The US is heading for a “harmful fall” with a surge in Delta Covid instances and the return of indoor masks mandates

People wearing protective masks shop at a Walmart store in Hallandale Beach, Florida on May 18, 2021.

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With the highly transmittable Delta-Covid variant continuing to spread rapidly in the United States and elsewhere around the world, scientists and other health experts are warning that indoor mask regulations and other public health measures in the US are likely to return this fall.

The country, which just celebrated July 4th with some of its first major gatherings in more than a year, is heading for a “dangerous” fall season, with Delta expected to cause another surge in new coronavirus cases, health experts say. Delta is already the predominant variant in the US and will hit the states with the lowest vaccination rates the hardest – unless those states and companies reintroduce mask rules, capacity limits, and other public health measures, which they largely withdrew in recent months have, say experts.

With new mutations discovered every few weeks, many scientists are now predicting that Covid will circulate around the world for at least the next two to three years, obliging nations to adopt ad hoc public health measures for the foreseeable future. Authorities in Australia, South Africa and Asia recently reinstated curfews or other measures to contain rising delta outbreaks. Japan has just declared a coronavirus emergency in Tokyo and banned spectators from the Olympic Games. High vaccination rates in the US and the warm summer months have bought the country a little more time, but outbreaks around the world are giving Americans a preview of what could come this fall.

Health workers chats near an ambulance in the parking lot of the Steve Biko Academic Hospital amid a coronavirus disease (COVID-19) nationwide lockdown in Pretoria, South Africa, Jan. 11, 2021.

Siphiwe Sibeko | Reuters

“I could foresee that certain parts of the country would reintroduce mask requirements, indoor distance and occupancy restrictions in the coming months,” said Lawrence Gostin, director of the World Health Organization’s Collaborating Center on National and Global.

He fears there will be “major outbreaks” in the US this fall, especially in states with low vaccination rates.

“We are heading for a very dangerous fall, with large parts of the country still unvaccinated, a swelling Delta variant and people taking off their masks,” he added.

The warning from scientists and other health professionals comes as many U.S. companies and offices have largely phased out mask requirements, social distancing, and other pandemic-related restrictions.

Almost immediately after the Centers for Disease Control and Prevention declared in mid-May that fully vaccinated people would not need to wear masks in most indoor spaces, Walmart and Costco followed suit, allowing fully vaccinated customers and employees without state or local laws. Similarly, the Detroit automakers and the United Auto Workers union agreed late last month to make face masks optional for fully vaccinated employees.

A General Motors assembly worker loads engine block castings onto the assembly line at the GM Romulus Powertrain plant in Romulus, Michigan, the United States, August 21, 2019.

Rebecca Cook | Reuters

Other companies like Apple and Amazon are urging most of their employees to return to the office in some capacity this fall as more Americans get vaccinated against the virus. Goldman Sachs employees returned to the office last month, while Citigroup and JP Morgan expect their employees to return this month on a rotating basis.

Confirmed Covid infections in the US have dropped to their lowest level since the pandemic began, averaging about 15,000 new cases per day for the past seven days from a high of about 251,000 average new cases per day in January, according to Johns Hopkins University. Hospital stays and deaths have also declined, with Covid deaths averaging around 225 per day – up from a high of an average of more than 3,400 deaths per day in January.

Should daily Covid cases pick up again in the fall, as expected by health professionals, some employers in states with low Covid vaccination rates may face the difficult decision to make public health measures such as wearing masks and social distancing capacities to reintroduce limits or send office workers home entirely.

There will be “two Americas,” said Dr. Paul Offit, a pediatrician and vaccine advocate who served on advisory boards for both the Centers for Disease Control and Prevention and the Food and Drug Administration. “There’s vaccinated America and unvaccinated America, and I think unvaccinated America will pay a price for that.”

There are about 1,000 counties in the U.S. with a Covid vaccination rate of less than 30%, mostly located in the Southeast and Midwest, said CDC Director Dr. Rochelle Walensky recently. In these areas, the authority already sees increasing infection rates due to the further spread of the delta variant.

This has led some state and local health authorities to reintroduce previously abandoned public health measures.

