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Wearing a mask could turn from a sign of caution to a vulnerability as California reopens

Days away from California’s full economic reopening, there remains one question that has not been fully resolved in the minds of many keen to resume normal life: to hide or not to hide?

As of Tuesday, most California mask rules imposed during the COVID-19 pandemic – covering shoppers’ trips to stores, gyms and restaurants – will disappear for those who are vaccinated.

There is growing evidence of the power of injections to prevent serious illness and direct transmission of the coronavirus, and health officials are increasingly united in their belief that those who are fully vaccinated can safely resume. many activities without wearing a face cover.

Yet, after more than a year of playing it safe, some still plan to wear masks in crowded indoor public places when they can’t be sure everyone around them has been vaccinated. Some public health experts say they will likely still wear masks for these occasions, while others say they feel perfectly comfortable ditching them even in these settings.

The discrepancy is symbolic of a new era that California faces on Tuesday, when people will make their own choices about whether to continue wearing masks, even if they are no longer needed. Although unvaccinated people are still required to mask themselves in most settings, historically there has not been much government enforcement tied to such warrants.

And given the heated debates over masking, authorities are already warning the public against contempt or dirty looks from those who decide to remain masked. Officials say it would be a mistake to start thinking that a face covering indicates a person’s immunization status.

“It’s still very nuanced, and there are people for whom wearing masks still saves their lives,” Los Angeles County Director of Public Health Barbara Ferrer said this week.

As of Tuesday, the state’s scheduled reopening date, California will align with the U.S. Centers for Disease Control and Prevention’s recommendations that fully vaccinated people no longer need to mask themselves – just a few exceptions which include transit centers or on board public transport; in health and long-term care facilities; inside kindergartens through 12th grade, day care centers or other establishments for young people; in homeless shelters, emergency shelters and cooling centers; and in penitentiaries and detention centers.

In contrast, people not yet fully vaccinated will be required to wear masks in businesses and indoor public places, including retail stores, restaurants, theaters and family entertainment centers.

Theoretically, this creates an easy-to-understand standard: fully vaccinated equals no mask.

But in practice, the stepping back state essentially throws the onus on individuals to decide how comfortable they are with throwing off their face coverings, and many places and owners to determine if they should always demand them for the public, or if they want to get in the delicate task of verifying if someone has actually been vaccinated.

Depending on the state, operators can either allow customers to self-certify that they are vaccinated and therefore can enter without wearing a mask, implement some sort of vaccine verification system, or require all customers to wear a mask.

Workplaces themselves will always be governed by standards set by the Occupational Safety and Health Standards Board, which votes on proposals submitted by the California Division of Occupational Safety and Health, or Cal / OSHA. On Wednesday evening, Cal / OSHA officials suggested they would submit proposed new standards next week that should incorporate California’s new mask rules.

But for many, the question of whether to stay masked depends on your level of risk tolerance. For a fully vaccinated person, is it worth it to continue to wear a face cover even if the risk of infection is extremely low?

LA County health worker Dr Muntu Davis said he would likely stick to habits he’s long been used to, such as wearing a mask and keeping a distance in environments interiors or overcrowded.

He’s not the only one: Some experts will continue to wear a mask in a supermarket or in the queue at a cafe for now, saying they prefer to take extra precautions to avoid an extremely rare disease. Others might still mask themselves primarily to make others feel more comfortable.

Davis and other medical experts agree that the immunity provided by the full vaccination is extraordinarily effective in preventing infections and disease, even for the identified coronavirus variants. Of the more than 135 million people in the United States who had been fully vaccinated by June 1, only 0.002% was then hospitalized for COVID-19 and only 0.0004% died, according to CDC data.

And of the 3.3 million people in LA County fully vaccinated as of May 7, only 0.03% subsequently tested positive for the coronavirus, including people who showed no symptoms but tested for. anyway due to the demands of the workplace.

