US heads for ‘serious fall’ with surge in delta virus cases and return of domestic mask mandates

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People wearing protective masks shop at a Walmart on May 18, 2021 in Hallandale Beach, Florida.

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As the highly disseminated delta variant continues to spread rapidly across the United States and elsewhere around the world, scientists and other health experts warn that mandates for indoor masks and other public health measures will likely return in the United States this fall.

Health experts say the country, which just celebrated the Fourth of July with some of its first large gatherings in more than a year, is headed toward a “dangerous” fall season as Delta is expected to cause another surge in new cases. Experts say delta, already the dominant variable in the US, will hit states with lower vaccination rates hardest — unless those states and companies reintroduce mask rules, capacity limits and other public health measures that they have largely rolled back in recent months. .

With new mutations discovered every few weeks, many scientists now predict that Covid will continue to spread around the world for at least the next two to three years, requiring countries to re-implement public health measures on an ad hoc basis for the foreseeable future. Authorities in Australia, South Africa and Asia recently reintroduced curfews or other measures to curb the growing outbreak in the delta. Japan just declared a state of emergency related to the coronavirus in Tokyo and banned spectators at the Olympics. High U.S. vaccination rates and warm summer months have bought the country some extra time, but outbreaks around the world are giving Americans an overview of what might happen this fall.

Health workers talk near an ambulance in the parking lot of Steve Biko Academic Hospital, amid the national coronavirus disease (COVID-19) lockdown, in Pretoria, South Africa, January 11, 2021.

Siviwe Sebiko | Reuters

“I can expect that in certain parts of the country there could be a reintroduction of indoor mask mandates, occupancy caps and occupancy” in the coming months, said Lawrence Justin, director of the WHO Collaborative Center nationally and globally. Health law.

He said he feared “large outbreaks” in the United States this fall, especially in states with low vaccination rates.

He added, “We’re heading into a very dangerous downfall, with huge swaths of the country still vulnerable, having some sort of rising delta and people taking off their masks.”

The warning from scientists and other health experts comes as many businesses and offices across the United States have largely dispensed with requirements for masks, social distancing and other restrictions related to the pandemic.

Almost immediately after the Centers for Disease Control and Prevention said fully vaccinated people did not need to wear masks in most indoor settings in mid-May, Walmart and Costco followed suit, allowing fully vaccinated customers and employees to go maskless. Not required by state or local laws. Similarly, Detroit automakers and the United Auto Workers union agreed late last month to make face masks optional for fully vaccinated employees.

A GM assembly worker loads engine block castings onto the assembly line at the GM Romulus Powertrain plant in Romulus, Michigan, U.S., August 21, 2019.

Rebecca Cook | Reuters

Other companies like Apple and Amazon are making a big push for most of their employees to return to the office in some capacity this fall as more Americans are vaccinated against the virus. Goldman Sachs workers returned to the office last month while Citigroup and JP Morgan expect their employees to return on a rotational basis this month.

Confirmed Covid infections in the United States have fallen to their lowest levels since the start of the pandemic, averaging about 15,000 new cases per day over the past seven days from a peak of about 251,000 new cases on average per day in January, according to data collected by Jones University. Hopkins. Hospitalizations and deaths have also fallen, with Covid deaths averaging around 225 per day – down from a peak of more than 3,400 average deaths per day in January.

If daily Covid cases are to rise again in the fall, as health experts predict, some employers in states with low Covid vaccination rates may have to face the difficult choice of reinstating public health measures, such as mask-wearing and social distancing, And capacity limits, or send office workers home altogether.

There will be “two Americas,” said Dr. Paul Offit, a pediatrician and vaccine advocate who has served on advisory committees to both the Centers for Disease Control and Prevention and the Food and Drug Administration. “There is a pollinated America and an unpollinated America, and I think an unpollinated America is about to pay for that.”

CDC Director Dr. Rochelle Walinsky said recently that about 1,000 counties in the United States have Covid vaccination coverage below 30%, most of which are located in the Southeast and Midwest. The agency is already seeing increased rates of infection in those areas due to the increased prevalence of the delta variant.