Patricia Cole receives a shot of the Moderna Covid-19 vaccination from a medical worker at a pop-up clinic operated by the Delta Health Center in that rural Delta community on April 27, 2021 in Hollandale, Mississippi.

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For example, in Mississippi, where less than a third of the state’s eligible population is fully vaccinated, officials last week recommended that all residents continue to wear masks indoors as Delta becomes the predominant variety in the state. About 96% of new Covid cases in the state belong to unvaccinated people, state health officials said when they called reporters.

White House senior medical advisor Dr. Anthony Fauci said that people in states like Mississippi, where transmission are high and vaccinations are low, may want to consider wearing masks even if they are fully vaccinated.

“Depending on your personal situation, that could be,” said Fauci in an interview that was held on Friday with SiriusXM’s “Doctor Radio Reports” with Dr. Marc Siegel is to be broadcast. “For example, someone who is an elderly person who may not have full robust protection even though the protection is very, very high, or someone with an underlying medical condition,” still wants to wear a mask, he said.

Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases at the National Institutes of Health (NIH) testifies ahead of a Senate hearing on Health, Education, Labor and Pensions to receive an update from federal officials on efforts to fight COVID 19 to be examined in the Dirksen Senate Office Building on May 11, 2021 in Washington, DC.

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Officials in Los Angeles County, California last week also recommended that “everyone, regardless of vaccination status,” wear masks as a precaution in public places indoors.

Offit, who advises the FDA on Covid vaccines, said he expected several more states to reintroduce indoor mask requirements this fall.

The United States is still “undervaccinated” and states with low vaccination rates are likely to be hit the worst, Offit said. Less than half of the US, about 158 ​​million people, have been fully vaccinated in the US, with more than a dozen states having fully immunized less than 40% of their population, according to CDC data. In Texas, the second most populous state after California, only 42% of residents are fully vaccinated, the data shows.

Even people who are fully protected have cause for concern when it comes to variants of Covid, Offit said. While the vaccines are good at protecting against serious illness and death, they may not protect as well against minor illness or the spread of Covid to others, he said. No vaccine is 100% effective, he noted.

“It is not a bold prediction to believe that SARS-CoV-2 will be circulating in two or three years. I mean, there are 195 countries out there, most of which haven’t received a single dose of vaccine. ”“ Offit said. “Will it still be circulating in the United States? I think that would be very, very likely.”

Dr. Christopher JL Murray, director of the Institute for Health Metrics and Evaluation, agreed that more states will need to re-implement mask mandates this fall. More vulnerable Americans may even have to wear masks every year during the peak covid and flu transmission season: November through April, he said. However, he noted that getting some Americans to wear face covers could be difficult now that the pandemic has subsided.

“Given the pandemic fatigue, getting most Americans to follow guidelines on mask use and social distancing will be more difficult. As cases and hospitalizations pick up again, maybe not until fall or winter, it might be easier to convince some. ” Take steps to be careful, “he said.

People crowd to eat at an outdoor restaurant as coronavirus disease (COVID-19) restrictions are eased on April 4, 2021 in Ann Arbor, Michigan, United States.

Emily Elconin | Reuters

Dr. Vin Gupta, a Harvard-trained lung specialist and NBC employee, said mask requirements should be reintroduced this fall, but should be enforced at the local level and with Covid vaccination rates and transmissions depending on events in the surrounding community.

“There has to be some specifics and multiple local jurisdictions have to make their own decisions, especially when the seasons shift and get back into cold, dry air,” he said.

Meanwhile, the federal government’s mask mandate for public transportation, including airplanes, commuter buses, and rail systems, is set to expire on September 13, unless the CDC renews it.

Whether the CDC does this is an open question, scientists said. Walensky and the White House have both advised there is no desire to reinstate the lockdowns and will leave much of the decisions about public health measures to the states.

“A lot of it isn’t science. It’s political science,” said Dr. Isaac Bogoch, professor of infectious diseases at the University of Toronto. “If you have a high rate of Covid-19 transmission in the community and you have a high rate of unvaccinated people, then from a scientific point of view it makes sense to mask indoor spaces. Whether or not this will go into policy is another question. “

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