This post was originally published on this site
Despite hopes of a summer free from Covid-19 worry, the Centers for Disease Control and Prevention is now recommending that vaccinated people wear masks in certain areas. While masks are important for protecting against infections, the United States must proceed carefully.
Health officials spent months assuring vaccinated Americans that they didn’t need to mask up against Covid-19 because they were protected from illness and were unlikely to spread infections to others. A return to masking for everyone could be interpreted as moving the goal posts or as a signal that experts are no longer as confident as they were in the vaccines — especially if new masking rules are not tied to specific metrics like vaccinations or if masking rules are in effect in places where hospitals are not dealing with crisis-level admissions.
There is a better way to carry out masking recommendations, by closely linking them to three specific factors:
Is Covid-19 spreading in areas where mask mandates are in effect?
Requiring everyone to wear masks may seem as if it can’t hurt, but experts shouldn’t waste time and credibility enforcing measures if they won’t have an impact.
Bringing back masks for everyone will be most effective if a significant amount of Covid-19 transmission is occurring in public spaces like grocery stores and dance clubs. But health officials haven’t shared sufficient data showing this is the case, and that’s a problem.
State and local health agencies need to have a better understanding of which activities are driving local transmission and tailor policy accordingly. For example, earlier in the pandemic, contact tracing revealed that high levels of transmission were happening at family and friend gatherings in people’s homes — like for holidays and birthdays — where masks are less common. If this remains true, then mask mandates alone will not be enough to cut back on rising cases.
Also earlier in the pandemic, case control studies — which look for differences in behaviors between people who catch Covid-19 and people who haven’t been infected — found that people diagnosed with Covid-19 were more likely to have reported dining at restaurants than uninfected people. If this remains the case, then other measures like limiting occupancy at restaurants and bars might need to be considered in addition to masking, since diners can’t wear masks while eating or drinking.
Genetic sequencing can also help provide clues as to how the coronavirus is spreading. With the increase in resources provided by the Biden administration to enable state agencies to use genetic sequencing to track variants, health agencies should embrace this technology as much as possible to identify large clusters of cases that share transmission patterns.
Do local disease and vaccination rates support mask wearing by vaccinated people?
The C.D.C. recommends that vaccinated people wear masks in areas “of substantial or high transmission” of Covid-19 to avoid getting infected and possibly spreading the virus to others.
To know exactly where those areas are, it’s important to look at local conditions. But in the past few months, most states have scaled back on the amount and frequency of Covid data they share with the public.
For example, Florida, which last week accounted for more than 20 percent of Covid-19 cases reported in the United States, has reduced its case reporting to once a week and no longer shares testing data or deaths broken down by county. The C.D.C. has a map that shows a summary of Covid-19 data for the nation, but it is less detailed than what states have typically reported.
At this stage of the pandemic, state and local governments should present more data, not less. At a minimum, they should publish the frequency and demographic breakdown of cases, tests, hospitalizations and deaths, as well as vaccinations. And they should do so daily.
County-level data is useful, but ZIP code or census tract level data is even better. Los Angeles County, for example, has been able to vaccinate more than 70 percent of eligible adults, but this statistic hides the fact that some parts of the county have much lower vaccination coverage. Highly localized data will help people understand the specific risks where they live and work and the need for mask recommendations more clearly.
At the same time, health officials should continue to provide data that shows the benefits of vaccines. Without it, experts might inadvertently send the signal that masks are a suitable alternative to getting a vaccine. Breakdowns of cases and hospitalizations by vaccination status should be regularly reported. This will also help experts monitor how well the vaccines are continuing to prevent severe illness.
When can masks come off?
Local experts should provide people with metrics they are using — like infections or vaccinations — to decide when masks will no longer be needed. Doing so underscores why the masks are back in the first place and provides hope for those who don’t like to wear them.
Since vaccines offer durable protection against serious illness, tying masking requirements to reasonable vaccination coverage goals and acceptable hospitalizations levels will provide a clearer view of progress than case numbers, which can fluctuate.
Everyone is weary of the pandemic. Vaccines offer the way out, but the United States has not convinced enough Americans of this. The nation cannot simply revert to the broad tactics employed during previous surges and expect compliance. It must be made explicitly clear to the public how measures like mask mandates will cut transmission and can be used to incentivize vaccinations.
Jennifer B. Nuzzo (@JenniferNuzzo) is an epidemiologist at the Johns Hopkins Bloomberg School of Public Health and a senior fellow for global health at the Council on Foreign Relations. Beth Blauer (@biblauer) is the associate vice provost for public sector innovation and the executive director of the Centers for Civic Impact at Johns Hopkins University. They are on the leadership team of the Johns Hopkins Coronavirus Resource Center.
The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.
Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.