The Centers for Disease Control and Prevention on Tuesday recommended that fully vaccinated Americans return to wearing masks indoors in locations with high Covid-19 transmission rates as infection rates rise again across the country.
CDC director Dr. Rochelle Walensky told reporters Tuesday that in areas of “high and high transmission” everyone, including those who are fully vaccinated, should wear masks in public, indoors.
But what exactly is “high” or “significant” transmission, and where are the areas that the CDC cares about?
The agency uses two measures to divide U.S. counties into four levels of community transmission: the number of new cases per 100,000 residents and the percentage of positive Covid tests in the past week.
If a county has reported 50 to 100 cases per 100,000 residents over a seven day period, or has a positivity rate of 8 to 10%, it falls into the “significant transmission” category, while those that report 100 cases or more per 100,000 or more have a positivity rate of at least 10% are referred to as “high transmission”. These are the two groups that the CDC recommends wearing masks.
The CDC said 1,495 counties fall into the highest broadcast grouping and another 548 counties fall into the “essential” tier – the areas where masks should be worn in restaurants, businesses and public spaces. These counties together account for 225 million Americans, or about two-thirds of the US population, according to a CNBC analysis of the agency’s data.
The low-transmission counties that are not subject to CDC advice make up an additional 31% of the population, while just over 1% of Americans live in low-transmission counties as of July 27 based on the CDC’s current criteria.
Federal health officials still believe that fully vaccinated individuals represent a very low level of transmission. The more contagious Delta variant, however, means that some vaccinated people may carry higher amounts of the virus than previously understood and may be just as easily passed on to others as unvaccinated people, Walensky said.
There are at least three states in which each county falls under the CDC’s mask recommendation: Florida, Louisiana, and Arkansas.
The Delta Covid variant is one of the most contagious respiratory diseases scientists have ever seen, Walensky said last week. The variant is highly contagious, mainly because people infected with the Delta strain can carry up to 1,000 times more viruses in their nasal passages than those infected with the original strain, according to new data.
“The Delta variant is more aggressive and much more transmissible than previously circulating strains,” Walensky told reporters at a briefing Thursday. “It’s one of the most contagious respiratory viruses we know and I’ve seen it in my 20-year career.”
The CDC guidelines are only a recommendation, leaving it up to state and local officials to decide whether to reintroduce their masking rules for specific individuals. Some areas have started to reintroduce mask requirements in the past few weeks.
Dr. Natasha Bhuyan, a GP at One Medical in Phoenix, said she recommends that her patients wear a mask because the Delta strain is so much more contagious than other varieties.
“We know that you are much less likely to be hospitalized or die of Covid after a vaccination,” she said. “But even if you are vaccinated, you can rarely get Covid and you can still be contagious and pass Covid on to other people.”
Phoenix is located in Maricopa County, which is in the highest category of community broadcasts.
“Delta has changed the way we think about when people should wear masks,” added Bhuyan. “It won’t take forever. If we increase the vaccination rate and the Covid case rate decrease, people will be able to take their masks off.”
– CNBC’s Berkeley Lovelace Jr. contributed to the coverage.
Correction: This article has been updated to remove Hawaii as one of the states where each county meets the CDC’s mask recommendations. Kalawao County has a population of 86 and has low transmission rates.