When is it really safe to take off your mask in California?

When is it really safe to take off your mask?

This question is becoming increasingly urgent as the Omicron wave crumbles and coronavirus rules ease. A growing number of states and counties are relaxing the rules, some much faster than others.

Here’s what we know:

Caution is advised even if the rules change

Even though California’s statewide mask order is set to expire next week, a top state health official is still encouraging people to wear masks as transmission rates rise.

“We always recommend it while rates are high, and certainly in indoor settings, crowded indoor settings – especially if you don’t know people’s vaccination status,” said Dr. Erica Pan, epidemiologist at State and deputy director of the State Center for Infectious Diseases, said during a briefing at the California Medical Assn.

Pan’s comments are in line with recommendations from the US Centers for Disease Control and Prevention, which suggest that vaccinated people always wear a mask in indoor public places when local transmission levels are “high” or “substantial”, the CDC’s two worst categories. four-tier system, colored red and orange on agency maps.

Geographical differences

Virtually all counties in California remain at ‘high’ coronavirus transmission levels, and some will continue local mask mandates even as the state’s two-month order expires, citing ongoing high transmission rates .

Most California counties are still experiencing “high” coronavirus transmission, the worst level as described in the US Centers for Disease Control and Prevention’s four-tier scale.

(US Centers for Disease Control and Prevention)

LA County health officials have set a goal to lift an indoor mask mandate when it reaches “moderate” transmission of the coronavirus for two consecutive weeks or when eight weeks have passed since children in less than 5 years old can have access to the vaccine, thresholds which should be met either in March or in April.

Other counties without local mask orders are on track to end mask mandates for those vaccinated in indoor public places starting February 16, including San Diego, Orange, Riverside and San Bernardino counties.

Unlike some of its neighbors, LA County is maintaining its rule that residents wear masks in indoor public spaces whether or not they have been vaccinated.

“I will say, unequivocally, that we should not lift the masking mandate when we are reporting thousands and thousands of new cases every day,” Los Angeles County Public Health Director Barbara said this week. Shoe. “That doesn’t make sense to us here at public health.”

Ferrer said she’s confident LA County will end its indoor mask mandate in a few months, as long as there are no concerning new variants in circulation that threaten vaccine effectiveness.

“From my perspective, there’s no way this is a ‘forever,'” she said. “It has an end point. If nothing else, it’s eight weeks after an early childhood vaccine was approved, but I think we’re going to get there much faster if we continue the decline. The problem is that the decline continues if the safeguards are in place to really help us limit transmission. And when we remove a lot of them, as we’ve seen in the past, we tend to see our numbers go up.

Some counties in California are beginning to repeal vaccination mandates to enter certain businesses. Contra Costa County said Friday it was lifting its vaccine or testing requirement for patrons of indoor restaurants, bars and gyms. Health officials in the Bay Area’s third-most populous county said the easing of the mandate, which has been in place since August, comes now that 80% of residents are fully vaccinated and 2 out of 5 residents have received a booster injection. By contrast, in Los Angeles County, 69% of residents are fully vaccinated and 1 in 3 residents have received a booster.

Debate to go faster

Some elected officials have expressed frustration that LA County’s indoor mask rules aren’t as lenient as the state’s.

“The state has public health experts advising the governor as well, and I think the recommendation to lift this mandate is also based on public health,” LA County Supervisor Kathryn Barger said. “And so I just find it very frustrating that, again, we’re the most restrictive.”

But a majority of supervisors supported Ferrer’s approach.

“It’s pretty clear to me that we still need to have people wearing masks,” said supervisor Hilda Solis, whose eastern district of LA County has been hit hard by the pandemic.

Supervisor Sheila Kuehl said extending the order until cases drop further will help protect frontline workers from customers without masks indoors.

“We have been wearing masks for two years now. I think we can probably do it for another month or two,” Kuehl said. “I support the very thoughtful approach that Dr. Ferrer presented, because it takes into account actual data from Los Angeles County – not what Sacramento thinks is some kind of fixed figure or approach for the whole of the state.”

Meanwhile, several states outside of California, including New York, New Jersey and Delaware, are moving to relax indoor masking rules — some even in schools — though CDC Director the Dr. Rochelle Walensky, said her agency’s guidelines had not yet changed.

