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February 10, 2022

Are leaders relaxing Covid-19 precautions too soon?

Daily Briefing

    Many U.S. states and other countries are starting to relax Covid-19 restrictions, like mask mandates, in response to dropping case rates. But public health authorities warn that these actions may be premature.

    The omicron scenario planning guide: 7 situations health care leaders must address

    States start relaxing mask mandates

    In response to Covid-19 cases dropping, many states have started rescinding or relaxing mask mandates. Los Angeles County Public Health Director Barbara Ferrer said on Thursday the county could end its outdoor mask mandate in a few weeks, and other health officials in California said the state's indoor mask mandate will be lifted after Feb. 15.

    "Since California's peak during the omicron surge, the state has experienced a 65% decrease in case rates," the California Department of Public Health said in a statement.

    Meanwhile, New Jersey Gov. Phil Murphy (D) announced Monday that his state will be ending its school mask mandates. "We have to learn how to live with Covid as we move from a pandemic to an endemic phase of this virus," Murphy said.

    In addition, Delaware Gov. John Carney (D) announced Monday the state will be ending its indoor mask mandate on Feb. 11 and its school mask mandate on March 31. "We're in a much better place than we were several weeks ago in the middle of the omicron surge of Covid-19 cases and hospitalizations," Carney said.

    And Connecticut Gov. Ned Lamont (D) announced Monday his state will end its school mask mandate on Feb. 28, saying, "The biggest difference I can tell you is the fact that we now have the tools to keep ourselves safe."

    New York Gov. Kathy Hochul (D) also announced Wednesday that the state will end its Covid-19 mask mandate for businesses. "Given the declining cases, given the declining hospitalizations, that is why we feel comfortable to lift this," Hochul said.

    Other countries also begin relaxing mandates

    Meanwhile, countries throughout the world have also started relaxing mandates in response to dropping Covid-19 cases. A weekly report from the World Health Organization (WHO) released Tuesday found that Covid-19 cases had dropped 17% worldwide between Jan. 31 and Feb. 6 compared with the week prior. However, the death rate, which tends to lag case numbers, rose 7%.

    United Kingdom Prime Minister Boris Johnson on Wednesday announced a plan to end the rest of England's Covid-19 restrictions later this month.

    "It is my intention to return on the first day after the half-term recess to present our strategy for living with Covid," Johnson said.

    "Provided the current encouraging trends in the data continue, it is my expectation that we will be able to end the last remaining domestic restrictions, including the legal requirement to self-isolate if you test positive, a full month early," he added.

    Similarly, Swedish Prime Minister Magdalena Andersson announced last week that all Covid-19 restrictions would be lifted Wednesday, and the Czech Republic announced Wednesday it would no longer require proof of vaccination to attend public events, bars, restaurants, or to use certain services.

    In addition, Denmark announced in late January that most Covid-19 restrictions would end. "We say goodbye to the restrictions and welcome to the life we knew before," Prime Minister Mette Frederiksen said in January. "As of Feb. 1, Denmark will be open."

    Norway also announced its intention to end Covid-19 restrictions. "Even if many more people are becoming infected, there are fewer who are hospitalized. We're well protected by vaccines. This means that we can relax many measures even as infections are rising rapidly," Prime Minister Jonas Gahr Støre said.

    'Let's transition from pandemic to endemic in a careful way'

    Many health experts have said that, while declining case rates are encouraging, it's important to remember the pandemic isn't over yet. CDC Director Rochelle Walensky on Wednesday said while current case and hospitalization rate trends are improving, CDC "continue[s] to recommend masking in areas of high and substantial transmission. That's much of the country right now, in public and indoor settings."

    Walensky added that CDC is working on new guidance for states to help determine when mask mandates should be relaxed.

    Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in an interview published Tuesday that the country is heading out "of the full-blown pandemic phase of Covid-19," adding that he hopes Covid-19 restrictions will be ending soon.

    "We are looking at a time when we have enough people vaccinated and enough people with protection from previous infection that the Covid restrictions will soon be a thing of the past," he said.

    However, Fauci cautioned, "Everything I am saying is based on a big caveat. We must be prepared for the eventuality that we might get a completely different variant that breaks through all of the protection that you get from prior infection."

    William Schaffner, an infectious disease specialist at the Vanderbilt University Medical Center, also advised caution.

    "There's a tendency to stop the control program before the disease is controlled," he said. "Hang in there with us for another month or two, and then let's transition from pandemic to endemic in a careful way."

    WHO Director General Tedros Adhanom Ghebreyesus similarly warned that it's "premature for any country either to surrender, or to declare victory" against Covid-19.

    "Depending on where you live, it might feel like the Covid-19 pandemic is almost over, or, it might feel like it is at its worst," he said. "But wherever you live, Covid isn't finished with us."

    However, other health experts were more supportive of relaxing mask mandates. "I think it's entirely appropriate that we start lifting school mask mandates now," said Joseph Allen, a researcher of indoor environmental quality at Harvard University. "We're in a much better place than we were before, and it's time to update our strategies to reflect the moment."

    Leana Wen, a public health professor at George Washington University, noted that leaders shouldn't exclusively be using Covid-19 case numbers to determine whether mask mandates should be relaxed.

    "We should not be using case numbers at all when making decisions about restrictions. The case numbers are not reliable," she said. "The metrics for deciding when restrictions should be lifted should be solely on hospitalizations and ICU capacity. As long as vaccines and boosters continue to protect well among the vaccinated and as long as hospitals are not overwhelmed, restrictions should all be lifted." (Adcox, Washington Examiner, 2/8; Bernstein et al., Washington Post, 2/9; Saric, Axios, 2/9; Knutson, Axios, 2/9; Firth, MedPage Today, 2/9; Banco/Cancryn, Politico, 2/9; Stolberg, New York Times, 2/9 [1]; Thompson, Associated Press, 2/9; Anthes, New York Times, 2/9; Miller, Associated Press, 2/9; Stolberg, New York Times, 2/9 [2]; Scully, The Hill, 2/9; Keaten, Associated Press, 2/9)

    The omicron scenario planning guide

    7 situations health care leaders must address

    guide

    For two years, the novel coronavirus has tested health care leaders. Staff are burned out, patients are confused, vaccination rates have stalled, and the future remains uncertain. As the highly transmissible omicron variant spreads among both vaccinated and unvaccinated groups, leaders must address its impact on capacity, staffing, and public health.

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