CDC makes it easier to orient outdoor masks for vaccinated Americans

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WASHINGTON – The Centers for Disease Control and Prevention took a major step on Tuesday to bring Americans into a post-pandemic world, relaxing rules on wearing masks outdoors as coronavirus cases recede and people s increasingly irritate against the restrictions.

The mask guidelines are modest and carefully drafted: Americans who are fully vaccinated against the coronavirus no longer need to wear a mask outside when walking, running, hiking or biking alone, or at small gatherings, including with members of their own household. Masks are still needed at crowded outdoor venues like sports stadiums, the CDC said.

But President Biden hailed it as a highlight of the pandemic, wearing a mask as he approached the lectern on a hot spring day on the White House grounds – and conspicuously kept it off as he returned to the White House when he was done.

“Go get the picture. It has never been easier, ”Biden said. “And once you’re fully immunized, you can do without a mask when you’re outside and away from large crowds.”

The CDC stopped before telling even people who were fully vaccinated that they could get rid of their masks completely outside – citing the still worrying risk of transmitting the coronavirus, vaccination levels unknown among those in the area. the crowds and the still high number of cases in some parts of the country. The guidelines also cautioned even those vaccinated against skipping masks at medium-sized outdoor gatherings.

But even CDC director Rochelle Walensky emphasized a broader interpretation, telling reporters at a White House briefing: “We no longer feel that vaccinated people need masks. outside ”, outside“ large public places, such as concerts, stadiums and the like. like that.”

The order had immediate ripple effects in the States. The governors of California, New York, Louisiana, Maine and Massachusetts all relaxed outdoor mask mandates after the CDC’s announcement. In Tennessee, Gov. Bill Lee, a Republican, went much further, ignoring advice from the federal government as he said it was “time for celebrations, weddings and conventions, concerts, parades. and balls “to take place” with no limits on gathering sizes. “

On Capitol Hill, a group of Republican lawmakers who are also medical professionals released an advertisement promoting vaccination on Tuesday, in which they appeared dressed in white coats with stethoscopes draped around their necks. Senator Roger Marshall, a first-year Republican from Kansas and a doctor, told viewers the reason for getting the shot was simple: “So we can throw off our masks and live as freely as before.”

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Mr Marshall, who organized the effort, said it was based on research conducted by Frank Luntz, a Republican pollster working to reduce vaccine reluctance among conservatives. In an interview, Mr Luntz said Mr Biden’s announcement was a positive step and could give people who are reluctant to get the shot a reason to get the shot.

“It gives them a light at the end of the tunnel,” he said. “Tell me when I can get rid of my mask” is actually the language they use, so that this is a significant and measurable step towards getting back to normal is a big deal. “

For Mr Biden, who will address Congress on Wednesday and mark his 100th day in office on Thursday, the CDC’s announcement was a time to bask in what he called the “amazing progress” Americans have made since. taking office. Next week, he said, he will lay out a plan “to bring us to July 4 as a target date to bring life in America closer to normal and start celebrating our independence from the virus.”

Americans have been criticized over the issue of wearing masks since the start of the pandemic, when senior health officials said people did not need them – in part due to severe shortages of protective gear for frontline healthcare workers. The masks have become the centerpiece of the cultural wars that surrounded the pandemic, especially after President Donald J. Trump insisted they were optional and he would not wear them.

This has led states to enact patchwork mask restrictions, often on partisan principles, despite evidence of mask protection for people and those around them. Many states have already lifted their restrictions on indoor and outdoor activities. Others have maintained mask-wearing requirements even for outdoor spaces, citing the threat of potentially more contagious variants.

The guidelines released on Tuesday reflect some basic math about coronaviruses: As the number of people vaccinated increases, cases decrease.

So far, about 43% of Americans have received at least one dose of a Covid-19 vaccine, and 29% have received both doses of both vaccines requiring a double injection. The United States averages 55,000 new cases a day, down about 20% from two weeks ago, according to a New York Times database.

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“I know the quarantine and closures throughout the pandemic have been grueling,” Dr Walensky said. “I know we’re missing all the things we did before the pandemic, and I know we all want to do the things we love and do soon. Today is another day when we can get back to normal. “

His remarks, and those of the president, were welcomed even by some of the Biden administration’s fiercest Republican critics in Congress, many of whom complained that the coronavirus restrictions were an intrusion on their personal freedoms.

“It’s about time,” said Rep. Jim Jordan, Republican of Ohio, who recently excoriated Dr. Anthony S. Fauci, the federal government’s senior infectious disease specialist, during a hearing on Capitol Hill. “Now when do we get the rest of our freedoms back?”

Wisconsin Republican Senator Ron Johnson, who has spread fringe theories and given vaccine skeptics a platform, called the guidelines “long overdue.”

Texas Republican Senator Ted Cruz, who quit wearing masks indoors after being vaccinated, said he was “ happy that the CDC has finally recognized what has long been evident, which is that wearing a mask outside is ridiculous and not remotely justified by science. “

In fact, the science behind the CDC’s new directions is not exhaustive. A growing body of research indicates that the likelihood of the virus spreading outdoors is much lower than indoors, but the risk is not zero and is difficult to quantify.

Most if not all of the research on viral transmission outdoors was done before the vaccine was available, so it does not distinguish between the risk to those who are inoculated and those who do not. are not.

But experts say the virus particles quickly disperse outdoors, meaning brief encounters with a passing walker or jogger pose very little risk of transmission.

“The two main things you have going for you outside is that the virus quickly dilutes” and disintegrates quickly in the sun, said Linsey Marr, an aerosol expert at Virginia Tech, adding: “I think to something like sitting at a baseball game where people are really cheek-to-cheek, side by side, in front of and behind each other, and there’s screaming, cheering – I’d wear a mask in that situation.

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Still, the evidence is somewhat thin. A recent systematic review of studies that examined transmission of the novel coronavirus and other respiratory viruses in unvaccinated individuals identified only five studies of the coronavirus that met the authors’ criteria.

The study concluded that less than 10% of infections occurred outdoors and the likelihood of transmission indoors was 18.7 times higher than outdoors (the likelihood of super- spread was 33 times higher than indoors).

One of the authors of the article, Dr Nooshin Razani, associate assistant professor of epidemiology, biostatistics and pediatrics at the University of California, San Francisco, warned that the low risks of transmission outdoors may simply reflect the makes people spend little time outdoors.

In one documented case in Italy, the virus spread between joggers who ran together outside, side by side.

The new CDC guidelines were released amid growing debate over why the federal government still recommended that people wear masks outdoors. Writing in the New England Journal of Medicine last week, Dr Paul Sax, an infectious disease expert at Brigham and Women’s Hospital in Massachusetts, said it was time to end the outdoor mask mandates.

Along with the guidelines, the CDC released a color-coded table outlining masking recommendations for a variety of scenarios such as “dining at an outdoor restaurant with friends from multiple households,” “visiting a barber or hair salon “And” go to a covered, uncrowded shopping center or museum. “

But Dr Marr said it sounded too complex: “I should carry around a sheet of paper – a cheat sheet with all these different stipulations.” She added: “I’m afraid this is not as useful as it could be.”

And there are other scenarios, not addressed in the guidelines, in which wearing a mask outside can still be an important social signal. For example, Dr. Mercedes Carnethon, an epidemiologist at Northwestern University, noted that no vaccines have yet been approved for children under 16.

“When we’re going to demand that children wear masks, at school and on the playground when they’re at school,” she said, “I think he’s responsible for the adults in situation to model this behavior and normalize the mask. even wear outdoors.

Emily anthes and Nicolas fandos contribution to reports.

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