Joe Biden. REUTERS/Brian Snyder
Joe Biden. REUTERS/Brian Snyder

Fully vaccinated Americans can now go without masks outdoors except in crowded settings

By The Washington Post Time of article published Apr 27, 2021

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WASHINGTON - Federal health officials said on Tuesday that fully vaccinated Americans can go without masks when walking, jogging or biking outdoors, or dining with friends at outdoor restaurants.

President Joe Biden celebrated the change in later remarks, urging people to get inoculated not just to protect themselves and those around them but so they can live more normally, by "getting together with friends, going to the park for a picnic without needing a mask."

The guidance from the Centers for Disease Control and Prevention addresses growing calls from infectious-disease and other public-health experts to relax mask mandates for the outdoors because breezes disperse airborne virus particles, distancing is easier, and humidity and sunlight render the coronavirus less viable.

For that reason, the guidance also says even unvaccinated individuals may go without masks when walking, jogging or biking outdoors with household members. However, officials caution that crowded outdoor settings still pose risks, and they urge everyone - vaccinated and unvaccinated individuals - to wear masks when attending sporting events, live performances and parades.

The recommendations come as more than 52% of eligible people in the United States have gotten at least one shot, but vaccine supply has begun to outstrip demand.

The guidance is aimed at helping the fully inoculated ease back into daily routines upended by the pandemic while encouraging others to get their shots to counter highly contagious new variants. States and localities across the country are opening walk-in clinics to make it easier for people to get vaccines.

"Over the past year, we have spent a lot of time telling Americans what they cannot do, what they should not do," CDC Director Rochelle Walensky said at a White House briefing. "Today, I'm going to tell you some of the things you can do if you are fully vaccinated."

A growing body of evidence suggests that fully vaccinated people are less likely to have asymptomatic infections or transmit the coronavirus to others. Officials do not know how long protection lasts and how much the vaccines protect against emerging virus variants.

But "taking steps toward relaxing certain measures for vaccinated people may help improve coronavirus vaccine acceptance and uptake," the guidance states. "Therefore, there are several activities that fully vaccinated people can resume now, at low risk to themselves, while being mindful of the potential risk of transmitting the disease to others."

Last month, the CDC told pandemic-weary Americans who were fully vaccinated that they could gather indoors with other fully vaccinated people without wearing masks, and could visit indoors with unvaccinated people under some conditions.

The guidance released Tuesday includes a color-coded chart that shows activities that fully vaccinated and unvaccinated people can do indoors and outdoors, and which ones can be done without masks. The safest activities, highlighted in green, are outdoors in small gatherings. Activities with the greatest risk are indoor settings that involve behaviors such as singing, shouting, heavy breathing, inability to wear a mask or inability to maintain physical distancing, such as indoor high-intensity exercise class.

The agency also provided additional clarifications and new guidance for fully vaccinated people in relation to working, quarantining and testing. Fully vaccinated workers no longer need to isolate after an exposure, as long as they do not have symptoms. Fully vaccinated residents of congregate settings outside health care no longer need to quarantine after a known exposure. And fully vaccinated people without symptoms or exposure may be exempted from routine screening tests - a change of enormous significance for schools trying to plan for summer school and fall reopenings.

The nearly 96 million Americans who are fully vaccinated can now forgo masks for many outdoor activities, including:

- Walking, running, hiking or biking outdoors alone or with members of your household

- Attending a small outdoor gathering with fully vaccinated family members and friends

- Attending a small outdoor gathering with a mix of fully vaccinated and unvaccinated people

- Dining at an outdoor restaurant with friends from multiple households.

Officials say some conditions increase risk: crowding, time spent, lack of ventilation and high community transmission. That's why the CDC is recommending that it is safest for fully vaccinated people to continue to wear well-fitted masks in these outdoor and indoor settings including:

- Attending a crowded outdoor event, such as a live performance, parade or sporting event

- Visit to a barber or hair salon

- Going to an uncrowded indoor shopping mall or museum

- Going to an indoor movie theater

- Attending a full-capacity service at a house of worship

- Singing in an indoor choir

"The examples today show that when you are fully vaccinated, you can return to many activities safely . . . and begin to get back to normal," Walensky said. "And the more people who are vaccinated, the more steps we can take towards spending time with people we love, doing the things we love to enjoy. I hope this message is encouraging for you. It shows just how powerful these vaccines are."

Walensky cited several factors that motivated the change in guidance: Coronavirus case rates are starting to decrease, and vaccinations are continuing to climb (more than 37% of those over 18 are fully vaccinated), making outdoor settings safer than before.

Indoor settings have an almost 20-fold increased risk of transmission compared to outdoor ones, she noted.

If more people continue to get inoculated and cases drop further, the CDC will release additional guidance for people who are fully vaccinated, she said.

Asked how she would describe the pandemic situation now compared to last month when she spoke of a feeling of "impending doom" as case counts soared, Walensky said that if the United States follows measures taken by other countries where "vaccinations continue to soar and the cases plummet, that we should be in good shape."

For states that have mask requirements outdoors, Walensky said the CDC says it is no longer necessary for fully vaccinated to wear masks unless they are in crowded outdoor venues, such as stadiums and concerts, where it is hard to know who is vaccinated and who is not.

Monica Gandhi, an infectious-diseases expert at the University of California at San Francisco, applauded the CDC's action after saying accumulating evidence shows the low risk of outdoor transmission.

"Viral particles disperse effectively in the outside air," she said in an email, citing numerous studies, including one in Wuhan, China, that found that one of 7,324 infection events investigated was linked to outdoor transmission.

Gandhi noted that the World Health Organization says masks are not necessary outside unless physical distancing, which the agency defines as about three feet, cannot be maintained.

She and others have said it's important for public health officials to provide incentives as "a great strategy to encourage those who are on the fence to get vaccinated." "Public health messaging since the time of HIV that focuses on positive, rather than negative, reinforcement has been shown to be more effective, so the CDC guidelines that vaccinated people don't have to mask outdoors will hopefully help persuade some of the vaccine hesitant in the U.S. to get the vaccine," Gandhi said.

The CDC guidance said there is limited data on vaccine protection in people who are immunocompromised. It urges people taking immunosuppressive medications to discuss the need for personal protective measures with their health-care providers, even if they are fully vaccinated.

Even before the CDC's announcement, a number of states were moving to ease mask mandates: Kentucky Gov. Andy Beshear, a Democrat, on Monday cleared groups of fewer than 1,000 to gather outside without masks.

Massachusetts Gov. Charlie Baker, a Republican, on Tuesday said his state's rule requiring masks outdoors would expire Friday, except in situations where social distancing is impossible.

The issue has become more politically charged recently as conservative media figures have used their platforms online and on cable news to turn outdoor masking rules into a cause celebre.

Fox News host Tucker Carlson urged viewers this week to contact child protective services to report the parents of children seen masked outdoors.

"Your response when you see children wearing masks as they play should be no different from your response to seeing someone beat a kid in Walmart," he said on his show, which is among the most watched on cable, regularly drawing 3 million viewers.

"Call the police immediately, contact child protective services. Keep calling until someone arrives."

His instructions were echoed Wednesday morning by Molly Hemingway, a senior editor at The Federalist, a conservative publication. She tweeted: "Even if you're an outdoor mask enthusiast at this late date, despite the complete lack of scientific support for same, I think we all can agree that masking children outdoors, at the very least, is abusive, right?"

The comments illustrate how face coverings, scorned by former president Donald Trump, remain a marker of political identity more than a year into the pandemic.

The Washington Post

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