USA TODAY International Edition

CDC urges masks inside, again

Reversal could increase pressure on unvaccinat­ed

- Adrianna Rodriguez

The CDC’s decision Tuesday to reverse course and urge even fully vaccinated Americans to wear masks indoors in areas of high coronaviru­s transmissi­on isn’t likely to crush community spread, experts say – but it might ratchet up pressure on the unvaccinat­ed and encourage businesses and schools to enforce mask mandates.

The CDC is also now recommendi­ng universal indoor masking for all teachers, staff, students and visitors inside schools from kindergart­en to 12th grade, regardless of vaccinatio­n status. That aligns closely with guidelines from the American Academy of Pediatrics, which recommende­d this month that anyone older than 2 be required to wear a mask in school.

The CDC and the AAP are still urging that children return to full- time inperson learning in the fall.

“The delta variant is showing every day its willingnes­s to outsmart us and be an opportunis­t,” CDC director Dr. Rochelle Walensky said in a briefing Tuesday. “In rare occasions, some vaccinated people infected with the delta variant after vaccinatio­n may be contagious and spread the virus to others. ... This new science is worrisome and unfortunat­ely warrants an update to our recommenda­tions.”

According to the new science, she said, fully vaccinated people with breakthrou­gh infections from the delta variant have a similar viral load to infec

tions in unvaccinat­ed people. That means the fully vaccinated are more likely to spread the virus with the delta variant than the original coronaviru­s.

“If you have a vaccinated individual who is in a place with substantia­l or high transmissi­on – and they’re contacting a lot of people – 1 in 20 or 1 in 10 could possibly lead to a breakthrou­gh infection” even with a vaccine that’s 90 to 95% effective,” Walensky said.

The goal behind the guidance may be to protect both the fully vaccinated and the unvaccinat­ed, health experts say, especially vaccinated people who may be immunocomp­romised and children under 12 who aren’t yet eligible to get their shot. But the reality is there’s hardly any transmissi­on among fully vaccinated people to truly affect community spread, they say.

“There isn’t a whole lot of benefit that’s going to be felt by this. … We have good data that vaccinated people don’t spread COVID as efficiently as unvaccinat­ed people,” said Dr. Eric Cioe- Peña, director of global health at Northwell Health in New Hyde Park, New York.

He suspects the recommenda­tions may be more successful in getting unvaccinat­ed Americans to wear masks in public and empowering businesses and schools to implement mask mandates without requiring proof of vaccinatio­n.

The CDC’s recommenda­tions now also align more closely with local health department­s that already have reimposed mask mandates, said Dr. William Schaffner, a professor and infectious disease expert at the Vanderbilt University School of Medicine in Nashville, Tennessee. “This gives more of an opportunit­y for local health department­s to not look as though they’re doing something different than what the CDC is suggesting. There was always an option for locals to make that determinat­ion, but now it’s much more explicit.”

The CDC’s announceme­nt comes a few days after Dr. Anthony Fauci, President Biden’s chief COVID- 19 medical adviser, said the agency was reexaminin­g mask recommenda­tions amid surging cases triggered by the highly transmissi­ble delta variant.

“We’re going in the wrong direction,” he told CNN on Sunday.

The delta variant accounts for more than 80% of COVID- 19 cases across the United States, according to the CDC.

Johns Hopkins University data shows daily cases are nearly doubled what they were last summer, and wearing a mask is an extra layer of protection to prevent another fall surge, said Dr. Ilan Shapiro, medical director of health education and wellness at AltaMed Health Services, a Los Angeles network of community health centers. “We already know how that movie ends. ... The delta variant has proven to us that it’s a very effective jumper,” he said.

Health experts urge fully vaccinated people to consult their local health department websites for mask guidance and vaccinatio­n rates. If rates are below 70%, they recommend wearing a face covering in indoor public places or crowded outdoor gatherings.

The No. 1 recommenda­tion, however, will always to be to get vaccinated, CioePeña said. “We have the tools and we’re one of the only countries in the world that can end the pandemic, and we’re just choosing not to,” he said.

For those who are already vaccinated, Schaffner urges them to be flexible and patient as CDC recommenda­tions are likely to change again with fluctuating vaccinatio­n rates and coronaviru­s transmissi­on.

“The virus is in charge, and we have to respond to what the virus is doing in our communitie­s. Some people would think of that as a step back, but when the opposing team makes a lot of points, you have to change your defense.”

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competitio­n in Healthcare. The Masimo Foundation does not provide editorial input.

 ?? SCOTT OLSON/ GETTY IMAGES ?? The highly contagious delta variant now accounts for 80% of infections in the U. S.
SCOTT OLSON/ GETTY IMAGES The highly contagious delta variant now accounts for 80% of infections in the U. S.

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