Don't lose your mask just yet—the Centers for Disease Control and Prevention announced it is now recommending masks in areas that are surging as cases rise nationwide and the Delta variant looms.
The CDC announced Tuesday that even fully vaccinated individuals should mask up indoors if their community is experiencing substantial transmission—defined as areas with more than 50 cases per 100,000 people. Travis County is sitting at an average of 94.59 cases per 100,000 over the past seven days, falling into the highest risk category, according to the CDC.
#DeltaVariant surging in U.S. New data show Delta much more contagious than previous versions of #COVID19. Unvaccinated people: get vaccinated & mask until you do. Everyone in areas of substantial/high transmission should wear a mask, even if vaccinated. https://t.co/tt49zOEC8N
— CDC (@CDCgov) July 27, 2021
After two COVID-19 recommendation stage jumps in the last two weeks, from Stage 2 to Stage 4, Austin-area cases are the highest they have been since February. The seven-day average for cases is on an upward trend, reaching 226 on Tuesday.
The CDC is also recommending that all students K-12 wear masks indoors, regardless of vaccination status. A May executive order by Gov. Greg Abbott prohibits schools from requiring masks, regardless of vaccination status. Austin ISD is "strongly" encouraging students to wear masks.
Although vaccinated individuals are still protected against the most severe symptoms of the variant, infections are spreading rapidly and now make up 83% of confirmed cases in the U.S. At least a dozen cases of the delta variant have been confirmed in the Austin area, though there are likely more since testing for it is limited.
CDC Director Dr. Rochelle Walensky said that hospital admissions are "almost exclusively" coming from people who are unvaccinated but those who are vaccinated can still catch and spread the virus.
"Unlike the alpha variant that we had back in May, where we didn't believe that if you were vaccinated you could transmit further, this is different now with the Delta variant," Walensky said. "That leads us to believe that the breakthrough infections, rare that they are, have the potential to pool and transmit at the same with the same capacity as an unvaccinated person."
Research suggests those who become infected carry 1,000 times more of the virus than other variants and could stay contagious for longer.The announcement comes on the heels of the Biden administration ramping up cautionary measures in the face of the Delta variant. Just last week, the CDC said it had no plans to change its May guidance of vaccinated not having to wear masks unless there was a significant change in the data. Officials met on Sunday night to review new evidence, according to reports.
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Some Austin businesses are reinstating mask mandates after local health officials announced a shift to Stage 4 on Friday.
At this stage, all residents—including those who are vaccinated—are encouraged to wear masks while indoors and unvaccinated individuals are asked to avoid nonessential trips, according to Austin Public Health's risk-based guidelines. These recommendations are unenforceable, however, after Gov. Greg Abbott issued an executive order in May prohibiting local government entities from issuing mask mandates.
But a handful of local businesses—including restaurants, retail establishments, universities and churches—have heeded local officials' recommendations by reinstating their own mandates, citing the Delta variant and breakthrough cases as reasons for the policy change.
Waterloo Records in downtown Austin and the Blue Starlite drive-in theater, which has three area locations, were among the earliest adopters, announcing new masking requirements on July 15, more than a week before local health officials announced the shift to Stage 4.
Unfortunately, with Covid infections rising in Austin, even some of the fully vaccinated getting infected, the uncertainty of the delta variant, and with Austin now in stage 3 on a collision course with stage 4 restrictions, we are going back to requiring masks at all times.— Waterloo Records (@WaterlooRecords) July 15, 2021
Attention patrons,— Blue Starlite (@UrbanDrivein) July 15, 2021
Due to the rising risk of the DELTA variant, and out of an abundance of caution, we will once again be enforcing a mask policy for all employees and guests. Thank you very much for your continued support of our little drive-in. https://t.co/Y8FAzHAWQY
BookPeople, in downtown Austin, soon followed suit.
Dear Readers,— BookPeople (@BookPeople) July 21, 2021
In order to keep our community safe from rising covid-19 cases in Austin we are now requiring masks from all employees, customers and vendors inside our store.
Thank you for understating and we hope to see y'all soon! pic.twitter.com/x0qXdJjxDy
Starting Monday, St. Edward's University in South Austin will require masks in indoor campus spaces.
With Austin's move to Stage 4, the university is requiring face coverings in campus indoor spaces to protect our community. This is effective on Monday, July 26th and applies to all community members and visitors regardless of vaccination status. Stay safe, Hilltoppers!— SEU Campus Safety (@SEUSafety) July 23, 2021
Retail establishments, including Method Hair in East Austin and Dragon's Lair Comics & Fantasy in North Austin, also joined in, citing the recent move to Stage 4.
Effective immediately, Dragon's Lair Austin is requiring masks for all guests and employees. No current changes to events at this time, but please stay tuned to social media for updates. If you have any questions about event changes, please email firstname.lastname@example.org pic.twitter.com/rmjKYPzYm4— Dragon's Lair Austin (@DLairAustin) July 23, 2021
At least a few restaurants, which have been especially hard hit during the pandemic, have reinstated masking requirements, including Justine's Brasserie in East Austin.
"This was not an easy decision (we're tired on masks, too), but breakthrough Covid cases are real and growing," the restaurant wrote in a Saturday Instagram post. "We wish we could follow France's lead and ask diners, particularly those opting for the (still limited) indoor seating, for proof of inoculation. Abbott, however, has made it illegal for us to do so."
Joe's Bakery in East Austin and Quack's 43rd Street Bakery and Hyde Park are asking patrons to mask up.
St. Matthew's Episcopal Church in Northwest Austin held its worship services outside on Sunday, with socially distanced seating and masks required for all attendees, regardless of vaccination status.
