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Federal health officials’ decision Thursday to rescind almost all masking and distancing recommendations for fully vaccinated Americans created as much confusion as it did celebration, sending states, businesses, and individuals scrambling to figure out what rules, if any, are still appropriate and when.

Many, including President Biden, hailed the relaxation of restrictions by the Centers for Disease Control and Prevention as a milestone that signaled a return to normal.

But with a majority of Americans unvaccinated, others questioned the sudden and blanket recommendation, worrying the onus is now heavier on state and local governments, businesses and individuals to determine whether precautions are necessary. They feared the guidelines could undercut two of the simplest and most effective tools— masks and physical distancing — for stopping the spread of a virus still infecting about 35,000 people in the United States every day.


Two of the nation’s medical societies — the American Society of Transplantation and the American Academy of Pediatrics — and more than a dozen physicians interviewed Friday also expressed concern the decision was premature, coming only days after regulators cleared a vaccine for 12- to 15-year-olds and when so many are still unprotected.

’'The guidance shifts all the burden onto individuals to be ‘on their honor’ and choose the appropriate actions when deciding whether to wear a mask,’' said Lisa Maragakis, an infectious disease epidemiologist at Johns Hopkins University School of Medicine. ’'There is no way to know who is vaccinated and who is not in most scenarios. The likely result is that almost no one will wear a mask.’'

Some said the instructions might be more effective if paired with a way to verify people’s vaccination status since that would give peace of mind to those gathering indoors and provide a real incentive to those yet to get the shots. Biden administration officials have said so-called vaccine passports would be left to the private sector, and numerous Republican-controlled states have moved to ban such tools.


Besides children, those potentially at greater risk include essential workers who interact with the public, and millions of immunocompromised people who may be vaccinated but whose bodies might not mount a full immune response, say doctors and labor groups.

’'It came much faster than we expected,’' said Emily Blumberg, director of transplant infectious diseases at Penn Medicine. ’'We are not ready for them to be as free as the CDC guidance allows.’'

The CDC defended the guidance, which allows vaccinated people to go without masks or physical distancing in many cases, even when they are indoors or in large groups. Officials pointed to a study released Friday of nearly 2,000 health care workers across 25 states that showed the two mRNA vaccines reduced the risk of illness from covid-19 by 94 percent.

’'This report provided the most compelling information to date that coronavirus vaccines were performing as expected in the real world,’' CDC Director Rochelle Walensky said in a news release. ’'This study, added to the many studies that preceded it, was pivotal to CDC changing its recommendations for those who are fully vaccinated against covid-19.’'

Meanwhile, some of the lowest immunization rates in the country are in communities without mask mandates, calling into question the effectiveness of the federal about-face as an incentive for the unvaccinated.

It was mostly in Democratic-led states where mask mandates remained in effect when the CDC shifted its stance. A handful of states, from Virginia to Oregon moved immediately to make their policies mirror the federal recommendations, while others, such as Massachusetts and California, held off and vowed to review the updated guidance.


Many large businesses, including Target, Home Depot, and CVS said they would continue to require employees and customers to wear masks. while others, like Trader Joe’s and Walmart, will no longer require fully vaccinated shoppers to wear mask. It was unclear, though, how retailers would determine which shoppers have been inoculated. (Washington Post)

Britain may crack down because of variant seen in India

British authorities said on Friday that they are considering changing vaccination protocols and reintroducing local lockdowns to stem the spread of a coronavirus variant first detected in India, a warning sign for countries that are easing restrictions even though their own vaccination campaigns are incomplete.

The numbers of cases involving the variant, known as B1.617, rose from 520 last week to 1,313 cases this week in Britain, according to official statistics.

The extent to which the variant has spread globally is unclear, because most countries lack the genomic surveillance capabilities employed in England.

That surveillance capability has allowed health officials in Britain to spot the rise of concerning variants more quickly than other nations, offering an early warning system of sorts as a variant seen in one nation almost invariably pops up in others.


Most cases detected in the Britain are in northwestern England. The focus has been on Bolton, a town of nearly 200,000 that has one of the country’s highest rates of infection and where health officials have warned of widespread community transmission of the variant. Some cases have also been reported in London.

National restrictions in England are scheduled to be eased on Monday, with indoor dining and entertainment returning, but officials have cautioned that those plans might be in danger. (New York Times)

Virus surging in Nepal

NEW DELHI — Just one month ago, after dropping steadily since a spike in the fall, the rate of coronavirus infections across Nepal plateaued at around 100 cases per day. Many hoped the worst was behind them.

But with vaccine programs languishing and thousands of workers returning from neighboring, hard-hit India, cases shot up to more than 2,000 a day in late April. By last week, that figure had soared to more than 8,000.

The surge has rapidly overwhelmed hospitals and depleted medical supplies in the Himalayan country of 30 million. Online covid-19 support groups, flooded with posts as people seek information, advice and solace, have become medical and emotional lifelines for a frightened, isolated population that has few other places to turn.

Last week, health officials said 20,000 oxygen cylinders had been ordered from abroad, but many private hospitals announced that because of the lack of oxygen, they could not admit any more patients.

The government of Prime Minister Khadga Prasad Oli warned this week that new infections could continue to rise while the country’s medical system is collapsing under the strain. Writing in the Guardian on Monday, Oli described the pandemic as an ’'overwhelming burden’' and appealed for international help. (Washington Post)