Mass. loosens recommendation on indoor masking

Baker dons a mask at a briefing earlier this month.Matthew J Lee/Globe staff

The state Department of Public Health on Tuesday loosened its recommendation on indoor masking in public places, advising that it is only necessary for certain groups of people, including those at risk because they are more vulnerable to COVID-19.

In December, as the Omicron variant fueled a major surge, the department advised all residents, regardless of vaccination status, to wear masks when indoors and not in their own homes.

On Tuesday, the department said, “DPH now advises that a fully vaccinated person should wear a mask or face covering when indoors (and not in your own home) if you have a weakened immune system, if you are at increased risk for severe disease because of your age or an underlying medical condition, or if someone in your household has a weakened immune system and is at increased risk for severe disease or is unvaccinated.”

The agency said it was revising the recommendation, “recognizing that Massachusetts is a national leader in vaccine acceptance, and in light of recent improvements in COVID-19 indicators.”

The agency said that residents who aren’t fully vaccinated should continue masking up when indoors with others.

“Individuals who have tested positive or are a close contact of someone with COVID-19 must follow the isolation and quarantine guidance which includes wearing a mask in public for 5 more days after leaving isolation or quarantine on Day 5, regardless of vaccination status,” the statement said.

Officials said state residents are “required to continue wearing face coverings in certain settings, including on public transportation and in health care facilities.” A complete list of such facilities is available here.

“I understand the rationale” of the state’s decision, said Dr. Paul Sax, clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital, “but suspect many of us will continue to mask indoors in public spaces while case numbers remain as high as they are now — we are still not down to the very low rates of May-June 2021.”

“I certainly would recommend ongoing masking for immunocompromised and older people, for people who simply don’t want to risk COVID, and for settings where crowding is unavoidable and ventilation cannot be guaranteed, such as on public transport or other densely populated indoor places,” Sax said in an e-mail.

Andrew Lover, an assistant professor of epidemiology in the School of Public Health and Health Sciences at UMass Amherst, said the change in the recommendation was “definitely something it’s almost time for - but not quite yet.”

“I’d be much happier with another month just to get a bit further through the winter,” he said.

At the same time, he acknowledged, “pandemic fatigue is real. Piling everything on people all the time is sort of bound to fail.”

He said it was necessary to balance a desire to extinguish the virus with “the practical realities that people are exhausted and compliance is getting more and more difficult.”

Jonathan Levy, who chairs the department of environmental health at Boston University’s School of Public Health, said Governor Charlie Baker should articulate which metrics the state used to make the decision “so that if those indicators worsen, we have a clear rationale for reinstating indoor masking.”

He also said that people who are more vulnerable to COVID-19 “will need to use higher-quality masks if they cannot rely on protection from those around them, so the state needs to take additional steps to ensure widespread and free access to higher-quality masks.”

“If we are reducing protection for the unvaccinated, we need substantial efforts to increase vaccination and booster rates,” he also said in an e-mail.

While other states mandated masking in indoor public spaces, Massachusetts was only recommending it. Cities and towns are still able to impose their own mask mandates. Boston is one example, though Mayor Michelle Wu on Tuesday suggested if trends in coronavirus declines continue, the city’s mandate could be rescinded.

The state’s recommendation is looser than that of the US Centers for Disease Control and Prevention. It continues to recommend that everyone, regardless of vaccination status, wear masks in indoor public spaces in areas of “substantial” or “high” community transmission. All Massachusetts counties are currently areas of high transmission, except for the island of Nantucket, which was rated by CDC as an area of substantial transmission.

Separately Tuesday, Dr. Carole E. Allen, president of the Massachusetts Medical Society, issued a statement laying out what her organization described as “insight about steps that should be taken as we move forward” in battling the pandemic.

“Recent trends are encouraging and demonstrate the efficacy of vaccines and mitigation tactics, and the rapid development of therapeutics show promise toward offering an additional safeguard for the immunocompromised and vulnerable,” Allen said. “It is appropriate to begin conversations about transitioning at a thoughtful and measured pace, and safely balancing risk and our shared desire to get back to a semblance of our pre-pandemic lives.”

Allen said there’s reason for optimism but stressed that it’s “not time to declare victory” over the virus.

“It will take some time for our health care system to catch up with patients who have deferred care, and staffing issues continue to challenge many of our health care institutions,” Allen said. “Increasing infection rates in other parts of the country and the world present a continued challenge. With the likelihood that COVID-19 is here to stay for the foreseeable future, we must continue to encourage vaccines and boosters that are proven to reduce hospitalizations and death. We must also be fully prepared to adjust mitigation recommendations when surveillance and data reveal or predict a renewed spike in cases.”

Tuesday’s announcement from DPH comes after Governor Charlie Baker last week announced that the the statewide mask mandate for K-12 schools will be lifted Feb. 28, joining a handful of other states that previously announced similar moves as the Omicron-fueled COVID-19 surge declined.

“Today’s announcement is another big step forward to safely manage COVID while we get back to what I would describe as the familiar and normal aspects of school and life,” Baker, a popular centrist Republican, said during a State House briefing Feb. 9.

Masks will still be required on school buses per federal order, officials said last week, and local school districts will have the option to keep their own mask mandates in place if they wish.

Allen said Tuesday that officials must respond to future COVID-19 variants prudently.

“We must meet future encounters with COVID-19 and emerging variants by drawing on science and robust data to communicate accurate and trustworthy information,” Allen said. “We must assure the ability and willingness to make a swift return to preventive measures when required to limit of the impact on health care and daily activities, including work and learning.”

Allen said it’s also critically important to understand the physical, emotional, and financial recovery process from COVID-19 won’t be the same for everyone.

“Those who are most medically susceptible and those who are part of historically marginalized populations and communities of color that bore a disproportionate level of infection and its social, economic and health consequences must remain a focal point of recovery and prevention efforts,” Allen said. “Paramount to successful prevention of future surges of infection that threaten to overwhelm our health care system and disrupt daily life is the restoration of trust in science and amplification of the voices of experts and leaders in medicine, science, and public health.”

Material from prior Globe stories was used in this report, Priyanka Dayal McCluskey and Martin Finucane of the Globe Staff contributed.