Aiming to get ahead of a country racing to declare the pandemic over, the US Centers for Disease Control and Prevention on Friday announced sweeping changes in how it assesses the status of the pandemic and Recommend public health measures such as indoor covering.
The impact of the CDC’s move was immediate and far-reaching: Under its new framework, indoor covering is no longer recommended for counties where 72% of Americans live. Students in those counties would no longer be asked to cover their noses and mouths while in school facilities.
In the 63% of counties currently considered to be at low or moderate risk of COVID-19, the decision to wear a mask in public places would be a personal choice.
Los Angeles County, the most populous in the country, falls within the riskiest of the three new “COVID-19 Community Levels” outlined by the CDC. So is San Diego and Imperial counties, most of the San Joaquin Valley, and most of rural Northern California.
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But most of LA’s neighbors — Orange, Riverside, Ventura, Santa Barbara, and San Bernardino counties — are a notch lower in the medium-risk category, and most of the San Francisco Bay Area is in the low-risk tier.
In crafting its new community risk assessment, the CDC chose to stop counting new infections and instead focused on whether there was a risk of overwhelming local health systems with critically ill COVID-19 patients. That, in turn, is a warning sign that the number of COVID-19 deaths is about to rise, another important sign for the CDC.
“We’re in a strong place today,” said Dr. Rochelle Walensky, the CDC director. “We need to focus our metrics beyond community cases and focus our efforts on protecting our employees at high risk of serious illness.”
Many Americans, including those with weakened immune systems and medical conditions that make them vulnerable to severe cases of COVID-19, will choose to continue wearing masks and taking other measures to protect themselves, Walensky said. The new system will help them identify where masking makes the most sense, while also allowing healthy people to go about their business, she added.
The new framework also defuses a growing political problem: the CDC’s masking advice clashed with Americans’ growing fatigue with safety measures and a widespread perception that the worst of the pandemic is over.
In recent weeks, even governors in some of the country’s most pandemic-vigilant states have declared their intention to roll back public health emergency measures, including mask mandates.
dr Marcus Plescia, chief medical officer for the Assn. of State and Territorial Health Officials, called the new CDC system a big win for Americans looking for clear guidance on how to live safely in a world where the coronavirus remains rampant and illnesses could suddenly rise.
“They’re really trying to cater to the idea that people need a little breather,” he said. “We need to scale back these public health measures, but still provide some indicators of when you really can’t scale any further.”
The new paradigm has radically changed the national pandemic map. As of Friday morning, 95% of U.S. counties were rated as “high” or “significant” for coronavirus transmission, and all had recommended covering indoors. As of Friday afternoon, nearly two-thirds of counties were considered safe enough to make masking optional.
Much of New York, Massachusetts, Maryland, Illinois, Wisconsin and South Dakota are colored green on the CDC’s new map, indicating a low risk of COVID-19. But California, Oregon, Montana, Kentucky, West Virginia, North Carolina, Tennessee, Florida and Maine had broad orange stripes, indicating their hospital systems remain at risk of being overwhelmed with COVID-19 patients.
“It is clear that the country as a whole is transitioning from a pandemic to a state where the virus is endemic,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “But we’re also a very big country, and we’re not all doing it at the same pace. This allows the people in the front of the line to move a little faster than those in the back.”
By signaling that even the CDC is ready to ease up, the new approach could accelerate unmasking in places least ready for it, Schaffner said.
He called the agency’s revised action reasonable, but cautioned that the CDC must prepare communities to return to public health action if necessary.
“Once we’ve turned the switch off, we have to remember that there’s a big world out there, and if there’s a new twist, I’m afraid we’ll have to turn that switch back on,” Schaffner said.
“It’s going to be very difficult,” he admitted. “Most Americans want to stick COVID in the rearview mirror.”
For the past two years, the CDC’s risk levels have been based largely on a combination of new infections and the percentage of positive tests in the previous week. The new “COVID-19 Community Levels” are calculated using a mix of local hospital capacity and the number of COVID-19 patients hospitalized. Walensky said these measurements will be refined over time with data from sewage monitoring networks and other sources.
The new system recognizes a new set of realities. New cases with the Omicron variant have fallen to about 75,000 from a peak of 807,000 per day in mid-January. COVID-19 deaths, which had risen to over 2,600 a day in early February, have fallen by a more modest 38%. These trends have led to fewer and fewer hospitals reaching their capacity limits.
Meanwhile, the Biden administration’s focus on expanding the availability of rapid home tests has made tracking new infections more difficult for the federal government.
With more than 215 million Americans fully vaccinated and many millions of Americans previously infected, Walensky suggested a version of herd immunity was effectively achieved. In immunocompromised people, infection with Omicron has generally resulted in mild symptoms at worst. Given this “widespread population immunity,” she said, “the overall risk of serious illness is now generally lower.”
At the same time, new COVID-19 drugs that can prevent severe COVID-19 disease in high-risk patients are beginning to find their way into widespread use. These antiviral drugs are expected to keep more newly infected people from being hospitalized.
At the White House, press secretary Jen Psaki said such changes had changed the pandemic landscape enough to warrant a new approach. At the same time, she urged caution when reopening the country.
“There are still people dying of COVID every day. There are still immunocompromised populations,” she said. “We’re trying to work towards a time when COVID doesn’t disrupt our daily lives.”
Anumita Kaur, a Times contributor in Washington, DC, contributed to this report.
https://www.latimes.com/science/story/2022-02-25/cdc-eases-pandemic-covid-19-indoor-mask-guidelines CDC eases indoor COVID-19 mask guidelines