COVID is 'not over,' but CDC says most of America doesn't need to wear a mask. Should you listen? – USA TODAY

No matter where you are in the U.S. these days, it’s likely you’ll be greeted by unmasked faces in public.
Today, more than 98% of the nation’s counties no longer fall under the Centers for Disease Control and Prevention recommendation to mask up. 
Last month, the CDC changed its guidance for masking to include hospital capacity, and raised the threshold for positive cases.
While the sea of full faces may make it seem like the pandemic is over, experts warn it’s far from done, and some worry the new metrics may fall short of projecting a community’s true COVID-19 risk.
“COVID will be around for a long time, there’s no doubt about that,” said Jason Salemi, associate professor of epidemiology at the University of South Florida’s College of Public Health. “I hate to boil down everything about COVID-19 into a single county level map that has three shades of color.”
Under the old CDC guidelines, masks were recommended for people living in communities of substantial or high transmission, which at the time applied to roughly 95% of U.S. counties.
But federal officials said case numbers and positive tests alone no longer gave an accurate picture of COVID-19 risk as many Americans rely on at-home tests and results go unreported. They also argued infections with the omicron variant were less likely to cause severe illness and hospitalization. 
Now, in addition to increasing the caseload threshold of low transmission from 10 to 200 weekly cases per 100,000 people, the guidance also considers hospitalizations, current beds occupied by COVID-19 patients and hospital capacity.
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Including hospital data was inevitable, Salemi said, but changing the caseload limit may have been premature. Areas reporting more than 200 weekly cases per 100,000 people are labeled as moderate-risk on the CDC map, and fall outside the indoor mask recommendations. 
“Omicron is still causing a lot of severe illness,” he said. “We have to start moving to where people are getting back to normal but I want to make sure that we’re doing that when you know the risk to people … from the virus is much lower than it was when we started to implement this new approach.” 
Although coronavirus cases have plummeted from the recent omicron surge, the CDC is still reporting nearly 40,000 new cases and 1,500 deaths per day.
If a novel variant arrives to the U.S. or an existing one causes a surge in cases, some health experts worry the CDC’s new metrics may not recognize it until it’s too late. 
Hospitalizations tend to lag behind case rates by about three weeks and are a poor measure of current community transmission, said Marney White, professor at Yale University School of Public Health.
“My concern is (if in a) couple of weeks we continue to see an increase in cases … it will translate to hospitalizations going back up,” she said. 
White and Salemi also warned that the CDC’s reliance on county-level hospital data leaves parts of the nation vulnerable. 
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“There’s a lot of room for error and contamination using (hospital data) as a single index,” White said. “It’s tricky because a lot of towns don’t have hospitals, so hospitalization data is kind of crude.” 
Salemi said the CDC tried to overcome the problem by clumping together counties that likely use the same health care system but it can still leave gaps. 
Americans living in moderate-risk areas should assess their individual risk before taking off their masks in indoor public settings, experts say. This not only means considering their age, vaccination status and health risks, but also the risks of those around them. The elderly and people who are immunocompromised or are on immune-suppressing medications are at greater risk of serious illness from COVID-19.
People living in low-transmission areas can generally feel comfortable about taking off their masks inside, said Dr. Carlos del Rio, an infectious disease expert at Emory University School of Medicine. But keep those masks handy in case there’s another surge. 
“(COVID) is not over but at this point in time, let’s take a deep breath and say, ‘OK, we can take our masks off for a while,'” he said. “It might not be forever but it’s nice, right?”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT. 
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.


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