That prompted some state and local health officials to reinstate public health measures they had previously dropped.

Patricia Cole gets a shot of a Moderna Covid-19 vaccine from a medical worker at a pop-up clinic operated by Delta Health Center in this Delta rural community on April 27, 2021 in Hollandale, Mississippi.

Spencer Platt | Getty Images

In Mississippi, for example, where less than a third of the state’s entire eligible population is vaccinated, officials last week recommended that all residents continue to wear masks indoors as Delta becomes the dominant alternative in the state. State health officials said in a call with reporters that about 96% of new Covid cases in the state are among people who are not immune.

White House chief medical advisor Dr. Anthony Fauci said people may want to consider wearing masks in states like Mississippi where transmission is high and vaccinations are low, even if they are fully vaccinated.

Depending on your personal situation, you can,” Fauci said in an interview scheduled to air Friday on SiriusXM’s “Radio Reports” show with Dr. Mark Siegel. “For example, an elderly person who may not actually have full strong protection, even though the protection is very high, or someone who has an underlying condition” may still want to wear a mask, he said.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health (NIH), testifies before a Senate Health, Education, Labor and Pensions hearing examining an update from federal officials on efforts to combat COVID-19 at the Dirksen Senate Building on 11 May 2021 in Washington, DC.

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Officials in Los Angeles County, California, also last week recommended that “everyone, regardless of vaccination status,” wears masks in public as a precaution.

Offit, who advises the Food and Drug Administration on Covid vaccines, said he expects several more states to reintroduce indoor mask requirements this fall.

The United States remains “undervaccinated,” Offit said, and states with lower vaccination rates are likely to be hit worse. Less than half of the United States, about 158 ​​million people, are fully vaccinated across the United States with more than a dozen states fully vaccinated and less than 40% of their populations, according to CDC data. Data in Texas, the second most populous state after California, shows that only 42% of its residents are fully vaccinated.

Offit said that even fully protected people have cause for concern when it comes to variants of Covid. He said that while vaccines protect well against severe illness and death, they may not also protect against mild illness or the spread of Covid to others. He noted that no vaccine is 100% effective.

“It’s not a bold expectation to think that SARS-CoV-2 will spread two or three years from now. I mean there are 195 countries out there, most of which haven’t been given a single dose of the vaccine,” Offit said. “Will it continue to be traded in the US? I think that would be very likely.”

Dr. Christopher J. L. Murray, director of the Institute for Health Metrics and Evaluation, agreed that more states will have to re-implement mask mandates this fall. He said Americans who are most at risk may need to wear masks each year during the peak coronavirus and flu transmission season: November through April. However, he noted, it may be difficult to get some Americans to use face coverings now that the pandemic has waned.

“Given the pandemic fatigue, it will be difficult to get most Americans to follow guidelines on mask use and social distancing. And when cases and hospitalizations begin to rise again, perhaps not until the fall or winter, it may be easier to persuade some to take action.”

People crowd to eat outdoors at a restaurant as restrictions for the coronavirus disease (COVID-19) have been eased in Ann Arbor, Michigan, United States, April 4, 2021.

Emily El Kunin | Reuters

Dr. Vin Gupta, a Harvard-trained lung specialist and NBC contributor, said mask requirements should be reintroduced this fall but are enforced locally and depend on what happens in the community surrounding rates of Covid vaccination and transmission.

“There has to be some determination out there and many local jurisdictions have to make their own decisions, especially with the changing seasons and the return to cool, dry air,” he said.

Meanwhile, the federal government’s mandate on public transportation, including planes, passenger buses and rail systems, is set to expire on September 13 unless the CDC extends it again.

Whether the CDC does this is an open question, the scientists said. Walinsky and the White House have indicated there is no desire to reimpose lockdowns and will leave a lot of decisions about public health measures to the states.

“A lot of this is not science. It’s political science,” said Dr. Isaac Bogosh, professor of infectious diseases at the University of Toronto. “If you have high rates of transmission of Covid-19 in the community and you have high rates of unvaccinated individuals, then it makes sense to hide indoor spaces from a scientific perspective. Whether or not that will be turned into policy is a different question.”

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