• Tue. Nov 29th, 2022

A message from The Center for Closing the Health Gap

By Clyde E. Henderson, MD

Cincinnati Medical Association

Faced with a population increasingly discarding masks in spite of an ongoing pandemic, the CDC changed the criterion used to determine the conditions under which masking should be continued. The CDC’s July 2021 transmission-prevention guidance measures were based on the percentage of the previous week’s positive test combined with the rate of new COVID-19 cases. Under those criteria 95% of our nation’s 3,200 counties still remain in the “substantial” or “high” transmission categories. According to the old criteria all of those Americans were supposed to be wearing masks in public. This was not happening, and governmental mandates have fallen to social and political pressure. Cases, hospitalizations, and deaths are continuing to recede from their recent highs, so the CDC (February 25, 2022) is now taking a different approach. This new criterion is based on the degree of strain on the hospital system as measured by the percentage of Covid-19 patients occupying beds and the rate of new cases in the community (county).

There is now information on the CDC website which tracks every county is the USA and determines its status  https://www.cdc.gov/coronavirus/2019-ncov/science/community-levels.html.

Counties are categorized as being LOW (green), MEDIUM (yellow), or HIGH (orange). Under this new system 70% of the counties in the US are in the low or medium categories. Residents of these counties can stop wearing masks in indoor public places, for now. The decision to get rid of the mask needs to be tempered by an individual’s own risk analysis which includes vaccination (booster) status and his/her preexisting health conditions.  The well fitted mask should still be worn if a person is having symptoms, has been exposed to someone with COVID-19, or tested positive. The federal government has maintained the masking requirement on public transportation (planes, trains, and buses) and indoors at bus and train stations, as well as airports.

The specific transmission risk of the Greater Cincinnati Area is as follows: Hamilton, Butler, Warren, and Clermont Counties in Ohio are all at MEDIUM level, along with Dearborn County, Indiana; Campbell, Boone and Kenton counties in Kentucky are all still at HIGH COVID-19 Community levels. Under the CDC new guidelines this means that when in these Northern Kentucky counties, which are part of the Cincinnati area, a well fitted mask is still “recommended when indoors in public regardless of vaccination status (including K-12 schools and other indoor community settings).” If you are in these areas, the same precautions of avoiding crowds, wearing a respirator mask (KN-95, N-95, or KF-94) pertain if you are immunocompromised or at high-risk for severe disease. Testing and home testing remain valuable tools in HIGH level areas as well. Persons at high-risk for severe disease need to be protected so those around them in HIGH level areas should wear masks and the same even if in a MEDIUM level area. Testing remains essential, regardless of community level, if one is symptomatic.

The new criterion provides plausible cover for giving people a break from masking, particularly since they were not being worn consistently. We must clearly acknowledge that our country is indeed in a better place than last July.  This is due to the immunity inferred to the 64.9% of Americans who have been fully vaccinated combined with the incomplete immunity for the partially vaccinated.  Additionally, there is immunity, albeit waning, imparted to the tens of millions of US citizens who have been infected by COVID-19. These immunities give the CDC justifiable rationale for changing the measuring sticks. Hopefully, our weariness and fatigue will be sufficiently relieved by this break from masking so that we are willing to “mask up” if these new indicators show our healthcare system about to be overrun.  With this new tool from the CDC, you can become aware of the risk you face in your community and then decide when you will wear a mask.

One might still wonder why I said “for now” a couple of paragraphs ago. This is because we are likely to face new variants and sub-variants more contagious than both the Omicron and “stealth” subvariant (BA.2). These anticipated new strains are likely to result in more counties reaching the HIGH community levels in the future. Keep your masks handy, this pandemic is not over!