The CDC’s new masking rules don’t mean you can unmask just yet

On Thursday, the Centers for Disease Control and Prevention issued huge news: If you’ve been fully vaccinated, you can stop wearing a mask. Now, health experts are expressing concern about the new rule and telling Americans to proceed with caution.

The CDC’s new guidelines come with a few caveats. Americans must follow the rules of local businesses and mask up on planes, trains, buses, and other transit. But for the most part, vaccinated people can go back to the way they lived life before the pandemic. What these broad recommendations don’t account for, health experts say, is how much COVID-19 is spreading in a given community versus how many people are vaccinated.

I remain concerned that we will see summer surges in states with low vaccine rates… but again, those states were largely unmasked to begin with. ?????????????????????

But – at some point, people can do unsafe things ***as long as*** it doesn’t endanger the rest of us.

— Megan Ranney MD MPH ???? (@meganranney) May 14, 2021

The problem is the way the recommendation bifurcates Americans into two health statuses: vaccinated and unvaccinated. There are people who do not want to get vaccinated and the new guideline may alienate unvaccinated Americans. The hope is that the recommendation will incentivize unvaccinated Americans to get vaccinated. But that may not be the way it works out.

“These guidelines rely on unvaccinated people to keep masking, and to be forthcoming about that status,” writes pediatrician Daniel Summers, in an opinion piece for The Daily Beast. “If you believe the same people who think Naomi Wolf is making good sense about the vaccines are going to cough up the truth to a maître d’ before taking their seat at a restaurant, please see me about a hot new purchase opportunity for shares in a diamond mine.”

Doctors and health experts are worried there may be COVID-19 case spikes in areas with low vaccine rates and higher case numbers. In those regions, it may be wise for vaccinated residents to continue wearing a mask. Of course, they don’t have to. Data shows that the vaccines are effective at preventing severe disease, reducing symptomatic disease, and curbing transmission.

Right now, there is no way to truly confirm someone’s vaccination status. The U.S. operates almost entirely on a honor code system. Earlier this year, the White House decided against launching a national vaccine credentialing system. That may be in part because it would have required a major shift in national health policy. As JP Pollak, cofounder and chief architect of the Commons Project, told me in April, “states have the mandate for maintaining vaccination registries and states are required to report things like how many people have been vaccinated for COVID-19, but they actually are not permitted to transmit the personal information of people back to the CDC.”

What it means is that vaccine credentialing of any kind has to be done by the states. Some states, like New York, have debuted apps that capture both COVID-19 testing results and vaccine status. However they are not required and they are not universal, making them somewhat useless. After all, in 18 states these so-called vaccine passports are banned. Online, scammers are already selling fake vaccine credentials to help people who don’t want to get vaccinated conceal their status.

As more people go unmasked, whether vaccinated or not, there will be ramifications for two groups of people: children and workers in restaurants and retail. If COVID-19 cases rise in areas with low vaccinations rates, children in those regions may be at risk of contracting COVID-19. While children 12 and older are eligible to get vaccinated, only a small portion of parents seem to want to vaccinate their kids, according to a recent Kaiser Family Foundation survey. Also, as Summers notes, the vaccine has not been authorized for younger kids and may not be for some time as those clinical trials will take time to complete.

As for workers, the United Food and Commercial Workers (UFCW) says the CDC’s guidelines put them in an awkward position within a contentious issue. “While we all share the desire to return to a mask-free normal, today’s CDC guidance is confusing and fails to consider how it will impact essential workers who face frequent exposure to individuals who are not vaccinated and refuse to wear masks,” the organization said in a statement. “Millions of Americans are doing the right thing and getting vaccinated, but essential workers are still forced to play mask police for shoppers who are unvaccinated and refuse to follow local COVID safety measures. Are they now supposed to become the vaccination police?”

Dr. Megan Ranney, an emergency room doctor and public health expert, tweets that for now, she’s going to keep wearing a mask in public places that are indoors. She’ll take off that mask inside when the majority of people in her area are vaccinated, when COVID-19 cases are low, and when her family is fully vaccinated.