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The World Health Organization is encouraging even the vaccinated to keep the masks on, particularly indoors, as the Delta variant of Covid-19 ricochets around the world.
Compare that with the US Centers for Disease Control and Prevention, which a month ago told vaccinated Americans they could largely take the masks off, indoors and out.
These are different organizations with different missions. The WHO is targeting an international audience, which includes many countries with low vaccination rates.
The CDC is targeting the US, which has a relatively high vaccination rate, particularly in certain states. It framed the new guidance that the science shows masks aren't necessary for the vaccinated as a nudge for people to get vaccinated.
But that doesn't jibe with the WHO officials' guidance.
"There are several safe and effective vaccines that prevent people from getting seriously ill or dying from COVID-19. This is one part of managing COVID-19, in addition to the main preventive measures of staying at least 1 metre away from others, covering a cough or sneeze in your elbow, frequently cleaning your hands, wearing a mask and avoiding poorly ventilated rooms or opening a window," the guidance states.
That's been reinforced as Covid ravages Latin America and Africa.
"People cannot feel safe just because they had the two doses. They have to, still need to protect themselves," Dr. Mariangela Simao, WHO assistant director-general for access to medicines and health products, said last week in Geneva.
If anyone needed a reminder that Covid is not over, this divide on masks is it. Read the CDC mask guidance here.
About-face on masks
The Delta variant is also taking off in the US -- and is surging in particular in places with low vaccination rates. So the question is whether the CDC will be forced to reassess its guidance.
Israel has done such a reversal, returning to mandatory indoor masking specifically to control the Delta variant. Some European countries took a more measured approach to ending mask usage, keeping requirements indoors and allowing them to lapse for outdoors.
Now some local US governments are also doing an about-face on masks.
In Los Angeles County, local officials took the precaution of reinstating mask guidance for public indoor spaces, regardless of vaccination status.
Calling it a "precautionary measure," the Los Angeles County Department of Public Health issued the voluntary mask guidance Monday, saying it was necessary until health officials can "better understand how and to who the Delta variant is spreading."
In Illinois, Gov. J.B. Pritzker this week encouraged people to carry masks with them even after they're vaccinated.
"I think when we leave our home every day, I would encourage everybody -- whether you're vaccinated or not -- to bring your mask with you," Pritzker said, according to the Chicago Sun-Times. "You know what the guidelines are across the state of Illinois, and use your mask accordingly."
There has already been some frustration among US health officials at how the CDC's guidance, which came as something of a surprise, has been interpreted, or, actually, misinterpreted.
"I think people are misinterpreting, thinking that this is a removal of a mask mandate for everyone. It's not," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Axios in late May. "It's an assurance to those who are vaccinated that they can feel safe, be they outdoors or indoors."
Fauci and the government lack consistency on masks
He and other experts counseled against wearing masks early in the pandemic, only to reverse course.
Fauci now says he initially advised against masks in part to make sure they were available for front-line workers. He also wrote an email to former Health and Human Services Secretary Sylvia Burwell in February 2020 saying that he didn't, at that time, think they were effective at stopping the spread of the disease.
Our understanding of the virus and the science has clearly evolved since then. But keeping track of mask mandates and recommendations can feel like a full-time job. It might be difficult for the government, now that it has relaxed guidance, to go in the opposite direction.
Most states have abandoned mask mandates for the vaccinated, although there are still many rules for public transportation and schools.
Some, like Florida, have even acted to preempt local governments that might want to return to masks.
The biggest question mark may be in schools, since children under 12, who aren't able to get vaccinated, may be driving the Delta variant spread.
New Jersey announced this week that there won't be a mask requirement for kids in school this fall, although individual districts can impose their own rules.
In California and Washington state there are efforts to frame mask wearing for children and vaccination as personal choices.
Masks, for whatever, reason, really hack some people off
Just consider these recent CNN reports on a sharp spike in misbehaving and even violent passengers on US airplanes, which includes 2,300 reports that passengers refused to comply with the federal requirement to wear masks on airplanes.
Recently, a Mexico national jumped off a plane onto the tarmac at LAX, breaking his leg and drawing federal charges. An off-duty Delta Air Lines flight attendant allegedly used the plane's intercom system and assaulted two other flight attendants, requiring the pilot to call for "all able-bodied men please come to the front of the plane for an emergency."
There is also the group of people who will wear masks from here on out. When CNN wrote about the lasting effects of the pandemic, it spoke with experts who foresee masks becoming a permanent part of our arsenal against the coronavirus and other viruses or bacteria.
"You're sneezing a little bit, you don't know whether it's a cold or allergies -- I could imagine people putting on masks in those circumstances or people putting on masks when they're going traveling," CNN Medical Analyst Dr. Leana Wen, an emergency physician and visiting professor of health policy and management at the George Washington University Milken Institute School of Public Health, told CNN.
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