Rather than stick to CDC guidance, officials in largely coastal states reviewed case counts, hospitalization rates
by Brianna Abbott and Jon Kamp, The Wall Street Journal, February 12, 2022
States rolling back mask mandates are relying on their own assessment of the pandemic’s trajectory, not just federal government scientists, as they rethink Covid-19 guidelines with the Omicron wave in retreat.
“I feel that now is the appropriate time to move forward,” Nevada Gov. Steve Sisolak, a Democrat, said Thursday while announcing the end of the state’s mask mandate for indoor public spaces. Businesses, organizations and school districts can enact their own policies, he said.
The governor cited rapidly dropping case and hospitalization rates as well as shrinking virus levels found in wastewater. A spokeswoman said the state didn’t rely on specific thresholds. Mr. Sisolak also said that the broader availability of Covid-19 vaccines, testing and treatment influenced his decision. The governor said he plans to continue to wear a mask in some situations, including when visiting his mother, to protect other Nevadans.
Nevada and other states that relaxed guidelines this week aren’t relying on the Centers for Disease Control and Prevention’s guidelines for when people should wear masks in indoor public places. Those guidelines are pegged to one of two metrics: a seven-day moving average of cases greater than 50 per 100,000 residents, or a high percentage of tests coming back positive. With Omicron-fueled cases still at high levels, more than 99% of U.S. counties meet metrics under which the CDC advises indoor public masking.
The CDC has said it is reassessing its guidance. CDC Director Rochelle Walensky said Wednesday that such decisions are often made at the state and community level but that the agency still recommends masking in areas with substantial and high transmission.
“We’ve always said that these decisions are going to have to be made at the local level and that policies at the local level will look at local cases. They’ll look at how local hospitals are doing, they’ll look at local vaccination rates,” Dr. Walensky said.
The fact that a smaller percentage of Omicron cases have led to serious outcomes compared with the Delta wave has fueled calls to use metrics other than cases, like hospitalizations, emergency-department visits or wastewater, to help guide virus-mitigation policies.
“Individual case counts are important, but they’re not telling the complete story,” said Janet Hamilton, executive director at the Council of State and Territorial Epidemiologists. Covid-19 vaccinations have also meant that more cases during this surge are milder, and the boom in at-home rapid testing has led to an even further underreporting of cases, she said.
Some public-health experts say states should proceed cautiously or wait in pulling back measures for fear of drawing out the Omicron wave recovery. While new-case and hospitalization counts have plummeted, the U.S. is still adding about 186,000 cases each day, Johns Hopkins data show. Deaths are averaging about 2,400 a day.
“I’m not saying we need to get to zero,” said Justin Lessler, an epidemiologist at the Gillings School of Global Public Health at the University of North Carolina. “I do think it’s worth having things under control, whatever your metric.”
Meanwhile, in addition to Nevada, Oregon, Rhode Island, Delaware, Connecticut, New Jersey and Massachusetts announced plans, effective on various dates, to lift statewide mandates requiring masks in schools. New York, California and Illinois lifted, or said they would end, indoor mask mandates.
The states represent roughly one-third of the U.S. population and maintained protective measures through the worst of the recent Omicron wave. Most, beyond Nevada, have vaccination rates above the national level of 64.3% for people who have received two mRNA shots or a single-dose inoculation. More than 35 states don’t have masking requirements, according to the National Academy for State Health Policy. Some, largely Republican-led states, don’t allow local officials or school districts to impose such measures.
The states dialing back mask requirements largely said the moves were fueled by an array of positive signs. New York cited declines in cases, the rate of positive tests, hospitalizations, cases per 100,000 people and hospital admissions. The state also cited rising levels of vaccines and boosters and hospital capacity. New York’s seven-day average for new cases has tumbled 93% from its Omicron peak, Johns Hopkins University data show, while the average for confirmed and suspected Covid-19 hospitalizations has fallen about 59%, according to federal data.
“We’re not done, but this is trending in a very, very good direction,” Gov. Kathy Hochul said.
New York’s school mask mandate is still in place, and some state lawmakers and school leaders are calling for the state to use specific metrics when modifying that policy. Ms. Hochul said the state would assess the school mask policy in early March based on a variety of data, including global trends and pediatric hospitalizations.
Massachusetts officials cited a variety of positive trends as the basis for their decision to lift a statewide school mask mandate at the end of February. Among other indicators, the state has one of the nation’s highest childhood vaccination rates, state officials said.
Boston will keep its mask mandate in place beyond Feb. 28, Mayor Michelle Wu said Thursday. Before removing that requirement, the Boston Public Health Commission is waiting to reach benchmarks including: fewer than 95% occupancy of hospital intensive-care beds; fewer than 200 Covid-19 hospitalizations a day; and a seven-day average showing the community positivity rate on Covid-19 tests is below 5%.
“Additionally there needs to be several weeks of downward trends,” to consider lifting the mandate, Ms. Wu said.
Oregon plans on removing its indoor public mask requirements no later than March 31, according to the state’s health authority, because researchers there estimate there would be 400 or fewer Covid-19 hospitalizations in the state at that time. There are still more than 900 hospitalized patients with Covid-19 in the state, and more than nine in 10 ICU and acute-care beds are occupied, straining medical staff.
“If we can maintain our vigilance over the next two months, we can all look forward to a spring and summer season in Oregon free of daily impacts from the pandemic,” said Dean Sidelinger, health officer and state epidemiologist for the Oregon Public Health Division.
—Jimmy Vielkind contributed to this article.