CDC updates masking guidelines, lists Maui in the ‘mediumʻ COVID-19 Community Level

The Centers for Disease Control and Prevention released updated masking guidelines today and unveiled a new COVID-19 Community Level tool to help communities decide on what prevention steps to take based on the latest data.

The mapping tool currently lists all counties in the state of Hawaiʻi in the medium level, with the exception of Hawaiʻi Island, which is at the low community level.

In Maui County, the seven day average for new daily cases dropped to 27. The countyʻs test positivity rate is now 3.7%, and the statewide positivity rate is now 3.0%. There are 12 people hospitalized in Maui County with COVID-19, below both the 41 reported during the height of the delta surge in August 2021, and the previous omicron high of 56 reported on Jan. 28, 2022.

Earlier this week, on Feb. 21, Maui’s longstanding rule regarding proof of vaccination status to dine-in at restaurants or to visit other “high risk” businesses like bars and gyms, was lifted.  Last week, Mayor Michael Victorino said any decision on masking would have to come from the governor, since the indoor mask mandate was part of the state’s emergency proclamation. That document, which includes the Safe Travels program and other COVID-19 rules, is set to expire March 25, but it is unclear how the governor will proceed. *The mayor’s weekly press briefing is scheduled to take place this afternoon at 4 p.m.

Statewide, there were 311 new infections across Hawaiʻi, including 38 on Maui. There were also nine additional deaths.

“As of today, more than half of counties, representing about 70% of Americans, are in areas of low or medium COVID-19 Community Levels,” said Dr. Greta Massetti, PhD, MPH, COVID-19 Response Incident Management Team during a CDC media telebriefing today. “This is an increase from about one-third of counties at low or medium Community Levels last week, and we continue to see indicators improve in many communities,” she said.

Dr. Rochelle P. Walensky, MD, MPH, Director at the Centers for Disease Control and Prevention said the nation is in a stronger place today, with more tools to protect communities from COVID-19.

“Over 200 million people have received a primary vaccine series, and nearly 100 million have been boosted, and millions more have had prior disease. With widespread population immunity, the overall risk of severe disease is now generally lower. Now as the virus continues to circulate in our communities, we must focus our metrics beyond just cases in the community and direct our efforts toward protecting people at high risk for severe illness, and preventing COVID-19 from overwhelming our hospitals and our healthcare systems.”

She said this new framework moves beyond just looking at cases and test positivity, to evaluate factors that reflect the severity of disease, including hospitalizations and hospital capacity.

“It helps to determine whether the level of COVID-19 and severe disease are low, medium, or high in a community. The COVID-19 Community Level, what we are releasing today, will inform CDC recommendations on prevention measures like masking; and CDC’s recommendations for layered prevention measures will depend on the COVID-19 level in the community.”

Dr. Walensky said this updated approach focuses on directing prevention efforts towards protecting people at high risk for severe illness, and protecting hospital and healthcare systems from being overwhelmed.

According to the CDC, a community’s COVID-19 level is determined by a combination of three pieces of information: new hospitalizations for COVID-19, current hospital beds occupied by COVID-19 patients or hospital capacity, and new COVID-19 cases. These metrics, Dr. Massetti said, will determine if the level is low, medium, or high.

Regardless of the level, the CDC recommends that people stay up to date on vaccines and get tested if they are sick.

• Low Level: There is limited impact on the health care system and low amounts of severe disease in the community. People should stay up to date with their vaccines and get tested if they are sick.
• Medium Level: More people are experiencing severe disease in the community and they’re starting to see more impact on the healthcare system. At this level, CDC recommends that people who are high risk, such as someone who is immunocompromised to talk to their health care provider about taking additional precautions, and may choose to wear a mask.
• High Level: There is high amount of people experiencing severe disease and high potential for health care strain. At the high level, CDC recommends that everyone wear a mask indoors in public, including in schools.

“Communities can use these metrics, along with their own local metrics, such as wastewater surveillance, emergency department visits, and workforce capacity, to update and further inform their local policies and ensure equity in prevention efforts,” said Dr. Massetti. She continued saying, “These categories help individuals assess what impacts COVID-19 is having on their community, so that they can decide whether they need to take extra precautions, including masking based on their location, their health status, and their risk tolerance.”

The CDC is also updating its recommendations for schools today. Since July of 2021, the CDC recommended universal masking in schools, no matter what level of impact COVID-19 was having on the community. “With this update, CDC will now only recommend universal school masking in communities at the high level.

“We want to give people a break from things like mask wearing when our levels are low, and then have the ability to reach for them again, should things get worse in the future,” said Dr. Walensky.

According to the CDC, the new framework was “rigorously evaluated” both with current data and retrospectively during the alpha, delta, and omicron waves. “These new metrics have demonstrated predictive capacity for weeks into the future,” said Dr. Walensky.