As states plan to lift school mask mandates, CDC remains vague on updating its guidance

CNN

By Jacqueline Howard, CNN

As many states see declines in their daily Covid-19 case numbers and hospitalization rates, some have moved forward with plans to lift a significant mitigation measure: mask mandates in schools.

The moves go against guidance from the US Centers for Disease Control and Prevention, but the agency has remained mum about the states’ decisions, simply telling CNN on Monday that it still recommends universal masking for all in schools.

However, some public health experts have questioned whether it’s time for the CDC to update its school guidance, especially as the nation mulls over what life after the pandemic might look like. Without federal guidance on when and how to transition out of the pandemic phase and into a Covid-19 endemic phase, some states are taking steps on their own.

‘Dropping like a rock’

The Democratic governors of three East Coast states — Connecticut, Delaware and New Jersey — announced Monday that they will lift mask requirements in schools in the coming weeks.

In Connecticut, Gov. Ned Lamont said he recommends ending the statewide mask mandate in schools and childcare centers effective February 28, leaving decisions on mask requirements in schools to officials at the local level.

In Delaware, Gov. John Carney said that public and private K-12 mask mandates will expire March 31, and in New Jersey, Gov. Phil Murphy said the state’s universal mask mandate for schools and child-care settings will lift March 7.

All three states referenced declines in their Covid-19 case counts, hospitalizations, test positivity rates and rates of transmission as reasons why they are planning to lift restrictions.

“Our case count, hospitalizations, the spot positivity rate, the rate of transmission are all dropping like a rock,” Murphy told CNN’s Jake Tapper on Monday, adding that the state is making progress with vaccinations and that there will be better ventilation options in four weeks, when the mask mandate lifts.

“We’ve adhered overwhelmingly with the CDC guidance. The reason why we’re making this step today is our reality in New Jersey,” Murphy said. “We are now in a dramatically different place than the norm right now across the country, which is why we feel like we can decouple and take this step.”

Also Monday, California Gov. Gavin Newsom announced that the state’s indoor mask requirement will expire February 15, though unvaccinated people will still need to wear masks indoors. He noted that California’s case rate has decreased 65% since its Omicron peak, and hospitalizations have stabilized across the state.

And the Oregon Health Authority announced Monday that the state will remove general mask requirements for indoor public places no later than March 31.

But as these states change their policies, the White House has not changed its position.

“The guidance is very clear, which is that we recommend masking in schools. That is the recommendation from the CDC,” White House Press Secretary Jen Psaki said during a news briefing Monday, referring to the CDC’s guidance urging universal mask-wearing in schools for everyone 2 and older, regardless of a person’s vaccination status.

“It is also true that at some point when the science and the data warrants, of course, our hope is that that’s no longer the recommendation — and they are continually assessing that,” Psaki said of CDC officials. “It is also true that it’s always been up to local school districts to make determinations about how to implement these policies.”

CDC spokesperson Jade Fulce wrote in an email to CNN on Monday that “CDC guidance is meant to supplement — not replace — any federal, state, tribal, local, or territorial health and safety laws, rules, and regulations. The adoption and implementation of our guidance should be done in collaboration with regulatory agencies and state, tribal, local, and territorial public health departments, and in compliance with state and local policies and practices.”

When asked whether the CDC plan to release any updated guidance on when it’s appropriate to lift mask mandates in schools, the agency responded that “CDC continuously reviews data on the pandemic as well as the latest science to identify when changes to guidance are recommended.”

‘There has been … a lack of clarity for some time’

The CDC could improve its communications with state leaders and the public regarding its mask guidance — including when and why mask mandates should be implemented, what the benefits are, and the science and data behind such recommendations, Glen Nowak, co-director of the Center for Health & Risk Communication at the University of Georgia and former head of media relations for the CDC, told CNN on Monday.

“There has been, I think, a lack of clarity for some time regarding what the end goal is,” Nowak said.

“Even now, it would help if the CDC talked about what they were thinking or what they were doing, if anything, with respect to updating their mask guidelines and recommendations,” Nowak said. “What efforts are underway, and what are they trying to do? What are they trying to learn? I think, right now probably still among many people, that’s sort of a mystery.”

State and local officials have had to “take matters into their own hands” when it comes to changing school mask mandates, and that’s bad news for federal public health authorities, CNN Medical Analyst Dr. Leana Wen told CNN’s John Berman on Monday.

“That means that the federal government is becoming less and less relevant,” said Wen, who is also an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. “If the CDC guidance that they’re putting out is now not being followed by virtually anyone, that makes the CDC and our federal public health authorities have less credibility.

“And so I really believe that they need to be changing their guidance, and look, they don’t have to do it overnight. They can say ‘here is an off-ramp to masking. You meet these criteria, and this is how you can begin to remove masks or remove other restrictions.’ But we need to hear their leadership here. The CDC has already lost a lot of trust and credibility. This is their time to rebuild and remove restrictions as quickly as they were put in.”

When it comes to lifting mask mandates, the decisions are typically based on the risk of someone getting infected with the coronavirus within the community, Dr. Georges Benjamin, executive director of the American Public Health Association, told CNN on Monday.

“If you’re fully vaccinated and boosted, and the broad community spread is low to moderate, then your risk is low,” Benjamin said. In New Jersey and some other states that plan to lift school mask mandates, state officials project that community spread of Covid-19 will probably be low.

Benjamin added that as the country looks ahead, beyond the public health emergency phase of Covid-19, it might be time for the CDC to update its guidance on mask-wearing in schools and the surrounding communities, especially as such guidance is based on data from Covid-19 case counts and test positivity rates in communities. Many people test for Covid-19 at home, which can skew data if they don’t report their results.

Separately, many state governors and leading public health experts are also calling for the White House to release guidance on what the end of the pandemic, and a transition into an endemic phase, might look like for the country. “Endemic” means a disease has a constant presence in a population but isn’t overwhelming health systems or affecting an alarmingly large number of people, as typically seen in a pandemic.

Consideration for lifting mask mandates

As some governors set timelines for the end of their states’ school mask mandates, Dr. Carlos del Rio, the executive associate dean of the Emory University School of Medicine, said it’s the right thing to do for school districts in highly vaccinated communities.

“In a highly vaccinated community, as the cases are decreasing right now with Omicron, in a couple of weeks, maybe removing masks is actually the right thing to do. It allows us the opportunity to actually peel off one of those restrictions that has been so controversial,” del Rio told CNN’s Bianna Golodryga on Monday. He added that there are other mitigation measures that schools can adopt, such as improving air ventilation in classrooms.

Del Rio said communities should continue to monitor Covid-19 cases as well as track hospitalizations and test positivity rates.

He thinks there are two possible metrics for lifting mask mandates, he told CNN in an email Monday: hospitalization rates and capacity levels in intensive care units.

“If hospitalizations are clearly coming down and positivity rates are coming down in the community, it is the right thing to do,” del Rio told Golodryga of lifting school mask mandates.

On the other hand, many states that continue to see high Covid-19 case counts and low vaccination rates have not changed their school mask policies. For instance, Kentucky Gov. Andy Beshear said Monday that the state will continue to recommend face masks in schools, citing low vaccinations rates in children.

When asked what it will take for him to lift that recommendation, Beshear said he will look at the positivity rate and vaccination rate in people 18 and under.

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