After a court ruling struck down a federal mask mandate, many airlines and state transit systems — including Maryland’s — made the face coverings an optional defense against COVID-19.
It’s one more decision people will have to make on their own as they increasingly return to in-person work, commute by bus or train, or travel on planes to spring events such as weddings and family reunions.
“When it comes to events, especially those that are somewhat voluntary that we have to make decisions on such as weddings, anniversary parties, bar mitzvahs, what should we do?” said Dr. Manoj Jain, an infectious disease expert at Emory University’s Rollins School of Public Health in Atlanta, during a Johns Hopkins University-led webinar Tuesday.
“It’s a challenge,” said Jain, who helped plan and host his daughter’s 400-person wedding during the January omicron-fueled surge.
Deciding to go, or host, an event can be tricky when it’s impossible to know when the next big surge occurs, he said. When cases began mounting in December and Jain’s daughter refused to postpone, he turned to planning and communication to ensure the gathering wouldn’t become a “superspreader” event.
That meant requiring all guests to be fully vaccinated, and asking two who refused to stay home. The guests agreed to test before travel and again before daily events. Jain held Zoom calls with guests to ensure they understood.
He spent months collecting rapid tests and even tapped his own lab for more accurate PCR testing of some people. While that is not available to the average person, testing turnaround times are not as long outside of a major surge. And rapid tests are far more widely available in stores, city and county libraries, and by ordering free kits on a federal website, covid.gov/tests.
Jain and webinar moderator Gigi Gronvall, a senior scholar in the Johns Hopkins Center for Health Security, said the self-administered rapid tests still work well with the omicron variants.
Jain found 10 positives among the guests but was able to repeatedly retest them to ensure that by the time some events occurred days later, most were no longer infectious and could attend with masks.
Jain called the efforts “layering,” with vaccinations, testing and masking of as many people as possible, including people working at the events such as hairstylists and food servers. Good ventilation systems or outdoor events are even better.
Children under age 5 who are not yet eligible for vaccination can likely safely go so long as they and others around them are tested, he said. Mask those age 2 and older, per guidance from the U.S. Centers for Disease Control and Prevention.
Even now that the January surge has subsided and cases remain low, though ticking up again, caution still is needed.
That includes continuing to wear a mask on planes, trains and buses, enclosed spaces with little opportunity for distancing, Jain said.
Lifting the mandate ordered by the CDC but struck down Monday by a federal judge appointed by then-President Donald Trump was “a terrible idea,” he said.
“We don’t know enough about the spread of the BA.2 variant,” which is now the dominant coronavirus variant nationwide, he said.
Nonetheless, the Maryland Department of Transportation joined other transit systems and airlines that dropped their mandates, leaving people to decide their own risk based on their age and health, and that of their family. MDOT said masks would be optional at BWI Marshall Airport, as well as on all buses, trains and mobility vehicles.
Most other mask mandates already had been abandoned, except for some college campuses and health care facilities that had kept or reinstated masking after cases again began to rise in recent weeks.
The Maryland Department of Health recommends people wear masks indoors if they are not fully vaccinated and outdoors when they can’t keep a distance from others. Though, officials note that schools, day cares, camps and businesses can set their own masking policies.
The health department “is evaluating the recent actions at the federal level and will provide updates to Marylanders as appropriate,” said Ebony Wilder, a spokeswoman.
Cases had been dropping to some of their lowest levels of the pandemic until last month when they started slowly rising again. The state’s data shows 667 more cases were reported Tuesday, well below the thousands reported daily during the pandemic peak in January. Hospitalizations and deaths have not ticked up but tend to lag cases by weeks.
Close to 4.2% of people tested in Maryland for COVID-19 were positive, according to Tuesday’s report, below the double-digit peaks but edging closer to the 5% threshold that public health officials say signals that COVID-19 is widespread.
Testing, however, may be less accurate these days as more people eschew a nasal swab or test at home and do not report results.
Another indicator of the spread of COVID-19, wastewater tested by the CDC, shows an increasing amount of virus. In Maryland, a plant in Howard County not far from Baltimore showed a sharp upturn in the load beginning in early March. Another plant, in Washington County in Western Maryland, shows a less sharp increase.
Many jurisdictions are following the CDC’s lead when advising the public about masking and other measures. The agency recently developed a county-level map tracking risk from the virus that weighs the level of severe illness from COVID-19, measured by the burden on the health care system rather than just cases.
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“We are utilizing CDC guidance, which is based on community indicator levels reading as high. We are currently low,” said Dr. Letitia Dzirasa, Baltimore’s health commissioner, when asked about when any mandates might return.
While hospitalizations usually lag cases by weeks, public health officials have said low hospitalizations could indicate that vaccines, coupled with natural immunity from recent infections with another omicron variant, could mean most people won’t get severely sick. Maryland health officials, however, warn that immunity wanes and have been encouraging booster shots for those eligible.
Federal regulators recently announced that they would allow a second booster dose of the COVID-19 vaccine for older people and those with medical conditions, leaving the public to decide whether and when to get another shot.
The state and local health departments continue to make the vaccinations available. Though far fewer are lining up for shots now, Maryland has a relatively high rate of vaccination, with about 80% of the eligible population age 5 and older fully vaccinated. Federal regulators are expected to authorize vaccinations for those under age 5 in coming weeks. Adults are eligible for booster shots, and those over age 50 for the second booster.
But going forward there also may be more useful information guiding personal decisions. The CDC launched a new center Tuesday called the Center for Forecasting and Outbreak Analytics.
Officials likened it to a National Weather Service for infectious diseases, making predictions based on data and relaying useful guidance to the public. It will fund modeling and other work at the center and private universities. Among the forecasting center’s leaders is Caitlin Rivers, a Johns Hopkins University epidemiologist.
“The capabilities and team we are building at the new center will improve decision-making in a health crisis,” said Dylan George, the center’s director for operations, in a statement. “Better data and analytics will give us better responses to protect all Americans.”