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CDC says fully vaccinated Americans can go without masks outdoors, except in crowded settings

Biden lays out changes as an incentive for people to get the shots so they can return to ‘more normal lives.’

Sheet metal worker Demetrius Buttelman gestures after being inoculated with the first dose of the Pfizer vaccine at a pop-up vaccination site in New York last week. (Pool/Reuters)
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Federal health officials said Tuesday that fully vaccinated people can go without masks outdoors when walking, jogging or biking, or dining with friends at outdoor restaurants — a milestone development for tens of millions of pandemic-weary Americans after more than a year of masking up and locking down.

President Biden touted the relaxation of restrictions as another reason for people to get vaccinated, urging them to move forward not just to protect themselves and those around them, but so they can live more normally, by “getting together with friends, going to the park for a picnic without needing a mask.”

Biden had set July 4 as a target for when people could get together for backyard picnics with a sense of normalcy, and both the new mask guidance and his remarks were geared to encouraging people to continue getting the shots.

“ I … want to thank everyone who has gotten the vaccine for doing your patriotic duty and helping us get on the path to Independence Day,” Biden said in remarks on the North Lawn of the White House. He arrived at the lectern wearing a mask. He returned to the White House without one, saying he didn’t have to put it on until he got back into the building.

CDC Director Rochelle Walensky on April 27 said it is safe for those who are fully vaccinated to remove their masks in small outdoor settings. (Video: Reuters)

The latest guidance from the Centers for Disease Control and Prevention comes as more than 52 percent of eligible people in the United States have gotten at least one shot, but the pace of inoculations appears to be slowing in the face of vaccine hesitancy, especially among rural residents and Republicans who believe the risks from the virus are overblown. Uptake has also been slower among communities of color because lack of health services and transportation have been barriers to access.

Officials said the changed guidance was aimed at helping those who are fully inoculated return safely to old routines, while encouraging others to get their shots to counter highly contagious new variants.

“Over the past year, we have spent a lot of time telling Americans what they cannot do, what they should not do,” CDC Director Rochelle Walensky said at a White House briefing. “Today, I’m going to tell you some of the things you can do if you are fully vaccinated.”

As drug companies expand coronavirus vaccine access to children, officials are working to persuade people who are skeptical or unwilling to get vaccinated. (Video: Luis Velarde, Jonathan Baran, Erin Patrick O'Connor/The Washington Post, Photo: Erin Cox/The Washington Post)

The recommendations also address growing calls from infectious-disease and other public health experts to relax mask mandates for the outdoors because breezes disperse airborne virus particles, distancing is easier, and humidity and sunlight render the coronavirus less viable.

For that reason, the guidance says that even unvaccinated individuals may forego masks when walking, jogging or biking outdoors with household members. Officials still caution that crowded outdoor settings pose risks and urge everyone — both the vaccinated and unvaccinated — to wear masks when attending sporting events, live performances and parades.

The advice to the unvaccinated applies to adults and children alike, according to the CDC. None of the covid-19 vaccines used in the United States is authorized for children under 16.

A growing body of evidence suggests that people who are two weeks past their final shot are less likely to have asymptomatic infections or transmit the coronavirus to others. Officials don’t know how long protection lasts and how much the vaccines protect against emerging virus variants.

But “taking steps toward relaxing certain measures for vaccinated people may help improve coronavirus vaccine acceptance and uptake,” the guidance states. “Therefore, there are several activities that fully vaccinated people can resume now, at low risk to themselves, while being mindful of the potential risk of transmitting the disease to others.”

Brightening U.S. picture

Walensky cited several factors motivating the changed guidance: Falling coronavirus case rates and climbing vaccinations (more than 37 percent of those over 18 are fully protected) make outdoor settings safer than before. Indoor settings have an almost 20-fold increased risk of transmission compared to outdoor ones, she noted.

If more people continue getting inoculated and cases drop further, she said, the CDC will release additional guidance for the fully vaccinated.

A year into pandemic, it’s even more clear that it’s safer to be outside

Asked how she would describe the nation’s situation now compared to last month when she spoke of a feeling of “impending doom” as infections mounted, Walensky said that if the United States follows measures taken by other countries where “vaccinations continue to soar and the cases plummet, that we should be in good shape.”

For states that currently have mask requirements outdoors, Walensky said the CDC feels it is no longer necessary for fully vaccinated to wear masks unless they are in crowded outdoor venues, such as stadiums and concerts, where it is hard to know who is vaccinated and who is not.

