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Masks again? The spread of the delta variant prompts a rethink on precautions.


During the pandemic, masks have been ranked among the most controversial public health measures in the United States, symbolizing a bitterly partisan divide over the role of government and individual liberties.

Now, with a new version of the coronavirus spreading rapidly around the world, masks are again the focus of conflicting views and fears, about the course of the pandemic and the restrictions needed to manage it.

Renewed concern follows wildfire growth delta version, a highly contagious form of the virus was first detected in India and later identified in at least 85 countries. It now accounts for one in five infections in the United States.

In May, federal health officials said fully vaccinated people no longer needed to wear masks even indoors. The advice signaled 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 version. Worried about the global surge in cases, the World Health Organization last week reiterated its long-standing recommendation that everyone – inoculated – wear masks to prevent the spread of the virus.

Health officials in Los Angeles County on Monday followed suit, recommending that “everyone, regardless of vaccination status, wear a mask indoors in public places as a precaution.”

The county’s director of public health, Barbara Ferrer, said the new recommendation was due to a rise in infections, a worrisome delta version of cases, and a persistently high number of unvaccinated residents, especially children, black and Latino residents and essential workers. was required. .

Nearly half of Los Angeles County residents fully vaccinated, and about 60 percent have taken at least one dose. While the number of positive tests in the county is still less than 1 percent, the rate is rising, Dr. Ferrer said, and the number of reinfections has increased among residents who were previously infected and not vaccinated.

Dr. Ferrer said the extent to which Los Angeles County has managed to control the pandemic is due to a multi-pronged strategy, which includes vaccination combined with health restrictions, aimed at preventing new infections. He said natural immunity in people already infected has also kept transmission down, but it is not clear how long natural immunity will last.

“We don’t want to revert here to a lockdown or a more disruptive mandate,” Dr Ferrer said. “We just want to stay on that path, which is keeping community transmission really low.”

Health officials in Chicago and New York City said Tuesday they have no plans to revisit mask requirements. Officials from the Centers for Disease Control and Prevention declined to comment, but have not indicated any intention to revise or re-examine masking recommendations for fully vaccinated people.

“When the CDC Recommended As for skipping masking, it was not anticipated to be in a situation where we might need to recommend masking again,” said Angela Rasmussen, a research scientist at the Vaccines and Infectious Diseases Organization at the University of Saskatchewan in Canada.

“Nobody would want to do that. People are accusing him of moving the goalposts.”

But the trajectory of the delta variant outside the United States suggests that concerns are likely to intensify.

Even Israel – which has one of the highest vaccination rates in the world and is aggressively immunizing young teens and eligible teens – has banned public indoor spaces and large-scale immunizations after hundreds of new Covid-19 cases were detected. Masking requirements at public gatherings have been reinstated. In recent days, those have included those who received both doses of the Pfizer-BioNTech vaccine.

This is not the first time the world has consumed a more contagious form of coronavirus. The alpha version surrounded the UK and stalled the rest of Europe earlier this year. In the United States, alpha quickly became the dominant form by the end of March, but the rapid pace of vaccination blunted its spread, spare the nation Huge surge in infections.

But Delta is known to be even scarier. What is known about the variant is based on its prevalence in India and the UK, but early evidence suggests it is twice as infectious as the original virus and at least 20 per cent more contagious than Alpha.

In several Indian states and European countries, delta quickly overtook alpha to become the dominant version of the virus. It is on track to do the same in the United States.

Among the many mutations of variants are some that may help the virus partially trick the immune system. Several studies have shown that while current vaccines are effective against delta, they are bit less So in comparison with most other variants. For individuals who have received only one dose of the two-dose regimen, protection against the variant is significantly reduced compared to efficacy against other forms of the virus.

The WHO’s argument for maintaining masking is that while vaccination is highly effective in preventing severe disease and death, the extent to which vaccines prevent mild or asymptomatic infections is unknown. (CDC officials disagree, saying the risk is minimal.)

WHO says that Vaccinated people should wear masks In crowded, close and poorly ventilated areas, and with other preventive measures such as social distancing should be continued.

“What we’re saying is: ‘Once you’re fully vaccinated, keep playing it safe, because you could end up as part of the transmission chain. kind of can’t be safe,'” Dr Bruce Aylward, a senior WHO adviser, 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 nearly two-thirds of the population has received at least one dose of Pfizer-BioNTech or AstraZeneca vaccine and less than half has received two, still struggles with a sharp rise in infections from the variant.

It is not certain what course the Delta version will take in the United States. Coronavirus infections have been falling for months, in the form of hospitalizations and deaths. But the country’s top infectious disease doctor, Dr. Anthony S. Fauci called the version the “greatest threat” to eradicate the virus in the United States.

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

But the variant’s brilliance for partial immune evasion troubles researchers, as it suggests that fully vaccinated people can sometimes pick up asymptomatic infections and inadvertently spread the virus to others, even if they have never been ill. be.

Bill Hannage, an epidemiologist at the Harvard T.H. Chan School of Public Health, said the delta variant can infect vaccinated people, although its ability to do so is very limited. “If you’re in a place where cases are on the rise, wearing a mask indoors in crowded public places is one way to keep yourself away from contributing to the spread of Delta,” he said.

Other scientists stop recommending that fully vaccinated people always wear masks indoors, but some now suggest that this may be appropriate depending on local conditions – for example, wherever the virus is high. spreading in numbers, or vaccination rates are too low.

Dr. Ravindra Gupta, a virologist at the University of Cambridge in the United Kingdom, said, “Masking in public places needs to continue even after vaccination, until we all get vaccinated or a new vaccine that prevents delta transmission.” more effective against.”

Even now, nearly half of Americans have not been vaccinated, and a large part of the country remains vulnerable to outbreaks of the virus and its variants. Vaccines for children under 12 years old are unlikely to be authorized until fall, the earliest.

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

Dr. Rasmussen of the University of Saskatchewan said the province is moving to Phase 3 of re-admissions on July 11, but may maintain indoor masking requirements and restrictions on the size of gatherings. 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 re-implement mask mandates and other precautions, even in places where it may be a good idea to do so.

“It’s hard to go back on that,” said David Michaels, an epidemiologist and professor at the George Washington School of Public Health, referring to the CDC advice. Yet with the rise of the Delta version, “it is extremely dangerous to continue to have the cultural norm of anyone wearing a mask.”

Dr. Ezekiel Emanuel, Vice President of Global Initiatives at the University of Pennsylvania, said the arrival of the edition should reconsider the mask mandate.

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

While drinking coffee outside Whole Foods Market in downtown Los Angeles on Tuesday morning, Monroe Harmon, 60, said she thought it might be a good idea to take a step back toward masking requirements for everyone.

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

Jill Cowan and Anna Facio-Kreuzer contributed reporting from Los Angeles.



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