WASHINGTON -- In a major step toward returning to pre-pandemic life, the Centers for Disease Control and Prevention on Thursday eased mask-wearing guidance for fully vaccinated people, allowing them to stop wearing masks outdoors in crowds and in most indoor settings.
"Today is a great day for America," President Joe Biden said during a Rose Garden address heralding the new guidance, an event where he and his staff went without masks. Hours earlier in the Oval Office, where Biden was meeting with vaccinated Republican lawmakers, he led the group in removing their masks when the guidance was announced.
"If you are fully vaccinated, you no longer need to wear a mask," he said, summarizing the new guidance and encouraging more Americans to roll up their sleeves. "Get vaccinated -- or wear a mask until you do."
The guidance still calls for wearing masks in crowded indoor settings like buses, planes, hospitals, prisons and homeless shelters, but it will help clear the way for reopening workplaces, schools and other venues -- even removing the need for social distancing for those who are fully vaccinated.
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"We have all longed for this moment -- when we can get back to some sense of normalcy," Rochelle Walensky, director of the CDC, said at an earlier White House briefing.
The CDC and the Biden administration have faced pressure to ease restrictions on fully vaccinated people -- those who are two weeks past their last required covid-19 vaccine doses -- in part to highlight the benefits of getting the shots. The country's aggressive vaccination campaign has paid off: U.S. virus cases are at their lowest rate since September, deaths are at their lowest point since last April and the test positivity rate is at the lowest point since the pandemic began.
Walensky said the long-awaited change is thanks to the millions of people who have gotten vaccinated and is based on the latest science about how well those shots are working.
"Anyone who is fully vaccinated can participate in indoor and outdoor activities -- large or small -- without wearing a mask or physically distancing," Walensky said. "If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic."
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The new guidance is likely to open the door to confusion, since there is no surefire way for businesses or others to distinguish between those who are fully vaccinated and those who are not. Walensky and Biden said people who are not fully vaccinated should continue to wear masks indoors.
"We've gotten this far -- please protect yourself until you get to the finish line," Biden said, noting that most Americans under 65 are not yet fully vaccinated. He said the government was not going to enforce the mask-wearing guidance on those not yet fully vaccinated.
"We're not going to go out and arrest people," added Biden, who said he believes the American people want to take care of their neighbors. "If you haven't been vaccinated, wear your mask for your own protection and the protection of the people who also have not been vaccinated yet."
The announcement came as many states and communities have already been lifting mask mandates amid improving virus numbers and as more Americans have been shedding face coverings after getting shots.
Dan Witte, a 67-year-old musician from Sioux Falls, S.D., stopped wearing a mask after receiving the vaccine two months ago and recently rejoined his band playing gigs at crowded bars and weddings. He was encouraged by the CDC's new guidance but said it just confirmed his trust that the vaccines offered protection from spreading infections.
"I went right from being hypervigilant for almost a year to being right in the crowd without a mask," Witte said.
To date about 154 million Americans, more than 46% of the population, have received at least one dose of covid-19 vaccine, and more than 117 million are fully vaccinated. The rate of new vaccinations has slowed in recent weeks, but with the authorization Wednesday of the Pfizer-BioNTech shot for children ages 12 and older, a new burst of doses is expected in the coming days.
"All of us, let's be patient, be patient with one another," Biden said, acknowledging some Americans might be hesitant about removing their masks after more than a year of living in a pandemic that has killed more than 580,000 people in the U.S. and more than 3.3 million people worldwide.
The CDC's announcement that Americans could begin to shed one of the most visible symbols of the pandemic stood in stark contrast to other nations, with much of the world still struggling to contain the virus amid global disparities in vaccinations.
Just two weeks ago, the CDC recommended that fully vaccinated people continue to wear masks indoors in all settings and outdoors in large crowds.
Walensky said evidence from the U.S. and Israel shows that the vaccines are as strongly protective in real world use as they were in earlier studies and that so far they continue to work even though some worrying mutated versions of the virus are spreading.
The more people continue to get vaccinated, the faster infections will drop -- and the harder it will be for the virus to mutate enough to escape vaccines, she stressed, urging everyone 12 and older who is not yet vaccinated to sign up.
And while some people still get covid-19 despite being vaccinated, Walensky said, that's rare. She cited evidence that those infections tend to be milder, shorter and harder to spread to others. If people who are vaccinated do develop covid-19 symptoms, they should immediately put their masks back on and get tested, she said.
There are some caveats. Walensky encouraged people who have weak immune systems, such as from organ transplants or cancer treatment, to talk with their doctors before shedding their masks. That's because of continued uncertainty about whether the vaccines can rev up a weakened immune system as well as they do normal, healthy ones.
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TRAVEL GUIDANCE
The Biden administration issued an order in January requiring masks for public transportation, including transit stations and airports. At the end of April, the Transportation Security Administration extended enforcement of the rules through Sept. 13.
TSA spokeswoman Alexa Lopez said Thursday that while the agency's order remains in force, "we will continue to work closely with the CDC to evaluate the need for these directives."
