PHSKC Issues Health Directive for Everyone to Keep Masks On in Indoor Spaces

by Carolyn Bick

Stating in no uncertain terms that the Centers for Disease Control and Prevention's most recent masking recommendations are "uncoordinated and counterproductive," Public Health — Seattle & King County Health Officer Dr. Jeff Duchin announced in a May 20 press conference a new local health directive for all King County residents. The directive — which is effective immediately, regardless of vaccination status — asks that everyone continue to wear a mask in public indoor spaces, such as grocery stores.

The current Centers for Disease Control and Prevention (CDC) masking guidelines state that vaccinated people no longer have to wear masks for most activities anywhere, including in indoor spaces. But this is a problem, Duchin said in the press conference, because there is no way to know who is vaccinated and who is not. An unvaccinated person can now simply choose to go out in public unmasked. In doing so, they put both themselves and other unvaccinated people at risk.

"The risk of COVID-19 spread is increased in crowded indoor spaces with unvaccinated people and especially with poor ventilation and activities that can increase the amount of virus in the air, such as loud talking, singing, shouting, and aerobic exercise," Duchin explained. The CDC's new policy "would result in unvaccinated and vaccinated people without masks in close contact in indoor settings at a time when we have substantial COVID-19 activity in the community, raising the risk for the spread of COVID-19."

The new health directive asks that everyone five years of age or older wear a mask in indoor public spaces — such as retail stores, grocery stores, government buildings and other places of employment where people may enter freely — regardless of whether they are vaccinated, "unless a State-approved method is used to assure that people allowed inside an indoor space have been fully vaccinated," Duchin said. The directive does not apply to private office spaces or other places of employment with limited access, but Duchin said that employers should continue to follow workplace safety guidance from the State's Department of Labor and Industries.

Duchin also said that everyone in healthcare, incarceration, school, homeless shelters, long-term care facilities, and public transportation settings must wear "a well-fitted and well-made face mask, and adhere to workplace guidance from the Washington State Department of Health."

This directive will remain in place, Duchin said, until Public Health – Seattle & King County (PHSKC) confirms that at least 70% of County residents aged 16 and older have been fully vaccinated. Duchin said that, coincidentally, PHSKC expects the County to reach this rate by June 30, the same day Gov. Jay Inslee is expected to fully reopen the state.

A person is considered fully vaccinated two weeks after their second shot of the Pfizer or Moderna vaccine or two weeks after their shot of the one-dose Johnson & Johnson vaccine.

Disease transmission in King County remains "substantial to high," with rates of disease still higher than what they were before the start of the fourth wave of disease in March and higher than what they were last year at this time, Duchin said. This means that the County is far from out of the woods, despite being in Phase 3 of the State's reopening plan.

Duchin also emphasized once again, as he has at each press conference for many months, that inequities in both vaccination and disease rates persist. These inequities fall along geographic and racial lines, he said, with People of Color suffering the highest rates of disease and death, and the lowest rates of vaccination, for a variety of reasons. Disease burden and transmission rates continue to be highest in South and Southeast King County, where many communities of color, immigrants, and refugees live.

Duchin explained that the masking directive is meant to protect frontline workers, like those in grocery stores and other public-facing businesses, who tend to be teens and young and middle-aged adults. Vaccination rates among these age groups continue to be low, Duchin said. He also said that there are many unvaccinated children in public settings, and children ages 12—15 have not had much time to get vaccinated yet. The Food and Drug Administration (FDA) approved the Pfizer vaccine for children ages 12—15 on May 10, and the CDC adopted its own immunization committee's recommendations to endorse the Pfizer vaccine's use for this age group on May 12. Currently, the Pfizer vaccine is the only vaccine recommended for those under the age of 18.

Moreover, even though infection among vaccinated people are rare, "there are tens of thousands of people in King County who have some form of immunosuppression," Duchin said, which means that even if they are vaccinated, they are more likely to contract some form of the novel coronavirus and develop COVID-19.

Duchin also said that CDC Dir. Dr. Rochelle Walensky later clarified that ending indoor mask mandates should be linked to local COVID-19 disease rates and vaccination coverage. Because of disease and vaccination inequities throughout the County, Duchin said, "it is clearly in the best interests of the people of King County to continue doing what has been working for us for over a year for just a bit longer, to allow more people to be vaccinated and for our COVID-19 rates to drop to safer levels, which will bring greater community protection to all of us."

📸 Featured Image: A Pixabay-licensed image attributed to leo2014.