Masking Guidance in Flux as Delta Variant Surges

Ralph Ellis

July 01, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Despite concerns of a spreading delta variant of the coronavirus, the CDC has no plans to walk back its guidance that fully vaccinated people can skip the mask when indoors.

In May, the CDC said that people who are fully vaccinated against COVID-19 no longer have to wear masks or physically distance, regardless of the location or size of the gathering.

The CDC has not changed its position on masking, even while warning that the delta variant could become the dominant strain in the United States. The variant now accounts for 1 in every 5 new infections in the United States, up from about 1 in every 10 the week before.

CDC Director Rochelle Walensky, MD, clarified the CDC's position Wednesday on the Today show .

"If you're vaccinated, you're safe from the variants that are circulating here in the United States," she said. "We would suggest that you look to your local policies because we would like our policymakers, even if you're one of the one-third of people vaccinated in their area, to adhere to the policies that are made to protect the unvaccinated."

When asked if fully vaccinated Americans don't need to wear face masks, Walensky said, "That's exactly right."

Some scientists say the CDC would create more problems if it switched directions and reimposed a widespread face mask mandate.

"It's difficult to walk that back," David Michaels, PhD, an epidemiologist and professor at the George Washington School of Public Health, told The New York Times. But Michaels said that because of the spread of the delta variant, it would be "extremely dangerous to continue the cultural norm of no one wearing a mask."

Meanwhile, the World Health Organization is sticking with its recommendation that everybody, vaccinated or not, wear a mask.

"People cannot feel safe just because they had the two doses. They still need to protect themselves," Mariangela Simao, MD, assistant director-general for access to medicines and health products for the World Health Organization, said last week during a news conference.

"Vaccine alone won't stop community transmission. People need to continue to use masks consistently, be in ventilated spaces, hand hygiene ... the physical distance, avoid crowding. This still continues to be extremely important, even if you're vaccinated when you have a community transmission ongoing."

L.A. County Advises Everyone to Mask Up

Los Angeles County is once again advising all residents, whether they're fully vaccinated or not, to wear masks indoors in public places and at grocery or retail stores, theaters, family entertainment centers, and workplaces.

"While COVID-19 vaccine provides very effective protection preventing hospitalizations and deaths against the delta variant, the strain is proving to be more transmissible and is expected to become more prevalent," Barbara Ferrer, PhD, director of the Los Angeles County Department of Public Health, said in a news release.

"Mask wearing remains an effective tool for reducing transmission, especially indoors where the virus may be easily spread through inhalation of aerosols emitted by an infected person."

L.A. County was once a COVID-19 hot spot but appeared to bring the spread of the coronavirus under control with the vaccination program. Masking rules were relaxed.

Then the delta variant, which was first detected in India, began crossing borders and infecting people all over the world, including California. That has local, state, and national governments taking different tactics concerning face masks.

Illinois Governor Says Carry a Mask

While L.A. County is urging indoor face masking, the California Department of Public Health has not changed its guidance, saying people don't need to mask up indoors in most cases.

Most states haven't gone back to strict face mask rules, though officials recommend people remain vigilant.

In Illinois, Gov. J.B. Pritzker urged people to carry a mask when they leave their homes, Fox News eported.

"I think when we leave our home every day, I would encourage everybody, whether you're vaccinated or not, to bring your mask with you," he said.

"I would say from my own perspective, if you're going into a heavily crowded area, you don't know if someone is vaccinated, so you should just bring your mask with you and keep safe."

Pritzker cited the spread of the delta variant in Israel , where an indoor mask mandate was put back in place only 10 days after it was dropped. An uptick in infections by that variant was the cause.

In Washington state, strict face mask mandates will not be brought back despite the threat posed by the delta variant, government officials told The Seattle Times .

But the state health department tweaked its rules Tuesday to say unvaccinated people should keep wearing masks in indoor public settings and that fully vaccinated people need to wear them in schools, health care settings, and on public transportation.


Los Angeles County Department of Public Health: "As Delta Variant Circulates, Public Health Recommends Masking Indoors as a Precaution ― 3 New Deaths and 259 New Confirmed Cases of COVID-19 in Los Angeles County."

Today: "CDC director clarifies mask guidance after WHO says vaccinated people should wear them."

CNBC: "WHO urges fully vaccinated people to continue to wear masks as delta Covid variant spreads."

The Seattle Times: "Emergence of coronavirus variants not enough to trigger strict mask guidance, Washington state officials say."

Fox News: "Illinois gov encourages residents to carry masks amid Delta variant spread."

The New York Times: "Masks Again? Delta Variant's Spread Prompts Reconsideration of Precautions."