Given all this, not all experts agree that additional caution is needed. Some say they won’t hesitate to go to a store without a mask since they are fully vaccinated, especially in places like LA County and San Francisco, which report extraordinarily low daily rates of coronavirus cases, never seen since the early days of the pandemic.

“As a fully vaccinated individual who lives in a place with the lowest transmission rates in the country… I would feel very comfortable not to be masked wherever it is allowed,” said Dr Monica Gandhi , a contagious from UC San Francisco. disease expert who was among the early proponents of the benefits of masking in the pandemic. “I really mean it, actually: I feel like I’m modeling good behavior to show the effectiveness of vaccines.”

Some officials fear that the choice to mask themselves may become the final battle line drawn in a politically charged and emotionally exhausting pandemic.

LA County Supervisor Janice Hahn has gone so far as to urge the public not to shame, intimidate or give a dirty look to people who continue to wear masks when they are no longer necessary.

State guidelines recognize this as well – indicating that no one can be prevented from wearing a mask as a condition of participating in an activity or entering a business.

“We want to make sure that those who have been vaccinated are protected and supported in their desire to wear a mask, if that is their choice,” said Dr. Mark Ghaly, California secretary of health and human services, on Wednesday.

Some will want to continue wearing masks even if they are fully vaccinated, Ferrer said. These people could include those who have weakened immune systems, are at greater risk of contracting COVID-19, or are parents of children too young to be vaccinated.

Others may simply prefer to wear a mask as additional protection not only against COVID-19, but also against other illnesses like the flu and colds.

Some experts also say that monitoring the local vaccination rate and the daily rate of coronavirus cases would play a role in whether they will hide in indoor public spaces.

UC San Francisco epidemiologist Dr George Rutherford said on Tuesday he probably wouldn’t wear a mask in a supermarket or stand in line at a cafe, say, in San Francisco. The city has averaged just 1.7 new cases of coronavirus per day per 100,000 residents over the past week, and 72% of residents are at least partially vaccinated.

But he might make a different decision if he was in Redding, a town in Shasta County, northern California, where there are 8.4 new cases of coronavirus per day per 100,000 people and where only 36% of inhabitants are at least partially vaccinated.

“If you’re, say, Redding, or somewhere like that, where the immunization levels are really low, and there’s not a lot of buy-in to wearing the mask. [among unvaccinated people] … I might be more inclined in a place like this “to wear a mask,” Rutherford said. “But I am fully vaccinated. I really don’t care that much.

Rutherford might also mask himself in other situations, such as in a movie theater or other crowded indoor location, such as a “mega” event with 5,000 or more people.

“There could be people who are contagious in this space,” he said. “And the more contagious people there are, the more likely you are to see a vaccine failure. “

Such failures are rare, on the order of 1 in 5,000 chance.

“But, you know, I’m 69. I don’t want to be that 1 in 5,000,” Rutherford said. “So I’m going to take a few more precautions. “

It is possible that some companies will choose to continue to require customers to wear masks to enter even if they are fully vaccinated, both to reduce the risk of unvaccinated people breaking the rules and entering without wearing a mask and, potentially, to make customers feel more comfortable.

The LA County Department of Public Health says it’s perfectly reasonable for a company to require all customers to be masked if it will be difficult to determine who is vaccinated or not, at least until the LA County get collective immunity, “which we’re definitely not right now,” Ferrer said.

In Illinois, Michigan, New Mexico, New York and Washington – all of which relaxed mask mandates shortly after new CDC guidelines last month – officials continued to see a decrease in cases coronavirus dailies, she noted. Importantly, all of these states are now reporting that at least 60% of their adult populations have received at least one dose of the vaccine.

In California, more than 71% of adult residents have received at least one dose of the vaccine. In LA County, about 65% of residents aged 16 and over have received at least one injection to date.

“This is promising news. And we hope that with our continued efforts to vaccinate LA County residents, we will also be able to maintain our low case rates once we begin a full reopening, ”Ferrer said.

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