Massachusetts public health officials on Tuesday relaxed their advice on masking, marking another move toward scaling back virus rules and recommendations as states emerge from the Omicron-fueled surge in COVID-19 infections.
The state released its new guidance on the same day Mayor Michelle Wu said improving COVID-19 metrics could prompt Boston to soon relax its own mandate on vaccines in some indoor settings.
The state Department of Public Health’s new advisory no longer recommends that healthy, fully vaccinated residents wear masks in indoor public settings, effectively pulling back guidance Governor Charlie Baker‘s administration had released in December when he urged all residents to do so. The change comes a week after Baker said the state would ease its mask mandate in schools.
The Baker administration now recommends that vaccinated people mask up if they have a weakened immune system, are older or have an underlying medical condition that makes them at higher risk for severe disease, or if they live with someone who falls in those categories.
The Tuesday guidance also said it is “important” for those who are not fully vaccinated to still wear face coverings. The recommendations closely hew to a mask advisory the state released last July after the Delta variant emerged.
The decision follows moves in other states, including Democratic-led ones, where officials have ended various mask mandates or restrictions. In no longer requiring masks in Massachusetts schools starting Feb. 28, Baker called it time “to give our kids a sense of normalcy.”
His administration argued Tuesday that the state is a “national leader in vaccine acceptance,” and cited what it called progress on COVID-19 indicators in relaxing mask guidelines: Case counts, for example, have dropped since early January, when the seven-day averaged topped 23,000 cases, as have hospitalizations.
The state did keep mask mandates in place in several settings, including on public transportation, in health care facilities, and in prisons and jails. Those who test positive, or are a close contact, also are still recommended to wear a mask in public for five days after they leave quarantine, regardless of their vaccination status.
“Due to these significantly lower levels of COVID-19 activity, masking recommendations now focus on those who are unvaccinated and those at higher risk of severe disease,” Margret Cooke, the state’s public health commissioner, said in a statement. “The best protection against COVID-19 is getting vaccinated and boosted, and there are thousands of appointments available across the Commonwealth.”
But there remains wide disagreement among public health officials and others whether states, including Massachusetts, should be pulling back on restrictions or their guidance to the public. By virtue of Tuesday’s announcement, the state’s own recommendations now stand in even starker contrast to other rules within Massachusetts.
Legislative leaders, for example, say they will require visitors to wear masks when the State House reopens to the public next week, more than 23 months after it first closed. Various towns and cities also continue to require that people wear masks in indoor settings, including in Boston.
Separately, an appeals court judge Tuesday granted an injunction blocking Wu’s administration from enforcing a vaccination mandate for workers from three municipal unions, continuing her ongoing dispute with a group of public safety labor groups.
The various disputes have fed into a fractious debate. One public health expert the Globe contacted Tuesday declined to talk, saying she didn’t feel comfortable weighing in publicly given the current environment.
Others underscored the tensions created by the divergent approaches.
“I think this is the most divisive period of the pandemic,” said Dr. Shira Doron, an infectious disease physician and epidemiologist at Tufts Medical Center. “We had a lot of divisiveness in the beginning, but it was along party lines and it wasn’t so much within a place like Massachusetts. Now we are just seeing this polarization, this rift between people who really feel like public health still needs to be a collective effort versus people who feel that’s not sustainable.”
The changing mask guidance is consistent with Baker’s other messaging, said Doron, who has advised the administration. Members of Baker’s Cabinet, for example, urged Massachusetts college leaders in late January to begin viewing the pandemic as an “endemic, a highly contagious virus that is manageable and allows us to regain a sense of normalcy.”
Dr. Carole E. Allen, president of the Massachusetts Medical Society, suggested in a statement Tuesday that it was “appropriate to begin conversations about transitioning at a thoughtful and measured pace,” citing the availability of therapeutics.
“We’re in a safer position to pull back a little bit on the cautious approaches to prevention,” added David Hamer, a Boston University professor of global health and medicine. “I think it’s a reasonable course to follow. The big question is: Is there going to be another wave?”
It’s because of that same uncertainty, others argue, that the state shouldn’t be pulling back on restrictions, let alone its recommendations, calling it a short-sighted approach to handling the pandemic. Baker previously resisted calls from some public health and elected officials to reinstitute a statewide mask mandate during the winter.
“No individual can clear the air of COVID. That’s only something we can do together,” said Julia Raifman, an assistant professor at Boston University’s School of Public Health. She called the Baker administration’s announcement on Tuesday a “terrible decision.”
“We all wish that the normal we had before the virus was possible. The virus is not going away and it’s harmful,” she said. “There’s no way around that. If we downplay or minimize the threat of the virus, it makes it that much harder to address it.”
There are other changes afoot. In Boston, everyone age 12 and over now must show proof of full vaccination to be admitted to certain indoor spaces in Boston, including indoor dining, fitness, and entertainment venues. The mandate first went into effect Jan. 15, when people 12 and over had to show proof of only one shot.
But Wu has said she will lift the mandate, known as the B Together policy, when three coronavirus metrics reach certain targets. And with the Omicron-fueled surge on the wane in recent weeks, those three are showing encouraging signs, including one that has already reached Wu’s target.
“We are seeing very, very good progress in terms of the metrics here,” Wu said Tuesday. “If the numbers continue along the trends that we’re seeing, we could see this policy lifted even in the next few days or so.”
Whether the change in the state’s recommendations drastically impacts behavior remains to be seen. Case counts, while dramatically lower than a month ago, are still hovering above the levels Massachusetts had last spring, when the seven-day case average dropped to just 64 at one point.
“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.”
Travis Andersen and Martin Finucane of the Globe staff contributed to this report.