The CDC still recommends masking in indoor public places in areas where community transmission of coronaviruses is considered “high” or “substantial,” the two worst categories on the agency’s four-tier scale. As of Wednesday morning, virtually the entire country fell under one of those two classifications, including all of California.

“We are of course looking at this closely in real time, and we are evaluating transmission rates as well as serious outcome rates as we consider updating and revising our guidelines,” Walensky said during a briefing.

However, she added, “we have always said that these decisions will have to be made at the local level, and the policies at the local level will look at the local cases; they will examine how local hospitals operate; they will look at local vaccination rates.

“I’m really encouraged that cases continue to drop dramatically, hospitalizations continue to drop dramatically as people make these decisions and we work through our guidance,” she said.

Masks provide protection

The California Department of Public Health has called the state’s temporary mask mandate essential to prevent the state’s winter surge from getting worse. The action “has been an important tool in reducing community transmission during Omicron’s highly contagious outbreak,” the officials wrote in a note this week.

“The current hospital census is still overcapacity, but the dramatic increase in cases and hospitalizations due to the highly infectious variant of Omicron over the past two months has declined significantly,” the memo reads. “California are also becoming more knowledgeable about how to protect themselves and their loved ones with effective masks when there may be a risk of exposure to COVID-19.”

Even a 10% increase in mask wearing can have an outsized effect on reducing coronavirus transmission, tripling the likelihood of slowing the spread of the virus, the memo says.

Although the Omicron variant did not result in hospital illness for many infected people, the enormity of this surge still led hospitals to face severe strain – far worse than in pre- pandemic. Even now, hospitals are still being forced to postpone scheduled procedures.

Omicron’s surge “has always put our hospitals on the brink,” Pan said. ‘It’s really, really stretched our hospitals and again they’re getting better…but it’s still way over the top [a baseline] and quite stretched – with less staff than we had in previous surges.

The San Joaquin Valley is still particularly hard hit, state data shows, with 44% of adult intensive care unit beds filled with coronavirus-positive patients, well above the 34% rate nationwide. of State. In the San Joaquin Valley, only 10% of staffed adult intensive care beds are available.

COVID-19 remains far more deadly than the flu. In one of California’s worst recent flu seasons, during the winter of 2017-2018, influenza accounted for 5% of all causes of death; in recent pandemic outbreaks, COVID-19 has accounted for between 15% and 45% of all causes of death.

So even with Omicron being relatively less severe than previous strains, “we still haven’t returned to more flu-like levels of severity,” Pan said.

High alert for the unvaccinated

Vaccinating and stimulating more people remains a top priority, Pan said. Unvaccinated people are 30 times more likely to die from COVID-19 and 15 times more likely to be hospitalized than vaccinated people who have received their booster.

But further progress can still be made, she said. Only 55% of vaccinated people eligible for a booster received one, while 72% of vaccinated eligible seniors did.

Children aged 5 to 11 are particularly vulnerable. Only a third of children in this age group are vaccinated with at least one dose of vaccine; in comparison, more than 7 in 10 adolescents aged 12 to 17 have received at least one injection.

Although COVID-19 is generally less severe in children than in adults, the disease is still worrisome for children, Pan said. COVID-19 causes four times more deaths nationwide than influenza; for unvaccinated adolescents, COVID-19 poses an 11 times greater risk of hospitalization.

Children aged 5 to 11 in the poorest neighborhoods are the least likely to be vaccinated – only 1 in 5 of them are, compared to more than 3 in the wealthiest neighborhoods, Pan said.

Children are also at risk for a rare but serious complication associated with COVID-19 known as multisystem inflammatory syndrome in children, which has been reported in more than 800 children in California, half of whom had no condition. underlying. Half of the reported cases of MIS-C required intensive care and eight children died from this syndrome.

Cases of MIS-C are seen disproportionately among children in California’s poorest neighborhoods, according to Pan, and disproportionately among black and Latino children. In adolescents and adolescents 12-17 years old, nearly 90% of MIS-C cases recorded in recent times have been in unvaccinated patients.

California has recorded 51 COVID-19 deaths in children up to age 17; they include 12 infant deaths.

Los Angeles Times

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