What the new CDC mask guidelines mean for Massachusetts

Several counties in the state have COVID-19 transmission rates at levels at which the CDC says even fully vaccinated individuals should be wearing masks indoors.

A mix of visitors Tuesday — some wearing masks, some not — at Faneuil Hall Marketplace and Quincy Market in Boston. Craig Walker / The Boston Globe

Amid a national spike in COVID-19 cases driven by the highly contagious Delta variant, the Centers for Disease Control and Prevention released new guidance Tuesday recommending that everyone in virus hotspots once again wear masks indoors, regardless of their vaccination status.

So what does that mean in Massachusetts — a state with one of the highest rates of fully vaccinated residents, and low but rising COVID-19 infection rates?

For now, local officials aren’t signaling plans for any sweeping rule changes.

However, residents in some parts of the state may want to consider the CDC’s advice.

The updated guidelines continue to say that fully vaccinated Americans can resume “many” of the activities they did before the pandemic.” It also says that unvaccinated individuals should continue to wear masks indoors.


The key difference under the new recommendations is that the CDC says that fully vaccinated residents in counties with “substantial” or “high” levels of COVID-19 transmission should wear masks indoors. That means counties that have reported at least 50 new cases per 100,000 persons in the past week or are averaging a positive test rate above 8 percent.

As a whole, Massachusetts is quickly approaching that threshold, with 49.6 new cases per 100,000 residents in the last seven days and a seven-day average positive test rate of 1.83 percent, according to the CDC’s website.

However, several counties are already in the “substantial” or “high” COVID-19 transmission range.

According to the latest CDC data, Suffolk and Bristol counties are both in the “substantial” transmission range, while Barnstable County — where officials are working to contain an outbreak in Provincetown — is in the “high” transmission range with 112 new cases per 100,000 residents in the last week.

During a press conference Tuesday afternoon, CDC Director Dr. Rochelle Walensky noted that the “vast majority” of transmission, hospitalization, and death due to COVID-19 is happening among unvaccinated residents.

Still, the Delta variant has shown it is more capable of infecting vaccinated individuals. And even if the overwhelming majority of those breakthrough cases aren’t severe, Walenksy said vaccinated individuals in hotspot areas should consider wearing a mask in all indoor public places.


“If you have a vaccinated individual who is in a place with substantial or high transmission, they’re contacting a lot of people,” she said. “One in 20, one in 10 of those contacts could potentially lead to a breakthrough infection if you have [vaccine] effectiveness of 90 percent to 95 percent. And so that’s why we’re saying in areas of substantial or high transmission, even if you are vaccinated, that we believe it’s important to wear a mask in those settings.”

Walensky also told reporters that data suggests that “breakthrough infections, rare they are, have the potential to fully transmit at the same capacity as an unvaccinated person.”

Still, for areas with lesser transmission rates — which means, at least for now, the rest of Massachusetts — Walensky said the CDC doesn’t plan on recommending vaccinated residents mask up indoors.

“If you have a vaccine that is 90 to 95 percent effective and you don’t have very much disease around, the chance of you getting infected should you meet somebody is already pretty low — but then the chance that you’re going to meet somebody who is infected is also pretty low,” she said. “So the potential for this to be a problem is much, much lower in areas with low amounts of disease.”


Of course, Walensky noted that individuals in low-transmission areas can still choose to wear a mask, and “that should not be something that is stigmatized.”

The new guidelines come after the CDC revised its mask guidance in May, amid declining COVID-19 rates and increasing vaccination rates, to recommend that fully vaccinated individuals could generally ditch their masks, except for places like buses, subways, planes, Ubers, health care facilities, and other specific indoor settings.

Those guidelines led to a number of states, including Massachusetts, lifting their mask mandates and other COVID-19 rules, even if many public health experts warned it was too soon.

Since May 29, the state has asked only that unvaccinated residents voluntarily wear masks in indoor settings and when they can’t socially distance.

That is the guidance that currently remains in place.

Even with the Delta-fueled increase in COVID-19 increase in cases, Gov. Charlie Baker has stressed that hospitalizations due to the disease in Massachusetts have remained low, even if they have ticked up since late June. The average number of new COVID-19 deaths per day also remains in the low single digits, although 12 deaths were reported on Tuesday.

“We’re not looking at changing any of our existing rules or policies,” Baker told reporters last week.

Asked if the CDC’s updated guidelines or the continued increase in COVID-19 rates might change their thinking, Baker’s press secretary Terry MacCormack told that the administration is currently reviewing the new face covering guidance released Tuesday afternoon.


The new CDC guidelines also included the recommendation that all teachers, staff, students, and visitors at schools across the country — regardless of their vaccination status or local transmission rates — wear masks. Baker said last week that the state does not plan to change its plan to drop COVID-19 mask rules this fall.

“We’re in a very different place than most other parts of the country,” he said.

The story is somewhat different in Boston, which is located in Suffolk County, an area seeing “substantial” transmission, according to the CDC.

Acting Mayor Kim Janey said last week that Boston Public Schools expects to continue to require universal masking in school buildings and buses, regardless of vaccination status, with children under the age of 12 still ineligible for shots.

Asked about the CDC’s new guidelines, Janey’s office said Tuesday that the city “will continue to use data to drive our decision making” and will adjust its public health guidance “as necessary.”

Baker has repeatedly noted that local municipalities, businesses, and other organizations are free to set their own masking requirements. For example, in response to the recent increase in cases, Provincetown reimposed its indoor mask mandate, and several other communities, including Cambridge and Nantucket have issued advisories urging all individuals to wear masks indoors.


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