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CDC changes mask guidance in response to threat of Delta variant of Covid-19

Nearly two-thirds of US counties have high or substantial transmission of Covid-19, according to CDC data; 46% of counties have high transmission and 17% have substantial transmission.

Posted: Jul 27, 2021 12:12 PM
Updated: Jul 27, 2021 12:29 PM

By Jacqueline Howard, CNN

(CNN) -- To prevent further spread of the Delta variant, the US Centers for Disease Control and Prevention updated its mask guidance on Tuesday to recommend that fully vaccinated people wear masks indoors when in areas with "substantial" and "high" transmission of Covid-19, which includes nearly two-thirds of all US counties.

New unpublished data showing that vaccinated people infected with the Delta coronavirus variant can have as much virus as those who are unvaccinated is the primary driver for the CDC's latest mask guidance change, a source involved with the decision process told CNN. Overall, vaccinated people still play a small role in transmission and breakthrough infections are rare.

In addition, the source noted two other factors that led to this decision: the prevalence of the Delta variant and low vaccine uptake.

When the CDC previously revised its guidance on May 13 for vaccinated people to unmask, Delta only represented 1% of reported infections. Now, according to the CDC, it represents at least 83% of cases.

The source also noted that the country's overall level of vaccination is lower than what was initially expected and that most transmission is happening in areas with vaccination levels below 40% of the population.

"When you get information about risks and how to mitigate risks, there's a public health obligation to let people know about it," a senior administration official said. The White House is hoping that the new guidance will give local officials "a lot of cover" to implement new mask mandates where appropriate.

Meanwhile, the guidance for unvaccinated people remains the same: continue masking until they are fully vaccinated.

Nearly half -- 46% -- of US counties currently have high transmission and 17% have "substantial" transmission, according to data from the CDC, as of Tuesday morning.

In two states, Arkansas and Louisiana, every county is currently listed as having "high" levels of community transmission of Covid-19, according to CDC data. Several other states -- including Missouri, Mississippi and Alabama -- also have "high" transmission in nearly every county. In Florida, every county was listed with high transmission on Monday; as of Tuesday morning, one -- Glades County -- has substantial transmission.

The CDC's latest guidance also recommends for community leaders to encourage vaccination and mask-wearing to prevent further outbreaks in areas of substantial and high transmission.

The agency recommends that local jurisdictions encourage universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status.

Earlier this month, the CDC's Covid-19 school guidance noted that fully vaccinated people do not need to wear masks, and then about a week later the American Academy of Pediatrics issued stricter guidance recommending that everyone older than 2 wear a mask in schools, regardless of vaccination their status.

Now the updated CDC guidance recommends everyone in schools wear a mask.

The updated CDC guidance makes "excellent sense," Dr. David Weber, professor at the University of North Carolina School of Medicine in Chapel Hill and board member of the Society of Healthcare Epidemiology, told CNN on Tuesday.

"Breakthrough disease clearly occurs, and for those cases, we know they're much more mild in vaccinated people, but we don't know how infectious vaccinated people are," he said. "But clearly, if you want to protect your children under 12 or grandchildren, or protect immunocompromised people, as well as protect your own health -- from even mild disease -- then you should be wearing a mask, particularly in areas of high transmission when indoors."

Guidance has been in talks for days
The last time the CDC updated its mask guidance was two months ago, to say most people who are fully vaccinated could go without masks indoors. That guidance moved so quickly that administration officials were informed less than a day before -- and many public health experts were taken by surprise.

This time, the CDC's updated guidance has been expected for some days now.

As the highly contagious Delta coronavirus variant continues to circulate across the United States, top federal health officials debated whether to issue new guidance on masks, huddling on Sunday night to go over the new data and evidence regarding the transmissibility of the variant and breakthrough cases among vaccinated people, according to a person familiar with the talks.

The CDC emphasized on Tuesday that while some breakthrough cases have occurred, getting vaccinated still prevents severe illness, hospitalization and death. The CDC also noted that the highest spread of Covid-19 cases and severe outcomes is happening in areas with low vaccination rates and among unvaccinated people.

"There are many reasons for getting vaccinated -- keeping you from dying, keeping you from being hospitalized, protecting loved ones, as well as not ending up with permanent symptoms, potentially like loss of sense of smell and taste and confusion that may last for a prolonged period of time," Weber said.

"There are many reasons still to get vaccinated. Even if under certain circumstances, it's recommended you wear your mask," he said. "The CDC and others will be flexible and if we can achieve higher percentages of vaccination and drive the rate of infections back down again, then the recommendation will go back to saying if you're vaccinated, you don't need a mask -- but I don't see that for a substantial period of time."

Oregon Coronavirus Cases

Data is updated nightly.

Cases: 357526

Reported Deaths: 4284
CountyCasesDeaths
Multnomah55810707
Washington38782324
Marion36837455
Clackamas29779309
Lane27744302
Jackson23059310
Deschutes20336125
Umatilla14492150
Linn12911131
Douglas12118243
Josephine9384196
Yamhill8715113
Klamath8020119
Polk737381
Malheur563677
Benton549431
Coos503794
Columbia382644
Jefferson376052
Lincoln319939
Union319549
Crook291846
Wasco288841
Clatsop244328
Baker203529
Tillamook196932
Hood River192837
Morrow185023
Curry180625
Harney113927
Grant100013
Lake93912
Wallowa68612
Gilliam1544
Sherman1523
Wheeler1121
Unassigned00

California Coronavirus Cases

Data is updated nightly.

Cases: 4850807

Reported Deaths: 71341
CountyCasesDeaths
Los Angeles148419226540
Riverside3716705041
San Diego3673614183
San Bernardino3586775692
Orange3242885562
Sacramento1596362309
Kern1463481648
Fresno1463182094
Santa Clara1455431897
Alameda1206921400
San Joaquin1027761721
Ventura1010381167
Contra Costa1000181008
Stanislaus862991335
Tulare80375978
San Francisco54440649
San Mateo54168623
Monterey50911586
Solano46063341
Santa Barbara45223523
Merced42422581
Sonoma40997404
Placer39435429
Imperial36071766
Kings32938325
San Luis Obispo29973333
Madera23955285
Shasta23924352
Butte23818273
Santa Cruz21034221
Yolo20397248
Marin17706244
El Dorado17207149
Sutter13937175
Napa12898100
Yuba1011582
Tehama9534110
Humboldt9269109
Nevada916790
Mendocino766787
Lassen754347
San Benito744972
Tuolumne691790
Lake6631105
Amador547364
Siskiyou451246
Glenn438433
Calaveras391481
Del Norte358742
Colusa307618
Inyo214241
Mono16723
Plumas16607
Mariposa133916
Trinity88011
Modoc6895
Sierra1880
Unassigned1460
Alpine1050
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