Monday, May 3, 2021

CDC: If You're Vaccinated, You Don't Need To Mask Outdoors (Unless You're In A Crowd) April 27, 2021 Heard on All Things Considered Allison Aubrey

 

CDC: If You're Vaccinated, You Don't Need To Mask Outdoors (Unless You're In A Crowd)

The CDC's latest guidance says people who are fully vaccinated do not need to wear a mask when they're outdoors unless they're in a crowded space.

Alexi Rosenfeld/Getty Images

The Centers for Disease Control and Prevention says people who are fully vaccinated do not need to wear a mask when they're outdoors unless they're in a crowd, such as attending a live performance, sporting event or parade. People are considered fully vaccinated two weeks after receiving the second dose of the Pfizer or Moderna vaccines, or two weeks after the single dose of the Johnson & Johnson shot.

"If you are vaccinated, things are much safer for you," CDC Director Rochelle Walensky said Tuesday at a White House briefing. "If you are fully vaccinated and want to attend a small outdoor gathering — with people who are vaccinated and unvaccinated — or dine at an outdoor restaurant with friends from multiple households, the science shows you can do so safely, unmasked."

As part of the new guidance, the agency spelled out settings in which it's OK for fully vaccinated people to be unmasked, including:

  • Walking, running, hiking or biking outdoors alone or with members of your household;
  • Attending a small outdoor gathering with fully vaccinated family and friends;
  • Attending a small outdoor gathering with a mixture of fully vaccinated and unvaccinated people;
  • Dining at an outdoor restaurant with friends from multiple households.

And, the risk is low enough that even unvaccinated people can exercise, bike and hike outside and attend small outdoor gatherings with fully vaccinated friends and family without wearing a mask.

"We continue to recommend masking in crowded outdoor settings and venues such as packed stadiums and concerts where there is decreased ability to maintain physical distance and where many unvaccinated people may also be present," Walensky said. "We will continue to recommend this until widespread vaccination is achieved."

The new guidance "shows just how powerful these vaccines are in our efforts to end this pandemic," she said.

In a brief appearance on the White House lawn after the CDC announcement, President Biden said that for those who haven't been vaccinated, or feel they don't need to be, "this is another great reason to go get vaccinated now."

"While we still have a long way to go in this fight," he said, "we've made stunning progress because of all of you, the American people. Cases and deaths are down, down dramatically from where they were when I took office [on] Jan. 20 and continuing to fall."

The CDC says COVID-19 vaccines are effective at protecting against illness but urges people to continue to take precautions since officials are still learning how well the vaccines work to curb the spread of the virus.

In public settings, it's hard to know if others around you have been vaccinated or if they're at increased risk for severe COVID-19, so the CDC continues to recommend that fully vaccinated people follow guidance to protect themselves and others, including wearing a mask, when indoors or at an outdoor setting or venue where masks are required. For instance, a city or municipality may continue to require masking at a farmer's market, a graduation ceremony or youth sports activities.

The agency continues to recommend that everyone — including vaccinated people — avoid medium or large-size gatherings, given the vaccines are not 100% effective at preventing infection, and there are documented cases of "breakthrough infections."

In addition, the CDC says that if you've been around a person who is sick and develop any symptoms of COVID-19, you should get tested and stay home.

The agency lists a range of settings where masking is still recommended for people who are fully vaccinated:

  • Attending a crowded outdoor event such as a live performance, parade or sporting event;
  • Visiting a barber or hair salon;
  • Visiting an indoor shopping mall or museum;
  • Riding public transport;
  • Attending a small indoor gathering with a mixture of fully vaccinated and unvaccinated people;
  • Going to an indoor movie theater;
  • Attending a full capacity service at a house of worship.

Given that more than 50% of adults in the U.S. have now received at least one dose, many public health experts agree it's time to start relaxing restrictions, including this new guidance to go unmasked in outdoor settings.

Throughout the pandemic, infectious disease experts have pointed to the lower risks of being outside. "Outdoors is safer than indoors with all the natural airflow, " says Dr. Judith Guzman-Cottrill of Oregon Health & Science University.

Linsey Marr, a researcher at Virginia Tech who studies airborne virus transmission and has studied mask efficacy, notes the evidence has long indicated that the risk of transmission outdoors is much lower than indoors.

"Virus just cannot accumulate in the air outdoors," Marr says. "It's like putting a drop of dye into the ocean. If you happen to be right next to it, then maybe you'll get a whiff of it. But it's going to become diluted rapidly into the huge atmosphere."

One meta-analysis published in The Journal of Infectious Diseases suggested that the coronavirus was nearly 19 times more likely to be spread indoors compared with outdoors.

But, as Marr notes, other research suggests the risk of outdoor transmission is even lower.

For instance, data from Ireland's Health Protection Surveillance Centre, obtained by The Irish Times, looked at more than 232,000 COVID-19 cases in that country through March; it found that just 1 in 1,000 cases could be traced to outdoor transmission.

Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco, notes that other countries with high vaccination rates don't have outdoor mask mandates.

"Israel released their outdoor mask mandates a week or so ago. The U.K. does not mask outdoors," Gandhi says.

And in recent days, the nation's chief infectious disease expert, Dr. Anthony Fauci, called the risk of spread in outdoor settings "minuscule."

"It's pretty common sense now that the outdoor risk is really quite low," Fauci told ABC News.

