This week, as the delta variant has spread, we’ve gotten new advice from the Centers for Disease Control, the Massachusetts Department of Public Health and the Massachusetts Department of Elementary and Secondary Education. I’m personally going with the stronger CDC advice.
New general advisory from DPH (July 30)
Today, in response to the emerging evidence of about the infectiousness of the Delta variant of the COVID virus, the Massachusetts Department of Public Health issued a new mask advisory. Masks remain mandatory in certain locations where risks of transmission are higher (including public transportation) and are newly advised in some additional circumstances. The mask rules page on the state’s website now includes the following summary.
The Department of Public Health has issued a new mask advisory in light of the Centers for Disease Control and Prevention’s updated guidance. Fully vaccinated individuals are advised to wear a mask or face covering when indoors (and not in your own home) if you have a weakened immune system, or if you are at increased risk for severe disease because of your age or an underlying medical condition, or if someone in your household has a weakened immune system, is at increased risk for severe disease, or is an unvaccinated adult. Masks are still mandatory for all individuals on public and private transportation systems (including rideshares, livery, taxi, ferries, MBTA, Commuter Rail and transportation stations), in healthcare facilities and in other settings hosting vulnerable populations, such as congregate care settings. For full details, see this statement from DPH.
Fall school opening guidance from DESE (July 30)
Today, the Massachusetts Department of Elementary and Secondary Education, working with the Department of Public Health issued health guidance for schools in the fall. The full guidance appears here. The following are highlights.
- All schools shall be open for in person learning 5 days per week.
- “Strongly recommend” that all students in kindergarten through grade 6 wear masks when indoors, except students who cannot do so due to medical conditions or behavioral needs. Masks are not necessary outdoors and may be removed while eating indoors.
- “Strongly recommend” that unvaccinated staff in all grades, unvaccinated students in grades 7 and above, and unvaccinated visitors wear masks indoors, in alignment with the statewide advisory on masking.
- Schools “Highly encouraged” to maintain or establish a robust plan for COVID-19 testing in schools, including both diagnostic testing and screening (pooled) testing for students and staff
CDC Guidance updates (July 27)
On July 27, the CDC strengthened their guidance for fully vaccinated people. The full guidance statement appears here and the bullets below are excerpted from that guidance.
- Fully vaccinated people should wear a mask in public indoor settings in areas of substantial or high transmission.
- Fully vaccinated people might choose to wear a mask regardless of the level of transmission, particularly if they are immunocompromised or at increased risk for severe disease from COVID-19, or if they have someone in their household who is immunocompromised, at increased risk of severe disease or not fully vaccinated.
Additionally, CDC recommends universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status.
Some comments from me
- The advice is likely to continue to change. The medical understanding of the Delta variant is evolving. Emerging advice is based on weak consensus in conditions of uncertainty.
- The CDC advice is stronger than both the DPH and DESE advice. Personally, I plan to follow the CDC advice. Official advice is always a compromise and one hears compromise even in the language of the CDC advice — “Fully vaccinated people might choose . . ..” Just guessing, but it appears that some of the people in the CDC’s guidance development process were pushing for even stronger guidelines. The most responsible approach would be to generally wear masks when you are indoors outside the home and are not eating. That would mean universal masking in schools.
- Clearly DPH and DESE are choosing their own compromises in taking a softer position than the CDC. It is worth remembering that (a) the guidelines are designed to protect others as well as yourself; (b) medical advice always incorporates an implicit risk/return tradeoff. It is signals lack of concern for the possible health risks of others to not follow the DPH/DESE masking guidelines, but it is reasonable for people and communities to decide to go further than the DPH/DESE guidelines and even the CDC guidelines.
- Almost everyone reading this post is already vaccinated, but if not . . . please get vaccinated!