Chicago's top doctor on Tuesday said the city will follow new guidance from the Centers for Disease Control and Prevention on wearing masks outdoors, calling the changes "exciting."
The CDC revealed Tuesday that vaccinated people don't need to cover their faces anymore unless they are in a big crowd of strangers. Officials said a focus in the coming weeks will be on easing guidance for vaccinated people, both in recognition of their lower risk and to provide an incentive to get shots.
Chicago Department of Public Health Commissioner Dr. Allison Arwady said she supports the decision, but noted that changes depend heavily on the future of vaccinations.
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"The point here in everything as we're moving ahead is that when you are vaccinated, that is the big difference between whether you are at significant risk for COVID," Arwady said. "And so what's different about the fact that, you know, yes, we still have almost 550 new cases of COVID every day. That's high risk. In general, the way we've already thought about COVID it means that when you're gathering in a setting there can be a significant risk, but the thing that is different now is that that risk is completely bifurcated on whether it's a highly vaccinated setting. If you are in a highly vaccinated setting, if you yourself are vaccinated and the great majority of the people around you are vaccinated, the risk of you getting COVID, even with 550 cases in Chicago, is very, very, very, very, very low."
Arwady said she expects the city to begin "turning that dial" and allowing further reopening in the coming days and weeks, depending on vaccine uptake. She did not specify what that reopening might include, however.
"We will be, I expect to sort of over just the next few days, be turning that dial and be announcing some additional reopening because you heard we're making some really good progress here, but I want people to hear that within that reopening we are making the assumption that Chicagoans will continue to make that decision to get vaccinated," Arwady said during a press conference.
Illinois' health department said Monday that it plans to follow CDC masking guidelines.
"At this time, Illinois plans to remain in concert with CDC masking guidelines," IDPH said in a statement.
The CDC guidance says that fully vaccinated or not, people do not have to wear masks outdoors when they walk, bike or run alone or with members of their household. They also can go maskless in small outdoor gatherings with fully vaccinated people.
But from there, the CDC has differing guidance for people who are fully vaccinated and those who are not.
Unvaccinated people — defined by the CDC as those who have yet to receive both doses of the Pfizer or Moderna vaccine or the one-shot Johnson & Johnson formula — should wear masks at outdoor gatherings that include other unvaccinated people. They also should keep using masks at outdoor restaurants.
Fully vaccinated people do not need to cover up in those situations, the CDC says.
However, everyone should keep wearing masks at crowded outdoor events such as concerts or sporting events, the CDC says.
And the agency continues to recommend masks at indoor public places, such as hair salons, restaurants, shopping centers, gyms, museums and movie theaters, saying that is still the safer course even for vaccinated people.
Illinois has been under a statewide mask mandate for more than a year, which states:
"Any individual who is over age two and able to medically tolerate a face covering (a mask or cloth face covering) shall be required to cover their nose and mouth with a face covering when in a public place and unable to maintain at least a six-foot social distance. This requirement applies whether in an indoor space, such as a store, or in an outdoor space."
A review paper published in The Journal of Infectious Diseases by researchers at the University of California, San Francisco, found that less than 10% of transmission occurs outdoors and the odds of spreading the virus indoors were 19 times higher, NBC News reports.
Some medical experts have increasingly called for mask restrictions to be eased for outdoor activities.
Dr. Ashish Jha, dean of the Brown University School of Public Health in Providence, Rhode Island, told NBC News that wearing masks indoors should still be required, but said outdoor infections are rare and mostly tend to happen when large groups gather in confined spaces for long periods of time.
“At this point in the pandemic, with more than half of Americans vaccinated, it's pretty reasonable to start thinking about peeling back outdoor mask mandates," Jha said.
Dr. Paul Sax, clinical director of infectious diseases at Brigham and Women’s Hospital in Boston, Massachusetts, also agreed, writing in a blog post on the New England Journal of Medicine website that it might be time to lift the mandates, especially in places were people can safely distance.
“Transmissions do not take place between solitary individuals going for a walk, transiently passing each other on the street, a hiking trail, or a jogging track,” Sax wrote. “That biker who whizzes by without a mask poses no danger to us, at least from a respiratory virus perspective.”
Sax similarly stressed that indoor mask regulations should persist, at least until more people are vaccinated.
However, experts at Northwestern University argue keeping masks on when you're outside — even after you're vaccinated — is not only a "social courtesy,” but also helps "model the behavior" for children, who can't yet get the shot. A mask shows “your civic engagement, the fact that you’re committed," said Mercedes Carnethon, vice chair of preventative medicine at Northwestern University Feinberg School of Medicine. "You’re sending a signal that you’re behaving in socially appropriate ways.”