Without masks, even the fully-vaccinated can play a part in spreading the COVID Delta variant

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KABC-TV 30 June, 2021 - 04:28pm 49 views

Without masks, even the fully-vaccinated can spread Delta variant

Health officials in Los Angeles County now strongly recommend that people wear masks indoors in public places - regardless of their vaccination status - to prevent the spread of the highly transmissible delta variant of the coronavirus.

While overall COVID-19 rates remain relatively low in Southern California amid continuing vaccination efforts, officials are increasingly worried about a growing threat from the delta variant.

New research shows promising signs that the Pfizer and Moderna vaccines may offer protection for a longer time than previously thought - and that protection could potentially last for years.

Read full article at KABC-TV

Delta Variant’s Spread Prompts Reconsideration of Mask Guidance

The New York Times 30 June, 2021 - 10:19pm

Los Angeles County and the W.H.O. warned that even immunized people should wear masks indoors. Some scientists agreed, but urged a localized approach.

Throughout the pandemic, masks have ranked among the most contentious public health measures in the United States, symbolizing a bitter partisan divide over the role of government and individual liberties.

Now, with a new variant of the coronavirus rapidly spreading across the globe, masks are again the focus of conflicting views, and fears, about the course of pandemic and the restrictions required to manage it.

The renewed concerns follow the wildfire growth of the Delta variant, a highly infectious form of the virus first detected in India and later identified in at least 85 countries. It now accounts for one in four infections in the United States.

In May, federal health officials said that fully vaccinated people no longer needed to mask up, even indoors. The advice signified a sea change in American life, setting the stage for a national reopening that continues to gain momentum.

But that was before the spread of the Delta variant. Worried by a global surge in cases, the World Health Organization last week reiterated its longstanding recommendation that everyone — including the inoculated — wear masks to stem the spread of the virus.

On Monday, health officials in Los Angeles County followed suit, recommending that “everyone, regardless of vaccination status, wear masks indoors in public places as a precautionary measure.”

Barbara Ferrer, the county’s public health director, said the new recommendation was needed because of upticks in infections, a rise in cases due to the worrisome Delta variant, and persistently high numbers of unvaccinated residents, particularly children, Black and Latino residents and essential workers.

Roughly half of Los Angeles County residents are fully vaccinated, and about 60 percent have had at least one dose. While the number of positive tests is still below 1 percent in the county, the rate has been inching up, Dr. Ferrer added, and there has been a rise in the number of reinfections among residents who were infected before and did not get vaccinated.

To the extent that Los Angeles County has managed to control the pandemic, it has been because of a multilayered strategy that combined vaccinations with health restrictions aimed at curbing new infections, Dr. Ferrer said. Natural immunity among those already infected has also kept transmission low, she noted, but it is not clear how long natural immunity will last.

“We don’t want to return to lockdown or more disruptive mandates here,” Dr. Ferrer said. “We want to stay on the path we’re on right now, which is keeping community transmission really low.”

“When the C.D.C. made the recommendation to quit masking, it didn’t anticipate being in a situation where we might need to recommend masking again,” said Angela Rasmussen, a research scientist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada.

“Nobody’s going to want to do it. People are understandably accusing them of moving the goalposts.”

But the Delta variant's trajectory outside the United States suggests that concerns are likely to intensify.

Countries in the Asia-Pacific region are now reimposing restrictions and stay-at-home orders as the variant drives new surges. Four Australian cites have reimposed lockdowns, and on Monday, the Malaysian government said nationwide stay-at-home orders would be extended indefinitely.

Even Israel — which has one of the highest vaccination rates in the world and is aggressively immunizing younger adolescents and teenagers who qualify — has reinstated masking requirements in public indoor spaces and at large public gatherings outdoors, after hundreds of new Covid-19 cases were detected in recent days, including among people who had received both doses of the Pfizer-BioNTech vaccine.

This is not the first time the world has been consumed by a more contagious variant of the coronavirus. The Alpha variant walloped Britain and brought the rest of Europe to a standstill earlier this year. In the United States, Alpha quickly became the dominant variant by late March, but the rapid pace of vaccination blunted its spread, sparing the nation a big surge in infections.

