As CDC Holds the Line, Doctors Debate Mask Mandates

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February 10, 2022 — The number of new COVID-19 cases in the United States is down nearly two-thirds from just a few weeks ago, and the drop has sparked heated conversations in the United States about when and if they should stop. the mandates for the use of masks.

On Monday, the governors of four states (Connecticut, Delaware, New Jersey and Oregon) said that end mandatory masking in schools at the end of February or March. Pennsylvania decided to remove its state mandate last month.

In Illinois, Governor JB Pritzker is fighting in court to uphold his mask mandate in schools. New York Governor Kathy Hochul of New York allowed the state’s mask or proof of vaccination mandate for all closed public places to expire Thursday.

Some doctors say that now is the right time and that adults and children have endured the mandates long enough and that the nation needs to get used to living with COVID-19 instead of fighting it every day.

But the CDC disagrees.

At a White House briefing on Wednesday, CDC Director Rochelle Walensky, MD, said the agency still recommends wearing a face covering in public places.

“We’re working to follow the trends at the moment. What I will say though is our hospitalizations are still high, our death rates are still high… While we’re encouraged by current trends, we’re not there yet. ” she said,

Not everyone is on board.

Leana Wen, MD, an emergency medicine physician and professor of public health at George Washington University in Washington, DC, said on Twitter Wednesday that “the CDC needs to change its mandatory school mask guidance, ASAP. Pandemic restrictions were always intended to be temporary: there must be a clear off-ramp that is realistic and takes into account the widespread availability of vaccines for 5+”.

Nicole Saphier, MD, a radiologist and director of breast imaging at Memorial Sloan Kettering in Monmouth, NJ, tweeted“The mask & vaccine mandates are doing far more harm than good. It’s time to ‘let’ anyone who wants to get out of the pandemic do so. I was criticized for saying this when Omicron started. Now, I’m doubling down as millions more have won immunity and has been pushed. “

In an interview, Saphier says that “parents and children have been traumatized by fear-based data manipulation tactics.”

“The bottom line is that there is no good, quality data to show that cloth masks in schools offer any benefit,” he says. low risk in the lowest risk population.

What has changed, he says, “is that a less severe variant is now circulating, and most children have some level of vaccine, natural or combined hybrid.” immunity.”

Amesh Adalja, MD, a senior fellow at the Johns Hopkins Center for Health Security in Baltimore, said schools must have pathways to mitigate COVID-19.

“This is especially the case as more and more people get vaccinated, antivirals become available, and rapid tests become more ubiquitous,” he says. “Children are at the lowest risk of severe illness. In Europe and the UK, school masking is not the norm.”

Adalja says that eventually COVID-19 will be treated like other respiratory infections without specific mitigation measures as people get used to the fact that it “will always be with us and much more tame because of our immunity and medical countermeasures.”

As to whether removing masks now may make it more difficult to re-mask if there is another outbreak in the future, Adalja says: “When the probability of serious illness decreases considerably, due to a high degree of immunity and availability of antivirals, masks are not going to have the same importance.”

“For those who want to wear masks, there’s no stopping them, and one-way masking works,” he says. “There will never be a time when there is not some level of circulation of COVID-19.”

the time is not right

However, other experts agree with the CDC and say it is no time and that abandoning the mandates would be reckless.

Maxine Dexter, MD, Oregon State Representative, tweeted, “I get it (VERY clearly) that people are done with mask mandates. I’m not in control of making a decision about when that will end. What I do know is that I just spent the weekend in the ICU taking care of people. very sick. , most with COVID and more hospitalized. This is not over.”

Mercedes R. Carnethon, MD, of Northwestern University Feinberg School of Medicine, says mask mandates “should not be driven by impatience or politics.”

Rather, he says, the reassessment should be based on metrics, including rates of community spread, the proportion of the community that is vaccinated, and hospital capacity in a given region.

She says the time is not right to remove mask requirements in schools.

“COVID-19 hospitalization rates remain high and our experience over the last 2 months with Omicron shows that it can evade even the protection of our vaccine,” he says. “While most cases are mild, especially in children, the effects are still considerable in members of the community who contract the disease.”

Carnethon noted that vaccination rates are low among children ages 5 to 11 and even among those ages 12 to 17.

“We’re a long way from where we need to be in terms of being able to rely on vaccination alone to stop transmission,” she says.

Stanley Weiss, MD, a professor of biostatistics and epidemiology at the Rutgers School of Public Health in Newark, NJ, says the rush to drop the mask mandate stems in part from pressure on politicians from a public reeling from COVID-19. 19 fatigue and a public frustrated with changing patterns as scientific information evolves.

He says that the decision must be based on science and that science says it is too soon to end the mandates.

“There’s a hopeful thought that it’s gone, when that’s clearly not true,” Weiss said. “In places like New Jersey, new cases have gone down, but the number of clusters of cases in schools hasn’t gone down yet.”

Lindsay Kalter contributed additional reporting to this story.

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