Tuesday’s guidance includes a color-coded chart that shows activities that fully vaccinated and unvaccinated people can do indoors and outdoors, and which ones can be done without masks. The safest activities, highlighted in green, are outdoors in small gatherings. Activities with the greatest risk are indoor settings that involve behaviors such as singing, shouting, heavy breathing, inability to wear a mask or inability to maintain physical distancing, such as indoor high-intensity exercise class.

The nearly 96 million Americans who are fully vaccinated can now forgo masks for many outdoor activities, including:

° Walking, running, hiking or biking outdoors alone or with members of your household.

º Attending a small outdoor gathering with fully vaccinated family and friends.

º Attending a small outdoor gathering with a mix of fully vaccinated and unvaccinated people.

º Dining at an outdoor restaurant with friends from multiple households.

Officials say certain conditions increase risk: crowding, time spent, lack of ventilation and high community transmission. That’s why the CDC is recommending that it is safest for fully vaccinated people to continue to wear well-fitted masks in these settings, including:

º Attending a crowded outdoor event, such as a live performance, parade or sporting event.

º Visiting a barber or hair salon.

º Going to an uncrowded indoor shopping mall or museum.

º Going to an indoor movie theater.

º Attending a full-capacity service at a house of worship.

º Singing in an indoor chorus.

“The examples today show that when you are fully vaccinated, you can return to many activities safely … and begin to get back to normal,” Walensky said. “And the more people who are vaccinated, the more steps we can take toward spending time with people we love, doing the things we love to enjoy. I hope this message is encouraging for you. It shows just how powerful these vaccines are.”

The agency also provided additional guidance for the fully vaccinated related to work, quarantine and testing. Fully vaccinated workers no longer need to isolate following an exposure, as long as they do not have symptoms. Fully vaccinated residents of non-healthcare congregate settings no longer need to quarantine following a known exposure. And fully vaccinated people without symptoms or known exposures may be exempted from routine screening tests — a change of enormous significance for schools trying to plan for summer school and fall reopening.

Monica Gandhi, an infectious-diseases expert at the University of California at San Francisco, applauded the CDC’s action after arguing that accumulating evidence shows the low risk of outdoor transmission.

“Viral particles disperse effectively in the outside air,” she said in an email, citing numerous studies, including one in Wuhan, China, that found just one of 7,324 infection events investigated was linked to outdoor transmission.

The rapid spread of covid-19 in the United States began in early 2020. A lot has changed in our day-to-day lives since then, including the use of face masks. (Video: Allie Caren/The Washington Post, Photo: Brian Monroe/The Washington Post)

Gandhi noted that the World Health Organization says masks are not necessary outside unless physical distancing, which the agency defines as about three feet, cannot be maintained.

She and others have said it’s important for public health officials to provide incentives as “a great strategy to encourage those who are on the fence to get vaccinated.”

“Public health messaging since the time of HIV that focuses on positive, rather than negative, reinforcement has been shown to be more effective, so the CDC guidelines that vaccinated people don’t have to mask outdoors will hopefully help persuade some of the vaccine hesitant in the U.S. to get the vaccine,” Gandhi said.

The CDC guidance said there is limited data on vaccine protection in people who are immunocompromised. It urges people taking immunosuppressive medications to discuss the need for personal protective measures with their health-care providers, even if they are fully vaccinated.

Growing pushback on masks

Even before the CDC’s announcement, some states were already moving to ease mask mandates: Kentucky Gov. Andy Beshear (D) on Monday cleared groups of fewer than 1,000 to gather outside without masks. Massachusetts Gov. Charlie Baker (R) on Tuesday said his state’s rule requiring masks outdoors would expire Friday, except in certain situations where social distancing is impossible.

The issue has become even more politically charged recently as conservative media figures have used their platforms online and on cable news to turn outdoor masking rules into a cause celebre. Fox News host Tucker Carlson urged viewers this week to contact child protective services to report the parents of children seen masked outdoors.

“Your response when you see children wearing masks as they play should be no different from your response to seeing someone beat a kid in Walmart,” he said on his show, which is among the most watched on cable, regularly drawing 3 million viewers. “Call the police immediately, contact child protective services. Keep calling until someone arrives.”

His instructions were echoed Tuesday morning by Mollie Hemingway, a senior editor at the Federalist, a conservative Web magazine. She tweeted: “Even if you’re an outdoor mask enthusiast at this late date, despite the complete lack of scientific support for same, I think we all can agree that masking children outdoors, at the very least, is abusive, right?”

The comments illustrate how face coverings, which were scorned by President Donald Trump, remain a marker of political identity more than a year into the pandemic.

Isaac Stanley-Becker and Ben Guarino contributed to this report.