But Delta is thought to be even more fearsome. Much of what is known about the variant is based on its spread in India and Britain, but early evidence indicates that it is perhaps twice as contagious as the original virus and at least 20 percent more contagious than Alpha.

In many Indian states and European nations, Delta quickly outpaced Alpha to become the dominant version of the virus. It is on track to do the same in the United States.

Among the variant’s many mutations are some that may help the virus partly dodge the immune system. Several studies have shown that while the current vaccines are effective against Delta, they are slightly less so than against most other variants. For individuals who have received only one dose of a two-dose regimen, protection against the variant is significantly reduced, compared with efficacy against other forms of the virus.

The W.H.O.’s rationale for maintaining masking is that while immunization is highly effective at preventing severe illness and death, the degree to which vaccines prevent mild or asymptomatic infections is unknown. (Officials at the C.D.C. disagree, saying the risk is minimal.)

The W.H.O. maintains that vaccinated people should wear masks in crowded, close and poorly ventilated areas, and should continue with other preventive measures, like social distancing.

“What we’re saying is: ‘Once you’ve been fully vaccinated, continue to play it safe, because you could end up as part of a transmission chain. You may not actually be fully protected,’” Dr. Bruce Aylward, a senior adviser to the W.H.O., said at a news briefing last week.

Even countries with relatively high vaccination rates have seen an increase in infections driven by the Delta variant. Britain, where some two-thirds of the population have received at least one dose of the Pfizer-BioNTech or AstraZeneca vaccine and just under half have received two doses, is nonetheless grappling with a sharp rise in infections from the variant.

It is not certain what course the Delta variant will take in the United States. Coronavirus infections have been plunging for months, as have hospitalizations and deaths. But Dr. Anthony S. Fauci, the nation’s top infectious disease doctor, has called the variant “the greatest threat” to eliminating the virus in the United States.

In May, when C.D.C. officials lifted masking recommendations, they cited research showing that fully vaccinated people were unlikely to become infected with the virus, even with asymptomatic infections.

But the variant’s talent for even partial immune evasion makes researchers nervous, as it suggests that fully vaccinated people may sometimes pick up asymptomatic infections and unknowingly spread the virus to others even if they never become ill.

The Delta variant can infect vaccinated people, although its ability to do so is very limited, said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. “If you are in a place where cases are climbing, wearing a mask indoors in crowded public spaces is a way to keep yourself from contributing to the spread of Delta,” he said.

Other scientists stop short of recommending that fully vaccinated people always wear masks indoors, but some now suggest that this may be appropriate depending on local circumstances — for example, wherever the virus is circulating in high numbers, or vaccination rates are very low.

“Masking in public enclosed spaces needs to continue even after vaccination, until we can get everyone vaccinated or a new vaccine that is more effective against Delta transmission,” said Dr. Ravindra Gupta, a virologist at the University of Cambridge in the United Kingdom.

Even now, roughly half of Americans are not vaccinated, and a wide swath of the country remains vulnerable to outbreaks of the virus and its variants. Vaccines for children under age 12 are not likely to be authorized until the fall, at the earliest.

In Saskatchewan, Canada, reopening has proceeded in stages that are tied to population vaccination rates and the percentage of people in certain age brackets who have been vaccinated.

The province is moving to Step 3 of re-entry on July 11, but may maintain indoor masking requirements and restrictions on the size of gatherings, said Dr. Rasmussen, of the University of Saskatchewan. The strategy “makes a lot more sense than just saying, ‘If you’re fully vaccinated, go ahead and take off your mask,’” she said.

Yet some scientists fear it will be nearly impossible to reimpose mask mandates and other precautions, even in places where it may be a good idea to do so.

“It’s difficult to walk that back,” said David Michaels, an epidemiologist and professor at the George Washington School of Public Health, referring to the C.D.C. advice. Yet with the rise of the Delta variant, it also is “extremely dangerous to continue the cultural norm of no one wearing a mask.”