The CDC advised against all travel through much of the pandemic, but last month it said taking a trip poses a low risk to people who have been vaccinated.
Airplanes in particular have become battlegrounds over mask enforcement, with the Federal Aviation Administration stepping in to levy hefty fines on disorderly passengers. When the TSA extended its order, Sara Nelson, president of the Association of Flight Attendants, said it would help keep passengers and aviation workers safe.
While it's not clear that airplanes present a greater risk of transmission than other indoor spaces -- some studies suggest that they are actually safer -- requiring masks in planes could help enforcement of the policy, especially as flight attendants have no reliable way to know which passengers have had their shots.
International travel continues to be subjected to stricter rules, with visitors banned from many nations, including much of Europe and India. Fully vaccinated people coming to the United States from other countries must still get tested within three days of boarding flights and are advised by the CDC to get tested three to five days after arriving.
PUBLIC HEALTH AID
The government is providing $7.4 billion to expand the nation's public health capacity, including hiring school nurses to vaccinate kids, setting up a health care service corps and bolstering traditional disease detection efforts, White House officials said Thursday.
Biden administration coronavirus testing coordinator Carole Johnson said it's part of a strategy to respond to immediate needs in the covid-19 pandemic while investing to break the cycle of "boom and bust" financing that traditionally has slowed the U.S. response to health emergencies.
"We really see this as funding that can help end the pandemic and help us prevent the next one," Johnson said. The money was approved by Congress in Biden's coronavirus response law. Officials are now acting to pump it out to states and communities through the CDC.
A new report published this month by the nonprofit Trust for America's Health found that the underfunding of U.S. public health played an outsized role in the country's disastrous response.
"Unfortunately, a pattern has emerged: the country temporarily pays attention to public health investment when there is a crisis and then moves on when the emergency passes," the report concluded. "This boom-bust cycle has left the nation's public health infrastructure on weak footing."
Among the report's recommendations is that Congress establish an annual, regularly occurring $4.5 billion infusion to public health to prepare for future crises, including the next pandemic.
"Given the fact that the core public health workforce is significantly smaller today than it was a decade ago, these are critically important steps," said John Auerbach, president of the nonprofit, which provides its expertise to governments at all levels. "Ensuring Americans' health security requires a standing-ready public health workforce." Auerbach served as an adviser to the Biden presidential transition.
About $4.4 billion of the new money will go to immediate priorities in fighting the pandemic.
That includes $3.4 billion for states and local health departments to step up hiring of vaccinators, contact tracing workers, virus testing technicians and epidemiologists, who are disease detectives trained to piece together the evidence on the spread of pathogens. The White House is stressing that local governments hire people from the communities being served, with an emphasis on lower-income areas.
There's also $500 million for hiring school nurses, who could play a key role in vaccination now that the Pfizer-BioNTech vaccine has been cleared for use by teenagers. Johnson said that would expand the pool of trusted clinicians able to give vaccines.
An additional $400 million will go to set up what's being called the Public Health AmeriCorps. It would be modeled on AmeriCorps, the volunteer program that annually deploys more than 250,000 people to serve in communities across the country. The goal of the new program would be to train and nurture aspiring young professionals interested in the public health field.
All told, the money is expected to support tens of thousands of new jobs over a period of five years, Johnson said.
Meanwhile, officials are leaping into action on a new strategy designed to involve family doctors, pediatricians and schools.
Parents can take their children to existing providers for the Pfizer-BioNTech shot after this week's authorization of the vaccine for use in youths ages 12-15. But a federal advisory board suggested Wednesday that a new family oriented approach will help improve access and equity.
There are almost 17 million kids that age in the U.S., or about 5.3% of the population. Now the nation will mobilize to protect that demographic.
"The push is that we now think about people as a part of a family unit, especially those that are disproportionately affected by the disease and have the lowest rates of vaccination," said Rhea Boyd, a pediatrician in California's Bay Area who has developed a campaign to provide Black communities with credible information about the shots.
WORLD VIEW
Mass vaccinations, falling case counts and waning coronavirus deaths in a few wealthy countries threaten to obscure ongoing worldwide suffering from the pandemic that's likely to last for months, and perhaps years.
That's Carl Bildt's worry as the new special envoy to the World Health Organization-backed effort set up last year to dispatch vaccines and other weapons against covid-19. Suppressing the virus that's advancing in India and beyond depends on persuading rich nations to share excess doses and help close a $19 billion funding gap, Bildt said in an interview.
An independent review of the international covid-19 response echoed Bildt's concerns Wednesday, calling for Group of Seven countries to commit 60% of the money needed this year. The report urged high-income nations to provide more than 2 billion doses to poorer regions by the middle of 2022.
"The risk is that if people in the U.K., EU or U.S. think the worst is over, the attention will shift," he said. "The worst isn't over."
Information for this article was contributed by Zeke Miller, Michael Balsamo, Lauran Neergaard and Ricardo Alonso-Zaldivar of The Associated Press; by Ian Duncan and William Wan of The Washington Post; by Riley Griffin of Bloomberg News (TNS); and by James Paton of Bloomberg News (WPNS).