NPR's Maria Godoy contributed to this report.

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COVID-19 Has Hit The Amish Community Hard. Still, Vaccines Are A Tough Sell April 28, 2021 ANNA HUNTSMAN

 THE CORONAVIRUS CRISIS

COVID-19 Has Hit The Amish Community Hard. Still, Vaccines Are A Tough Sell

Holmes County, Ohio, General Health District staff members (from left) Michael Derr, Jennifer Talkington and Abbie Benton prepare materials for a COVID-19 vaccine clinic this month inside St. Peter's Catholic Church in Millersburg.

Anna Huntsman/WCPN

The Amish communities of northeast Ohio engage in textbook communal living. Families eat, work and go to church together, and through the pandemic, mask-wearing and social distancing have been spotty. As a result, these communities have experienced some of the state's highest rates of infection and deaths.

Nevertheless, health officials are struggling to get residents vaccinated. Holmes County, where half of the population is Amish, has the lowest vaccination rate in Ohio, with just 10% of its roughly 44,000 residents fully vaccinated.

Less than 1% of Amish have received any doses of vaccine, according to Michael Derr, the county's health commissioner.

In an effort to increase that number, health officials are holding vaccination clinics in rural areas. They've also reached out to bishops and community leaders to spread the word about the safety of the vaccines. Still, few Amish residents are showing up to the health department's clinics.

Marcus Yoder, who lives in Holmes County, was born Amish and is now Mennonite and still has close ties to the Amish community. He says the few Amish who are getting vaccinated are doing so privately through doctors' offices and small rural clinics – and they are keeping it to themselves.

"There were Amish people getting the vaccination the same day I was ... and we all kind of looked at each other and smiled underneath our masks and assumed that we wouldn't say that we saw them," Yoder says.

He says many Amish don't want to get vaccinated because they already had COVID-19 and believe the area has reached herd immunity.

Another main driving force is "the misinformation about COVID itself — that it's not more serious than the flu," says Yoder, who runs a history center about the Amish and Mennonite. "They're saying, 'Well, it didn't affect me that much. Look at all these old people who survived.' "

A man zips by on a walking and biking trail in Holmes County, home to one of the largest settlements of Amish in the United States.

Anna Huntsman/WCPN

Some Amish residents are skeptical of the safety and effectiveness of the vaccines, and anti-vaccination conspiracy theories also spread throughout the community. There is also a lack of awareness about the more contagious variants spreading across the country, Yoder says.

"I think we're going to see some more cases in our community, unfortunately, because of this," he says. "There simply is a lot of COVID news fatigue. They simply do not want to hear about it, and that's really unfortunate."

While some sort of herd immunity could explain why Holmes currently has a low incidence of new cases, Derr at the health department is concerned that those who previously had the virus may not be protected.

"As a region, we definitely surged over the winter, and we know that that happened about 90 days ago," Derr says. "We're primed and ready for another surge because we're not vaccinating enough."

Health officials in Indiana and Pennsylvania — which, combined with Ohio account for the largest Amish communities — also are ramping up outreach in heavily Amish areas. Local health departments in Pennsylvania's Lancaster County, home to the largest Amish population in the country, are connecting with Amish bishops to try to spread the word about the vaccines.

The widespread reluctance to get vaccinated in Amish communities is not surprising to West Virginia University sociologist Rachel Stein, who studies Amish populations across the country.

"We as non-Amish are more on board with preventative medicine," Stein says. "They certainly don't have that mindset that we need to do things to stop this from happening."

Instead, she says there's an acceptance that people will get sick and get better – or not. While childhood vaccinations have increased in Ohio's Amish communities in recent years, adults are still more hesitant, she adds.

"There's oftentimes frequent breakouts of whooping cough in a settlement, and it's just like ... 'This is happening now. We're in whooping cough season, and so it's time to deal with this sort of thing,' " she says.

In 2014, a measles outbreak spread rapidly through Ohio's largely unvaccinated Amish communities. Even after this experience, many Amish residents still choose not to vaccinate their children against other diseases.

The low vaccination interest in Holmes County tracks national trends showing residents of rural areas are less likely to consider getting vaccinated.

A recent poll from the Kaiser Family Foundation found 3 in 10 rural residents will "definitely not" get the COVID-19 vaccine unless it is mandated.

Yoder says he thinks the best path forward is to encourage Amish residents who were vaccinated to talk openly about their positive experience getting the shots.

"I think that hammering people for not doing it will not get us anywhere," Yoder says. "Some of the local business leaders have done very, very well at saying, 'Look, let's get the vaccination so we don't have to wear masks in the future, so we don't have to worry about social distancing as much in the future.' And they've used that tact and that has been a healthy way to approach it."

Derr, the Holmes County health commissioner, is trying to get business owners who employ Amish workers to encourage their staff to get the shot. Officials hope eventually to hold vaccine clinics at these businesses and take the shots to them, but not every business owner is on board with that yet, he says.

"People are going to listen to their friends and their family, people who they interact with more, and it's going to be that telephone effect," Derr says. "The more and more people we tell about it and the better experiences they have, word will get around."

Derr expects more Amish will get vaccinated in the fall after the shots have been around for some time but worries the community could see a spike in cases long before then.

This story comes from NPR's partnership with Cleveland's ideastream and Kaiser Health News.

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