by BLOOMBERG / pic by TMR FILE

U.S. health officials dialed back their threshold for Covid-19 masking recommendations, a signal that the federal government is shifting into a new phase of its pandemic response that prioritizes protecting hospitals and vulnerable people over broadly preventing infections.

The Centers for Disease Control and Prevention on Friday introduced a new three-tiered system for classifying local Covid-19 risks. In areas where the risks from the virus are low, officials said that most people can go without masks in indoor public places such as restaurants or shopping malls.

In medium-risk areas where the virus is having some impact on the health-care system, people who are at potential increased risk of severe Covid-19 should talk with their doctor about masking, according to the new guidelines. Less than a third of the population is in high-risk areas where masks should be required in indoor public spaces, compared with 82% under the earlier regime.

The recommendations also apply to schools – the first update to school guidance since July. While the CDC earlier recommended masks for schools regardless of community risk level, the updated recommendation is for a requirement only in high-risk areas.

The new guidelines are going into place as the U.S. comes out of a dizzying spike and rapid descent in Covid-19 infections caused by the fast-spreading omicron variant. With cases quickly ebbing, many states have already relaxed masking guidelines, and the CDC has come under criticism for not acting more quickly to set a new baseline for mitigation steps across the country.

While the earlier risk system mainly focused on case counts, the CDC is now taking into account disease severity and local health resources. White House medical adviser Anthony Fauci said earlier this week that, although the pandemic is still a global concern, vaccines, treatments and tests have put the U.S. in a better position to pull back on restrictions.

“We’re at a stronger place today as a nation, with more tools to protect ourselves and our community from Covid-19,” CDC Director Rochelle Walensky said Friday in a briefing on the guidelines.

Illinois Governor J.B. Pritzker said he was removing the state’s school mask mandate, effective Monday, following the CDC’s recommendation. Before the CDC announcement, New York City public schools dropped a requirement for students to wear masks outdoors as of Feb. 28. For now, masks will still be required inside New York schools, but Mayor Eric Adams said he’s eager to lift all city mask rules when health officials say it’s appropriate.

School districts should act cautiously in response to the CDC’s announcement, with the health and safety of students, educators and their families always in mind, said Becky Pringle, president of the National Education Association, which represents millions of U.S. teachers.

“With Covid-19 rates declining around the country, we are optimistic that brighter days are ahead for our students, educators, parents and communities,” she said. “If a shift in the pandemic warrants, we must be prepared to apply what we have learned these past two years to prevent more tragic losses.”

While attention focuses on Russia’s invasion of Ukraine, President Joe Biden will likely touch on the evolving pandemic response in his State of the Union address next week. New drugs, such as Pfizer Inc.’s Paxlovid, can prevent hospitalisation or death in 90% of infected, high-risk patients. Also, protein-based shots from Novavax Inc. and the Sanofi-GlaxoSmithkline Plc partnership that may be more acceptable to the vaccine-hesitant are nearing the market.

The highly transmissible omicron variant and its even faster-spreading subvariant, BA.2, now dominate the world. Still, data indicate that the strain causes less severe disease than earlier versions, such as delta, giving health officials increased confidence to drop some defenses.

“I would say I’m cautiously optimistic,” said Philip Landrigan, an epidemiologist and director of the Global Public Health Program at Boston College. “We seem to be moving towards an endemic state, but we certainly have to keep an eye on the rest of the world and be very much alert to the possibility of any new variations of the virus emerging.” 

Masks have been emblematic of the struggle against Covid, and their use has been controversial, with health officials originally saying they had little impact outside health-care settings, then recommending them much more widely. While some opponents have claimed negative health effects from masks, epidemiologists credit their use for preventing transmission of the coronavirus, which is primarily spread via small exhaled droplets.