The Centers for Disease Control and Prevention announced Friday it is relaxing its mask guidance for communities where hospitals aren’t under high strain. Under the new guidance, nearly 70% of the U.S. population lives in an area considered to be low or medium risk, and residents there are advised they can go indoors without masks. Most of Alaska falls into the medium risk category, according to the CDC.
The CDC recommends continued mask use in communities where serious cases of COVID-19 are straining the health system.
The move to ease up on masking, federal officials say, reflects current conditions at this phase of the coronavirus pandemic, including widespread immunity through vaccination and prior infection as well as better access to testing and treatments.
“We want to give people a break from things like mask-wearing,” said CDC Director Rochelle Walensky at a news briefing Friday. But, she added, new risk guidelines that the agency is implementing will help people know when to reach for masks again if conditions warrant it.
Health officials emphasized that people should still wear face coverings if they wish or if they are personally at high risk. And regardless of local conditions, they should mask if they have COVID-19 symptoms or a positive test or have been exposed to someone with COVID-19.
As part of the change, the CDC is dropping its recommendation for universal school masking and instead will recommend masking only in communities at a high level of risk.
The agency’s new guidelines for assessing community risk, released Friday, weigh hospitalizations for COVID-19 and the proportion of beds occupied by COVID-19 patients in local hospitals more heavily than rates of new infections alone.
“As the virus continues to circulate in our communities, we must focus our metrics beyond just cases in the community and direct our efforts toward protecting people at high risk for severe illness and preventing COVID-19 from overwhelming our hospitals and our health care system,” said Walensky.
The agency has changed course on masking several times during the pandemic. In May of last year, it announced guidance that fully vaccinated people could safely stop wearing masks indoors, only to reverse that advice two months later as the delta variant of the coronavirus surged and breakthrough cases rose.
At that point, the CDC said masking indoors was advised in parts of the U.S. with “substantial” or “high” spread of the virus, which it defined as 50 to 100, or 100 or more, respectively, new weekly cases per 100,000 people.
Though cases are rapidly declining in the country, currently around 95% of counties are still seeing those “substantial” or “high” levels of spread, according to the CDC’s older risk metrics, which were based primarily on new cases.
Under the CDC’s new risk metrics, an area is deemed “high” risk if it has concerning levels of COVID-19 hospital admissions and hospital capacity taken up by COVID-19 patients.
About 38% of U.S. counties are in this new high-risk category, where mask-wearing is recommended, but these counties account for only 28% of the population.
The CDC will release county-by-county risk levels weekly on its website, officials said.
Many public health experts say the shift in guidance makes sense in the context of declining case rates and the widespread availability of COVID-19 vaccines.
“I think we’re moving to a pragmatic strategy, one that recognizes that those who want to protect themselves have every tool available,” says Dr. Ali Khan, a former CDC official and now a dean at the University of Nebraska: “There are free vaccines, free masks, free tests and free antivirals.” Khan says it’s now up to communities and individuals to determine what actions to take to protect themselves and those around them.
It makes sense for the CDC to put in place shared metrics for understanding risk, says Khan, “and then locally [for communities] to make decisions to relax mask guidelines based on what the local conditions are: how well people are vaccinated, how many people are going to hospitals, what sort of absenteeism levels you have [among hospital staff].”
Dr. Georges Benjamin, executive director of the American Public Health Association, says the new risk levels give people a way to think about the pandemic as we go forward. “I think it’s a good road map,” he says. “It gives us a way of moving up or down the spectrum based on what could change in the future, and most of us do think that we’re still going to have recurring outbreaks of this disease in the community.”
On the other hand, the new risk metrics, which now include a combination of case levels, hospitalizations and hospital capacity, are not easy to understand, notes Dr. David Dowdy, an epidemiologist at Johns Hopkins University.
“I’m always a little concerned when guidance gets more complicated rather than simpler,” he says. “I understand the desire to incorporate both cases and hospital admissions and maybe even staffed hospital beds. But trying to come up with a formula like this risks making it difficult for people to actually implement this guidance in a real-time fashion.”
He says perhaps the emphasis could have been simply on new hospital admissions, which he calls “a very near real-time indicator of when severe cases are starting to rise again.”
Still, he says, it’s a reasonable time in the pandemic to be stepping down precautions like mask-wearing.
Will Stone contributed to this report.
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