It was a great day and turning point in our fight against COVID-19 on May 13 when the CDC announced its new mask policy. This new guidance comes in the contest of continuing great news in the USA regarding this deadly pandemic. The May 16th Covid-19 USA case count was 16,616. This represents a 33% decrease over 14 days. Deaths were 291 (a 13% decrease) and hospitalizations where down 17% to a continuing manageable level of 34,004. This level of improvement is a direct consequence of the massively effective, yet unfinished, vaccination program. There indeed is more work to be done!

The new guidance is very straight forward in spite of the characterizations of many in the national media. The bottom-line is that all of those who are fully vaccinated no longer need to wear masks or physically distance outdoors or indoors except where mandated by governmental regulations or by the rules of individual businesses or workplaces. For the sake of clarity, remember that a person is defined as “fully vaccinated” two weeks after they have received the second dose of their Moderna or Pfizer vaccine or two weeks after the one required dose of the Johnson&Johnson vaccine. If you are fully vaccinated your path to normalcy is now so much clearer. The full scope of the guidance is available at cdc.gov/coronavirus/2019 under “When You’ve Been Fully Vaccinated”. Additional key points are that the fully vaccinated no longer need to self-quarantine or be tested before or after domestic travel. Their international travel is more convenient as well since the guidance indicates that they no longer need to be tested before leaving the US (unless required be the destination country) and quarantining upon returning to the US is no longer necessary. They no longer need to be tested or self-quarantine, as long as they remain asymptomatic, after a known exposure to a Covid-19 positive person (and as long as they are not an employee or resident of a correctional facility or homeless shelter). People who are immunocompromised should consult their private physician before ditching their masks.

One might ask what prompted the CDC to issue such a relieving guidance to Americans. We can rest assured that the relief from masking for the fully vaccinated is based on the solid science of several studies of results after vaccination. One study published in the Journal of the American Medical Association analyzed nearly 5000 healthcare workers. It showed the vaccine to be 97% effective at preventing symptomatic Covid-19 and 86% effective at preventing asymptomatic infection. The studies show that people who have been fully vaccinated are not likely to spread the virus. Since getting the virus and spreading the virus are less likely if you are fully vaccinated, then mask wearing is no longer necessary. Be reminded that there are “break-through” infections that have been identified in people who have been fully vaccinated. This circumstance is known to have occurred in less than 10,000 cases out of the approximately 120 million Americans fully vaccinated.

Clearly people who have been vaccinated are benefiting from the earned privileges of less masking. A major concern is that Americans who have not earned the privileges will claim the benefit. We are now depending on an “honor system” to be confident for Americans to remain masked when they have not been vaccinated. Government, at all levels, and some businesses are showing reluctance to demanding proof of vaccination. Many employers and educational institutions may not be so lenient, and thus demand proof of a person’s vaccination declaration. Although the concept of a “vaccine passport” is repulsive to many, research out of the University of Louisville reveals that 25% if people lie about consequential things often and many people lie daily. Actual research reveals that people are more likely to lie when the incentive is greater and the risk is lower. Those who lie and go maskless are more likely to contract and spread Covid-19. We all bear the brunt of their individual decisions they also delay the total safe reopening of our society. If you have not been vaccinated, please do so and in the meantime be honest and WEAR your mask.

Clyde E. Henderson, MD

Cincinnati Medical Association