San Diego Union-Tribune

CDC GUIDANCE:

Concern over surge prompts agency to call for masks indoors when not at home

- The New York Times and the Los Angeles Times contribute­d to this report.

soaring With across coronaviru­s the nation, infections federal health officials on Friday urged

Americans in the most forceful language yet to take steps to protect themselves — starting with

“universal mask use indoors” — and pressed local government­s to adopt 10 public health measures deemed necessary to contain the pandemic.

The guidance ref lected deep concern at the agency that the pandemic is spiraling further out of control and that many hospitals are reaching a breaking point, potentiall­y disrupting health care across the country.

The CDC has for months encouraged mask-wearing in public spaces household. with The people new outside guidance, the published Friday, asks people to put on masks anywhere outside their homes.

The urgent recommenda­tions came on the same day California recorded another daily record number of cases, with 22,018, and hospitaliz­ations topped 9,000 for first time.

The number of Americans hospitaliz­ed with COVID-19 hit an all-time high on Thursday at 100,667, according to the COVID

Tracking Project. That figure has more than doubled over the past month, while new daily cases are averaging 210,000 and deaths are averaging 1,800 per day, according to data compiled by Johns Hop

kins University.

Federal health officials have issued increasing­ly stark warnings in the waning weeks of the Trump administra­tion, and Presidente­lect Joe Biden has promised a new national strategy to turn back the virus. On Thursday, Biden said he would call on Americans to wear facial coverings for 100 days.

To some experts, the CDC’s appeal appeared to augur a more comprehens­ive and coordinate­d national approach to controllin­g the pandemic.

“We’re seeing CDC and other public health institutio­ns awaken from their politics-induced coma,” said Dr. Thomas Frieden, who served as the agency’s director under President Barack Obama.

“This is them aligning themselves more with science, which also aligns them more with the Biden administra­tion,” he added.

While most of the directives are not new, experts said the rising case numbers demonstrat­ed a need for a more uniform approach, rather than the patchwork of restrictio­ns adopted by states.

“The role of the CDC is to lead with the science,” said

Dr. Celine Gounder, an infectious-disease physician and member of Biden’s COVID-19 advisory group. “In the absence of strong national guidance from the CDC, we’ve had a variety of responses across the country, some more scientific­ally grounded than others.”

The scientific evidence supporting the effectiven­ess of certain health measures, such as wearing masks, has been accumulati­ng, and those measures are urgently needed now to stop the spread, CDC officials said.

Though the agency has issued most of the recommenda­tions in earlier guidance, the new summary represente­d the first time the CDC had published a multiprong­ed list of strategies for states, a sort of battle plan.

“This idea of a 50-state solution is completely impractica­l when we live in one nation,” said Jennifer Nuzzo, an epidemiolo­gist at Johns Hopkins University’s Bloomberg School of Public Health. “We are not going to get past this pandemic unless we have a concerted national approach.”

Mask use is most crucial indoors, and in outdoor spaces where social distancing cannot be maintained, the CDC said in its report. The agency recommende­d mask use at home when a member of the household has been infected or potentiall­y exposed to the virus, including those with high-risk occupation­s such as meatpackin­g or agricultur­al processing.

“Compelling evidence now supports the benefits of cloth face masks for both source control (to protect others),” the report said, “And to a lesser extent, protection of the wearer.”

Mitigation measures are particular­ly essential in light of recent research that suggests roughly 50 percent of transmissi­on of the coronaviru­s is from asymptomat­ic people, the report said. It also recommende­d that communitie­s make a plan for distributi­ng masks to people who might struggle to access them.

In addition to stepping up mask use, the CDC also recommende­d postponing travel plans. For those who do plan to travel, both domestical­ly and internatio­nally, the agency encouraged staying home, getting tested before and after traveling and quarantini­ng for a week upon return, regardless of test results.

The new recommenda­tions place high priority on keeping schools open, from kindergart­en through 12th grade, saying schools should be both “the last settings to close” and “the first to reopen” because of the critical role they play in providing meals and support services to children. Closures take a disproport­ionate toll on lowincome families, the agency noted.

Failure to implement the preventive measures will lead to continued spread of the virus and more unnecessar­y deaths, said Margaret Honein, the first author of the CDC report.

She emphasized that Americans could take many important steps on their own: wearing masks, physically distancing from others, limiting their contacts and avoiding nonessenti­al visits to indoor spaces.

“We want to make sure every person is aware that it’s within their power to take this critical step: Wear a face mask and prevent transmissi­on, and maintain physical distance from others,” said Honein, a member of the agency’s COVID-19 emergency response team.

Scientific evidence that masks can both prevent an infected individual from spreading the disease and protect the user from infection is “compelling,” she added. “Clearly, not everyone is hearing how important that is,” she said. “It’s an action everyone can take to protect each other.”

The CDC emphasized Americans should avoid indoor spaces outside the home, as well as crowded outdoor spaces.

Faced with the accelerati­on in COVID-19 cases, California on Thursday pulled an emergency brake — announcing new restrictio­ns tied to regional strains on critical care services.

For purposes of the new statewide order, officials carved California into five regions: Southern California, the San Joaquin Valley, the San Francisco Bay Area, the Greater Sacramento area and rural Northern California.

Additional restrictio­ns — such as closing hair and nail salons, playground­s, zoos, museums, aquariums and wineries; and requiring restaurant­s to return to takeout service only — would be implemente­d when a region’s intensive care unit capacity falls below 15 percent.

The new stay-at-home order takes effect Saturday, although the earliest it would be imposed is Sunday.

So far, none of the regions has dipped below the stateset threshold — though officials have said they expect all of them will do so soon.

Though their regional ICU capacity has yet to fall below the designated level, health officers for Alameda, Contra Costa, Marin, San Francisco and Santa Clara counties, as well as the city of Berkeley, announced Friday that they would proactivel­y implement the additional restrictio­ns.

“We cannot wait until after we have driven off the cliff to pull the emergency brake,” Santa Clara County Health Officer Dr. Sara Cody said in a statement.

The new closures are scheduled to take hold across most of the Bay Area starting Sunday and will stay in place until Jan. 4.

Nationwide, the coronaviru­s is blamed for almost 277,000 deaths and 14 million confirmed infections.

An inf luential modeling group at the University of Washington said Friday the expected U.S. vaccine rollout will mean 9,000 fewer deaths by April 1.

But even with a vaccine, the death toll could reach 770,000 by April 1 if states do not act to bring current surges under control, the group said.

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