The national Centers for Disease Control and Prevention has issued new COVID-19 guidelines that will allow many people to take off their masks. Before you do so, though, be aware that the guidelines are more complicated than you might think.
The guidelines released Friday are based on the level of disease spread and hospital resources on a county-by-county basis. They also are based on personal risk factors.
At the same time, Austin Public Health last week moved Travis County from Stage 5 to Stage 4 of its risk-based guidelines, and it expects us to move to the safer Stage 3 in the coming weeks.
Austin finished last week with 183 people hospitalized for COVID-19 but was down to 166 patients Monday, including 54 in intensive care units and 27 on ventilators.
The moving seven-day average of new hospital admissions for COVID-19 on Monday was 20. The community transmission rate was 63.3 cases per 100,000 people, and the positivity rate was 7.5%.
The seven-day average of new hospitalizations reached a pandemic high of 129 this year on Jan. 19, at the peak of the omicron surge. The transmission rate was above 1,000% on multiple days in January.
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What are the new CDC guidelines?
The CDC has categorized every county into low, medium and high community levels of COVID-19. At cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html, you can plug in your state and county and see what the level is. The levels are also indicated on a map with green being low, yellow medium and orange high.
How are the levels determined?
The CDC is looking at three things:
- New COVID-19 cases per 100,000 people in the past seven days. That is also considered the transmission rate. If you have 200 or more new cases per 100,000 people, your county is automatically in the medium or high level.
- Percent of COVID-19 hospitalizations per 100,000 people in the past seven days. If you have fewer than 200 cases per 100,000, you can be in the low level if you have fewer than 10 new admissions. You’ll be in medium between 10 and 19.9 new admissions and in the high level for 20 or more. If you have 200 or more cases per 100,000 people, you’re in the medium range with fewer than 10 admissions and in the high range at 10 or more.
- Percent of staffed hospital beds taken by people with COVID-19 over the past seven days. With fewer than 200 new cases per 100,000 people, you can be in the low category with less than 10% of beds occupied by COVID-19 patients, in the medium category between 10% and 14.9%, and in the high category for 15% or more of the beds taken by COVID-19 patients. If you have 200 or more cases per 100,000 people, you’ll be in the medium category at less than 10% and in the high category if 10% or more of the beds are taken by COVID-19 patients.
Your level is determined by whatever indicator puts you at the highest level.
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What level is my county?
Travis, Williamson, Bastrop, Burnet and Caldwell counties are all in the green or low level of community spread. Hays County is in the orange or high level of community spread.
“As long as we can continue to monitor those three categories of new cases, hospitalizations and available beds, we should be nimble to change as needed,” said Dr. Suneet Singh, medical director for Austin-based CareHive Health.
If local cases go up again, more people are hospitalized, and we don’t have open hospital beds, our county level will change as the situation changes.
“It does allow for fluctuation between green, yellow and orange,” Singh said.
What if I live in a county that’s green or at low level?
If you are in a green or low-level county, the CDC recommends that you stay up to date with vaccines and get tested if you think you might have COVID-19. You should maintain good ventilation in indoor areas. You should follow recommendations about testing and quarantining if you have been exposed or have symptoms.
You do not need to wear a mask, but you might choose to do so.
You should talk to your health care provider if you are at high risk for severe illness — typically people with lung disease, cancer, heart disease, diabetes, obesity, dementia or mental health disorders or people who are smokers, are inactive, are on immune suppressants or corticosteroids, have had an organ or stem cell transplant, are pregnant or have had a recent pregnancy. If you’re in one of those categories, have a plan for testing and for access to early-stage treatments such as the new antiviral pills or monoclonal antibodies.
What if I live in a county that’s yellow or at medium level?
In addition to the precautions for the green level, you will want to consider wearing a mask if you are immune-compromised or at high risk for severe disease, or if someone in your household or with whom you are in contact has those risk factors.
What if I live in a county that’s orange or at high level?
In addition to the precautions of the green and yellow levels, you should wear a mask in public regardless of risk factors or vaccination status.
People who have high risk factors or are immune-compromised should avoid nonessential indoor activities. People who are in contact with someone who is immune-compromised or at higher risk should wear a mask around that person.
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What’s the difference between CDC and Austin Public Health guidelines?
Austin Public Health will meet Tuesday to discuss changing its guidelines. Currently, Austin Public Health is recommending vaccinated people wear masks indoors and outdoors under Stage 4. They can travel, shop or dine indoors while wearing a mask.
Unvaccinated people should not gather indoors or outdoors and should do only essential travel or shopping and dine using carryout or delivery.
These are very different from the CDC’s guidelines for a low-level county, which Travis County is. The CDC guidelines allow for gathering without wearing a mask if you choose and don’t distinguish between vaccinated and unvaccinated status.
If the CDC says it’s OK not to wear a mask, do I still have to?
You must follow the rules in place where you live. It also doesn’t change what individual businesses can require.
For now, many doctor’s offices, clinics and hospitals will continue to require masks. Public transportation such as buses and airplanes still requires a mask.
Schools that have a mask mandate in place will continue requiring masks, though the Austin school district is surveying parents and students about its mask mandate. The district’s trustees will meet Wednesday to discuss the new CDC guidelines.
Is it really OK to take off my mask?
This new guidance doesn’t say you can’t wear a mask, CareHive Health’s Singh said. It allows for individual choice, assessing your own health risk factors as well as the virus levels in the community where you live, he said.
“If you are otherwise healthy, it should be safe to unmask in a green light population,” Singh said. “Remember, it doesn’t mean you’re not going to get (COVID-19).”
Some questions to consider:
- What are my personal health risk factors?
- Do I live with someone or am I in contact regularly with someone with high risk factors?
- If I get sick, do I have access to testing and symptom-reducing medications?
- If I get sick, do I have the ability to quarantine and to miss work or school?
People will still get very sick from COVID-19 and some will die, just as there are people who get very sick from flu and die of it, Singh said.
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Why is the guidance changing?
The CDC has constantly adapted its guidance as the COVID-19 situation has changed. Before the delta variant, the CDC said vaccinated people no longer had to wear a mask based on the effectiveness of the vaccines for the alpha variant. That guidance changed once the delta variant increased the number of cases and resources such as hospital beds and medications became scarce again.
Masking remained necessary during the surge of the omicron variant because of the lack of resources, including testing kits, hospital beds and medications.
Right now, though, cases are decreasing, testing is readily available and so are medications to reduce symptoms. For many people, especially healthy, vaccinated people, the omicron variant of the coronavirus has not been particularly severe.
“There are more tools available than ever before,” Singh said.
Could the guidelines change again?
“These guidelines get us closer to a place of normalcy,” Singh said, because they allow us to adapt as the situation changes.
The CDC’s surveillance partners are testing samples of positive tests for genetic markers to look for the next variant.
If a new variant comes along that produces more severe illness than omicron, numbers surge again or we run out of resources, the recommendations to mask up would be in place again if we returned to the high (orange) level.
Locally, we’ll also be looking at what happens to our numbers and our resources as more people take off their masks during spring break and the South by Southwest festivals, which will bring people in and out of Austin.
George is Digismak’s reported cum editor with 13 years of experience in Journalism