The Centers for Disease Control and Prevention recommended Tuesday that Americans wear masks indoors again, particularly in crowded indoor settings.
The new indoor mask recommendations apply to vaccinated and unvaccinated people who live in areas where the CDC has classified Covid-19 transmission as “high” or “substantial,” a health official said — a category that includes much of the South as well as western states like Arizona and Wyoming.
The announcement marks a sharp change in policy for the nation’s leading health agency. In May, the CDC said vaccinated Americans no longer needed to wear masks outdoors or indoors in most circumstances. Internal deliberations about encouraging Americans to yet again wear masks indoors came to a head Sunday when senior officials from the White House and the CDC met to discuss new data that supported changing those guidelines, a person with knowledge of that meeting said.
“This weighs heavily on me,” CDC Director Rochelle Walensky told reporters Tuesday. “Not only are people tired, they are frustrated. We have mental health challenges in this country. We have a lot of sickness and death. Our health systems are being overrun. In the context of all that this, I know this is not welcome news. I just want to convey that this was not a decision that was taken lightly.”
Tuesday’s policy switch underscores the extent to which the Biden administration is increasingly worried about the highly transmissible Delta variant infecting the unvaccinated population across the country. It also points to a frustrating new reality for the White House — that the country needs to revert to wearing masks at a time when the U.S. was supposed to be returning to normal life.
“This is the story of Covid,” said Megan Ranney, an emergency physician and associate professor of emergency medicine at the Warren Alpert Medical School of Brown University. “The virus keeps changing. Everyone is doing the best they can. The CDC was under a lot of pressure to get rid of masks but unfortunately it didn’t pay off. We couldn’t get shots into arms and then Delta started spreading.”
White House press secretary Jen Psaki said Tuesday the U.S. was “at war” with Covid-19 and the Delta variant. “The reality is we are dealing with a much different strain of this virus than we were even earlier in the spring,” she told reporters at a White House briefing.
The Delta variant remains the predominant variant in the U.S. and that recent outbreak data shows the variant “behaves differently and uniquely than past strains of Covid-19,” Walensky said.
The CDC’s decision to issue the recommendations came after weeks of agency scientists conducting outbreak investigations among people who contracted Covid-19 post vaccination and among those who chose not to get vaccinated. Breakthrough infections in vaccinated people are rare, Walensky said, but noted that the CDC investigation data shows the viral load in vaccinated individuals is similar to those who are unvaccinated. That means vaccinated people who contract the Delta variant “have the potential to transmit with the same capacity as an unvaccinated,” she said.
The mask recommendations come at a time when portions of the South and Midwest are experiencing sharp upticks in Covid-19 cases and hospitalizations. In Louisiana, Alabama and Missouri, ICUs are overcrowded with patients, many of them between the ages of 30 and 60. More than 95 percent of the patients hospitalized nationwide are unvaccinated, according to state public health officials and the CDC.
“I’m glad the CDC headed the overwhelming consensus of public health officials across the country,” said Leana Wen, a doctor at Georgetown University. “I wish that they went further and finally called for a system of proof for vaccination otherwise the vaccinated are being punished for the actions of the unvaccinated.”
The CDC is also urging local officials to encourage universal masking indoors for all teachers, staff, students and school visitors no matter their vaccination status. At least one major union, the American Federation of Teachers, has come out in support of the new guidance, which comes just weeks before the start of the school year in many parts of the country.
State and public health officials are in the throes of planning for increased testing and how to handle masking requirements.
“Masking inside schools, regardless of vaccine status, is required as an important way to deal with the changing realities of virus transmission,” said AFT president Randi Weingarten. “It is a necessary precaution until children under 12 can receive a Covid vaccine and more Americans over 12 get vaccinated.”
The Biden administration has for months rolled out a national vaccine campaign to convince Americans to sign up for the shot. But vaccination rates plateaued earlier this summer, and the administration has had difficulty messaging to Americans in more conservative, rural parts of the country.
“Without a way to differentiate between the vaccinated and the unvaccinated, without some sort of national solution to this problem, the only option is to get people to wear masks again,” said Ali Khan, dean of the University of Nebraska College of Public Health.
But there are lingering questions within the CDC and the top echelons of the Biden administration about whether the new recommendations will have any measurable impact on the spread of the virus, which depends on whether people adhere to them. “It is going to be all about whether state and local officials implement mandates,” Khan said.
“I would question whether some people were masking to begin with. There are many people who rarely masked who still aren’t masking and who aren’t going to go back to masking,” Ranney said. “I think that’s up to local officials to push people to mask up. They need to message to their local communities.”
Walensky said Tuesday that the CDC was leaving the task of finding “motivational” ways to convince the unvaccinated to sign up for the shot to state and local officials.
Republican state officials are already begin to push back against the new CDC guidelines.
“I don’t think there is going to be any mandate to wear masks,” Scott Harris, Alabama’s health officer told reporters shortly after the new CDC guidance was released. “We’ve learned that even when we had a mask mandate people who aren’t going to wear masks aren’t going to wear masks, when we had other restrictions people certainly felt free to flout those.”