Dr. Ezekiel Emanuel, vice president for global initiative at the University of Pennsylvania, said the arrival of the variant should prompt a rethinking of mask mandates.

He still wears a mask indoors in public places like grocery stores, and even on crowded city sidewalks. “We don’t know the long-term consequences of even a mild infection,” he said, referring to so-called long Covid. “Is a little more insurance from wearing a mask worth it? Yes.”

Sipping coffee outside the Whole Foods Market in downtown Los Angeles on Tuesday morning, Monroe Harmon, 60, said he thought a step back toward masking requirements for everyone might be a good idea.

“There’s so many people suggesting that they just want their lives back,” said Mr. Harmon, who works for a security company. “I think you kind of roll the dice when you decide, ‘I want my life back, I’m not going to wear the mask, I’m not going to distance.’”

Jill Cowan and Ana Facio-Krajcer contributed reporting from Los Angeles.

California releases statement on masks after Los Angeles County changes guidance

SFGate 30 June, 2021 - 10:19pm

If you're vaccinated, you are protected from the highly transmissible Delta variant and in most cases you can keep your mask off. That's the message both the California Department of Public Health and the Centers for Disease Control and Prevention are putting out this week. 

Los Angeles County updated its masking guidelines earlier this week, calling on all people, regardless of vaccination status, to put their masks on indoors in public places due to the Delta variant spreading across the L.A. area. The World Health Organization also released a statement over the weekend reiterating its longstanding recommendation that everyone wear masks to lessen the spread of the virus.

These announcements created some confusion and led many to wonder if more changes were coming to mask rules. 

California's health department said in a statement Wednesday that guidance for face masks will remain in alignment with the CDC recommendations, allowing fully vaccinated individuals to resume everyday activities without wearing a mask in most settings.

"Unvaccinated individuals must continue to wear masks in indoor public settings and businesses to help protect against the risk of infection or infecting others," said Dr. Tomás Aragón, the state's public health officer. "Under this guidance businesses have the option of requiring all customers to wear a mask, even if they’re already vaccinated, and local health jurisdictions may impose stricter guidance or provide additional recommendations as a result of local conditions."

Aragón reiterated that getting vaccinated is the best line of defense against the Delta variant. 

"The California Department of Public Health is closely monitoring the spread of COVID-19 and its variants across our state," Aragón said. "Currently, the Delta variant accounts for approximately 15 percent of cases sampled in California, and we anticipate this percentage will increase. The most important thing we can do to stop the spread of COVID-19 is ensure everyone who is eligible gets vaccinated."

CDC Director Dr. Rochelle Walensky made appearances on both the "Today" show and "Good Morning America" Wednesday to get out the message that there are no plans for the nation's health agency to change its mask rules. But she said local officials can set up their own guidelines in areas with low vaccination rates. 

She pointed to the difference between the CDC, which is the health protection agency for the United States, and WHO, which is responsible for issuing guidelines for the world. 

"We know that the WHO has to make guidelines and provide information to the world," Walensky said. "Right now, we know as we look across the globe that less than 15 percent of people around the world have been vaccinated, and many of those people have only received one dose of a two-dose vaccine. There are places around the world that are surging, and so as the WHO makes those recommendations, they do so in that context."

San Francisco has a history of issuing guidelines that are more strict than those of the state, but it said in this case it will continue to align with California recommendations.  

"We are working closely with state health officials to understand the risks of the Delta variant," Noel Sanchez, a spokesperson with San Francisco's Emergency Operations Center, said in a statement. "We know that it is present in the state and the Bay Area, and we continue to align with state guidance that states that people who are not yet fully vaccinated are required to wear masks indoors or at large outdoor events.  Those who are vaccinated can choose to wear masks if they feel more comfortable doing so. We continue to follow emerging data and science and will adjust this approach to expand masking recommendations, if necessary."

Research shows that fully vaccinated people appear to be well protected from infections caused by Delta variants, but those with only one vaccine dose of Pfizer or Moderna are not as well-protected. The smaller number of COVID-19 infections identified in people who are fully vaccinated have been mild illnesses, health officials said.

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