The pandemic is getting worse. The risk of the delta variant mutating into future strains that could evade vaccines is becoming a fearful possibility. And the U.S. has hit a wall in vaccinations.
Citing this information on Tuesday, the Centers for Disease Control and Prevention recommended universal masking in K-12 schools and for fully vaccinated people to wear masks in public indoor spaces in areas facing substantial to high rates of transmission — defined by the CDC as having between 50 and more than 100 infections per 100,000 people.
In Virginia, that’s most localities.
Vaccination rates vary in the region.
Threatening to worsen these rates is how vaccination — the best protective measure to slow community spread — has plateaued to less than 12,000 shots a day statewide. And Friday’s case increase of 835 is the highest since the first week of May, when declining figures prompted the CDC to say vaccinated people no longer needed to wear face coverings.
Right before Virginia’s infections began to trend upward in mid-July, the CDC said those who are vaccinated could forgo masks in K-12 schools, even as children under 12 remain ineligible for a vaccine.
The American Academy of Pediatrics last Monday defied the federal agency’s guidance and called for masking regardless of vaccination status, noting the delta variant’s threat to kids.
The state’s health and education departments pivoted slightly last week, urging students and staff in elementary schools to wear masks regardless of vaccination status but fell short of the AAP’s suggestions with middle and high schoolers — pushing to consider universal masking if possibility of spread severely worsened.
Across Virginia, 10- to 19-year-olds have the third-highest number of infections caused by delta at 31, and the majority of the state’s 213 delta cases are among Virginians under the age of 40.
The Virginia Department of Health and Gov. Ralph Northam’s office told the Richmond Times-Dispatch on Tuesday that they’re reviewing the recommendations but emphasized how their approach has consistently been driven by science.
Northam spokesperson Alena Yarmosky credited this strategy for why the state has among the nation’s lowest total rates of infection and deaths. Virginia’s cases in the last week places it 23rd in the country and 33rd when adjusting for population, according to a New York Times analysis of COVID-19 trends. And infections have quadrupled in the past month, even as they linger below figures reported in the winter surges.
“As [Northam] has said repeatedly, the only way to end this pandemic is for everyone to get vaccinated,” Yarmosky said. “The facts show vaccines are highly effective at protecting Virginians from this serious virus — over 98% of hospitalizations and over 99% of deaths have been among unvaccinated Virginians.”
As of Tuesday, 46% of the state is not fully vaccinated. On Tuesday, the CDC’s Dr. Rochelle Walensky noted the rare possibility of infection after vaccination — in Virginia, there’s less than a 1% chance for fully vaccinated residents — but the severity of disease when up against the delta variant is “reduced by seven fold” for vaccinated people.
“The delta variant is showing, every day, its willingness to outsmart us and to be an opportunity in areas where we have not shown a fortified response against it. ... In rare occasions, some vaccinated people infected with a delta variant after vaccination may be contagious and spread the virus to others,” Walensky said. “This new data weighs heavily on me, this new guidance weighs heavily on me, and I just wanted to convey that this was not a decision that was taken lightly.”
Confusion, frustration over changing guidance
The sharp turnabout from earlier guidance is not a new criticism against the CDC, and the back-and-forth has frequently left states scrambling to catch up and adjust to the ongoing data behind the shifts. But in the age of misinformation and limited access to information, getting the updates out as quickly as they’re changed poses challenges.
VDH spokeswoman Cat Long noted that “it can be reassuring to folks to know that changing guidance can be the result of systems working as they should (i.e. government agencies updating guidance swiftly in accordance to scientific findings)” but in places like Richmond, where distribution of public health guidance depends on in-person outreach, that can leave some behind.
“Our community health workers and outreach workers can only feasibly knock on a person’s door so many times,” Long continued. “It can be challenging when our outreach workers have rich and informative conversations with someone and then the guidance changes soon after.”
Long emphasized that it’s not a result of new guidance, but “rather the nature of battling the spread of a new, complex, and changing virus.”
The uncertainty trickled into restaurants and businesses in the Richmond area on Tuesday afternoon.
“It’s been so hard to try to keep up with everything, and we’re trying to do everything that we can to keep everyone safe. And we’re trying to do everything that we can to just abide by the guidelines,” said Karolyn Mundy, owner of Red Rooster Country Store in Mechanicsville, who was unaware of the CDC update.
Other restaurants such as Hanover Cafe have already been requiring all patrons to wear masks, with manager Demetria Anderson noting how workers have grandkids at home who can’t get vaccinated. Other places, such as Cafe Rustika and the Virginia Museum of Fine Arts, are awaiting state direction.
Norm Gold, developer and operator of The Market @ 25th grocery store, isn’t waiting that long. Starting Wednesday, the store is requesting staff and customers don face coverings inside, although Gold added that the policy won’t be enforced. He said that if the state makes it mandatory, he’ll require everyone to wear a mask.
“It is very difficult to know who should and who shouldn’t be masked,” Gold said. “And even more difficult to tighten up the policy after it was relaxed.”
Like the verification of vaccination status, state and federal guidelines are not enforceable.
On Tuesday, as the CDC implored schools to require masks regardless of vaccination status inside K-12 buildings, Henrico County Public Schools told staff face coverings will be optional in the fall. Masks will still be required on school buses due to a federal order.
“While we encourage mask-wearing for those not fully vaccinated, we respect that mask-wearing is currently an individual’s choice,” said the Tuesday email obtained by The Times-Dispatch.
The HCPS Back to School Safely group, which includes educators and parents, released a statement four minutes later saying the “hesitancy to require universal masking is unacceptable.”
“As the country has seen, the COVID-19 pandemic continues to take a toll on Americans of color,” the statement read. “As HCPS has repeatedly stated a commitment to equity and opportunity for all students, especially students of color, we believe adopting the above safety measures will protect these families who may be disproportionately affected by COVID-19.”
Health department data shows that Henrico would be classified as substantial risk because it is averaging about 63 cases a day. The county has the highest rate of infection among children under the age of 10. Children under 12 are not eligible for a vaccine. The earliest chance of that changing is in late fall, when Pfizer is expected to apply for emergency use authorization after receiving its clinical trial results among kids ages 5 to 11.
The third-highest infection rate, behind 20- to 29-year-olds, is the 10-to-19 age group.
“We ... understand that masking is only one layer of COVID-19 infection prevention in our schools and thus we are steadfast in our continued efforts to encourage daily self-screenings before reporting to work or school, ensuring 3 feet distancing where possible, the frequent cleaning of high touch areas and more,” Henrico schools chief of staff Beth Teigen said in a statement Tuesday.
And the COVID-19 risk within localities varies, with health disparities that debilitated Black communities before and throughout the pandemic persisting.
In Richmond, whose school system was one of the first to announce that its universal masking will remain in place, Black residents have been 65% of cases in the past month. They are 47% of the population. White Richmond residents have been 16% of infections in the same time frame while being 43% of the population and having 1.5 times the vaccinations of their Black counterparts.
Staff writers Caitlyn Freeman, David Tran, John Ramsey, Kenya Hunter, Mel Leonor and Gregory J. Gilligan contributed to this report.