are likely to be reintroduced during future or seasonal surges. That's why it's important for the U.S. to relax public health restrictions, including mask mandates and indoor gathering restrictions, as the omicron surge recedes, according to Ashish Jha, MD, dean of Brown University's School of Public Health in Providence, R.I. "Why not leave them on? Because mask mandates are costly and should be used sparingly, and because during future surges, we may need to ask people to pull back or mask up again," he said in a series of Jan. 24 tweets. "Preserving people's willingness to do things is critical. … We should use the reprieve to prepare." 

6. The CDC's guidance for universal masking in healthcare facilities has not budged throughout the pandemic. During the surge of the highly contagious omicron variant, more hospitals took upon themselves to require medical-grade masks for patients, visitors and staff. Physicians have made calls for universal use of N95 masks in hospitals, noting they decrease exposures by 95 percent or greater.



 

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