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Many experts say to keep masks on, as pushback to CDC guidance intensifies

Couple embrace on escalator
A masked couple embrace on the escalator while shopping at South Coast Plaza on Thursday in Costa Mesa.
(Gina Ferazzi / Los Angeles Times)

A growing number of health experts vaccinated against COVID-19 said they’d keep their masks on in public settings as federal officials acknowledged that new relaxed mask recommendations issued by the Centers for Disease Control and Prevention needed clarification.

The comments underscore a growing pushback in some quarters over the CDC’s surprise decision to roll back mask recommendations last week. Some retailers said they were keeping mask requirements, while others, including Trader Joe’s and Walmart, lifted them, with some chains clarifying the relaxation applied only in states and local areas that already have relatively loose mask rules.

In California, which has relatively strict mask mandates, officials have yet to release their detailed response to the CDC’s relaxed guidance, although Gov. Gavin Newsom on Friday said the federal recommendations had “created some new anxiety for many: that it may be too soon, too much.”

Experts are divided, but a number have said it’s better to be on the safe side for now.

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Some fear the CDC is moving too fast in lifting COVID-19 mask guidance for the vaccinated.

“I strongly recommend to others that when at an indoor place where both vaccinated and unvaccinated people mix, such as grocery stores, that they wear a mask too,” tweeted Dr. Carlos del Rio, infectious diseases expert and executive associate dean at Emory School of Medicine in Atlanta.

Added Dr. Ashish Jha, dean of the Brown University School of Public Health, in a tweet: “Here’s my personal practice for now: Continue indoor masking in public places like grocery stores until more are vaccinated, infection numbers are down.”

“Add me to this list as well,” Dr. Kirsten Bibbins-Domingo, chair of UC San Francisco’s department of epidemiology and biostatistics, responded in a tweet. “Wearing my mask indoors just awhile longer until the rates [of vaccinated people] are higher.”

Leading scientists and doctors have generally agreed that vaccinated people should feel very safe that they have good protection against COVID-19.

But some have suggested waiting longer before allowing masks to be shed among vaccinated people in indoor public settings; they worry that unvaccinated people will defy the rules and go maskless as well, increasing the risk of transmission among unvaccinated people and potentially putting at greater risk children too young to be vaccinated or immune-compromised people.

In an interview last week, Bibbins-Domingo said the new guidelines also could pose a threat to people who want the vaccine but haven’t been able to get it for a variety of reasons.

Some experts welcomed the CDC’s guidelines and agreed it would provide an incentive for those who may have put off getting a COVID-19 shot.

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Dr. Monica Gandhi, infectious diseases expert at UC San Francisco, tweeted that the CDC was trying to communicate the effectiveness of vaccines after being criticized for a previously overcautious approach, but the guidance that came out Thursday “likely backfired.”

An approach that may end up working best, Gandhi said, will be for local public health authorities to lift mask mandates when vaccination rates reach a certain threshold and daily coronavirus case rates also hit a goal.

Some parents, citing declining case rates and the newness of the vaccine, are opting to hold off or decline when it comes to their kids.

Each department of public health “will make their own decision & many will wait to lift mask mandates for all at the same time, which is reasonable,” Gandhi added.

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The CDC on Thursday changed its mask guidance to suggest fully vaccinated people can stop wearing masks in most places — either outdoors or inside, with certain exceptions, such as on airplanes, buses and trains. Under the new federal guidance, unvaccinated or partly vaccinated people are still asked to wear masks in most indoor and outdoor public settings when close to people outside their household.

National Nurses United, the largest union representing registered nurses in the U.S., criticized the CDC for suggesting that vaccinated people could stop wearing masks. “All of our protective measures should remain in place, in addition to vaccines. This pandemic is not over,” Deborah Burger, the union president, said in a statement.

The CDC’s guidance, while influential, is a recommendation, and it’s up to state and county governments to make the final call on what rules apply, or whether to allow businesses to make their own decisions.

The CDC director, Dr. Rochelle Walensky, faced sharp questioning this weekend following the updated guidance.

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On NBC’s “Meet the Press,” Walensky clarified that the new mask guidance was meant to help people understand that the latest science showed that, generally speaking, fully vaccinated people can safely remove their masks in most settings. But she also acknowledged that the CDC now needs to come out with more guidance on what this means in settings where it’s not easy to know who is vaccinated.

“We all need to work together — and CDC is hard at work now — saying what does this mean for schools, for travel, for camps, for businesses,” Walensky said.

She added: “There’s no need for everybody to start ripping off their masks. We have been told for 16 months to keep ourselves and our family safe by putting a mask on. Those behaviors are going to be really hard to change, and there is no mandate to take it off. What we’re saying is: Now, this is safe. Work at your own speed, work with your own family and your own businesses to remove them when necessary.”

Anyone with a compromised immune system — such as from chemotherapy and transplants — should consult with a physician before removing a mask because the COVID-19 vaccine may not have worked as well for these patients, Walensky said.

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The head of the Centers for Disease Control and Prevention is defending the decision to ease mask-wearing guidance for fully vaccinated people.

Dr. Anthony Fauci, President Biden’s chief medical advisor for the pandemic, acknowledged on CBS‘ “Face the Nation” that there may be some merit to criticism that the CDC should have better prepared the public for this sudden shift in mask guidance. Fauci said clarifying information will likely be issued in the coming weeks.

“People will say, well, what about the workplace? What about this? What about that?” Fauci said. “I would imagine, within a period of just a couple of weeks, you’re going to start to see significant clarification of some of the actually understandable and reasonable questions that people are asking.”

In California, mask rules have not changed since the CDC relaxed its guidance. They generally reflect the CDC’s previous mask guidance, and, as of May 3, require masks to be worn by everybody in indoor settings outside the home. There are exceptions, such as when you’re outside a workplace setting and everyone indoors is vaccinated or when there are only members of one unvaccinated household present and all have a low risk of severe complications should they get COVID-19.

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In comments Thursday afternoon, Barbara Ferrer, L.A. County’s public health director, said she also was not ready to immediately implement the CDC’s new approach, saying local health departments were not notified about the new guidance in advance and asked for time to review the CDC’s guidelines. Ferrer said it will be important to keep workers as safe as possible and said California occupational safety standards requiring masks in workplaces remain in place.

L.A. County Supervisor Kathryn Barger wrote to Newsom, asking the state to align with federal guidance.

“While we still want to keep our communities safe, I am encouraged by the new guidance from the CDC and believe that the state and Los Angeles County should immediately align with the new federal recommendations,” she wrote.


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