Other businesses have taken the Stage 4 announcement to reiterate their existing masking requirements.
REMINDER: Masks are required on board ALL #CapMetro services regardless of vaccination status.— Capital Metro (@CapMetroATX) July 23, 2021
If you do not have a mask, disposable masks are available on board--just ask the operator.
Let's keep each other safe out there! #MaskUpATX pic.twitter.com/5wQihjwQyr
Although the aforementioned businesses have reissued mask mandates, they appear to be in the minority, with most letting customers decide whether to mask up—at least for now. These include major retailers like H-E-B, which made masks optional for fully vaccinated customers on June 9, citing guidance from the Centers for Disease Control and Prevention.
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Students and staff can now be on University of Texas grounds without a mask, according to the latest campus masking guidance released by University President Jay Hartzell.
The guidance states masks are optional inside and outside of UT building, and masks are recommended but still optional for those not fully vaccinated or have a weakened immune system. It goes into effect immediately as Gov. Greg Abbott issued an executive order that bars public schools and government entities from requiring masks. The Centers for Disease Control and Prevention and the City of Austin have also released new guidance that fully vaccinated individuals do not need to wear masks or social distance.
The new guidance will first be noticed at upcoming sporting events and commencement ceremonies.
Down south in San Marcos, Texas State University released the same guidance earlier on Wednesday.
There are a lot of questions circulating about the pandemic and its impact locally. Each month, Austonia will answer a new batch of them.
Is the local COVID situation improving?
Despite the good news of V-Day, local health officials painted a grim picture of disease spread in Austin, which they attributed to the "Thanksgiving effect"—and warned that Christmas gatherings could cause a surge on par with El Paso.
"Our situation is getting worse in Travis County," Austin-Travis County Interim Health Authority Dr. Mark Escott said Wednesday. "Right now we are at a place where we have more active infections in our community than we've had at any other time in this pandemic."
Since the beginning of December, Travis County has seen a 45% in the average number of COVID-19 cases confirmed each day and a 57% increase in the number of daily COVID-related hospital admissions. The positivity rate has also increased to 9%, up from 7.4% last week, which Austin Public Health Director Stephanie Hayden said was "extremely high" on Wednesday.
Escott attributed these numbers to Thanksgiving gatherings and relaxed adherence to pandemic precautions, such as masking, social distancing and hand washing.
"It's a concern for us because if we see surge happening now because of Thanksgiving and we see a repeat of that activity during Christmas, we really have the risk of an El Paso or Lubbock type of substantial and catastrophic surge," he said Tuesday.
How are hospitals faring?
Hospitals in the five-county Austin metro are faring okay—for now.
The three major hospital systems—Ascension Seton, Baylor Scott & White Health and St. David's Healthcare—reported an overall occupancy rate of 82% and an ICU occupancy rate of 83% on Wednesday.
"We're not at the stage yet of asking our hospitals to scale back on elective procedures, because we do have enough cushion there to absorb a bit more," Escott said Tuesday. "What we're concerned about is two or three weeks from now."
The current surge in cases is due to Thanksgiving gatherings, Austin Public Health officials have stressed. If people continue to gather for Christmas, New Year's and other holidays, the surge could accelerate quickly.
"We're very concerned that the Christmas holiday may transition into that hockey stick, or exponential, phase of active case growth, which would put our hospitals in danger," Escott added.
Does this affect the local risk level?
The Austin-Travis County area is at Stage 4, according to APH's risk-based guidelines. At this stage, local health officials recommend that individuals at high risk or who live in households with people who are high-risk avoid gathering with others as well as non-essential activities, such as dining out and shopping.
Updated projections from the COVID-19 Modeling Consortium at the University of Texas at Austin, which were published on Sunday, suggest the region is on the precipice of reaching the threshold for Stage 5, which is a daily average of 50 or more COVID-related hospital admissions.
Already, local health officials are imploring Austinites to avoid nonessential trips in an effort to flatten the curve.
"Everything you do should be essential trips only," Hayden said. "We really encourage you not to connect with others who do not live in your household."
(COVID-19 Modeling Consortium at the University of Texas at Austin)
How does this compare to the state of Texas?
Compared to other large Texas counties, Travis County has reported the fewest active cases and cumulative deaths per capita over the course of the pandemic.
However, Austin officials said that the area could see a surge approaching the severity of that seen in El Paso and Lubbock prior to Thanksgiving if residents don't work to flatten the curve.
"This is what the beginning of that kind of surge looks like, what we're seeing now," Escott said Wednesday.
What does this mean for schools?
Disease transmission has largely occurred outside of classrooms, with local officials pointing to extracurricular activities and social gatherings as major reasons for cases among students and staff.
"So schools are safe," Escott said Wednesday.
However, increased community spread could affect schools. Escott doesn't anticipate making a blanket recommendation to close schools, he said, but may advise campuses to return to virtual learning for one or two weeks following the winter break, as happened after Thanksgiving.
If the pandemic continues to worsen locally, the next step would be to significantly reduce or halt extracurricular activities, he added.
In the case of school closures, APH officials would recommend closing high schools first and then middle schools in an effort to preserve in-person elementary education, where students are most adversely affected by virtual learning.
Who will get the COVID-19 vaccine first (and second)?
The initial allotment of COVID-19 vaccines were distributed across Texas earlier this week. UT Health Austin, the clinical arm of Dell Medical School, administered its first shots to frontline healthcare workers on Tuesday.
Earliest access to vaccines will go to frontline healthcare workers, EMT first responders and nursing home residents and staff.
As more doses of the vaccine become available, APH will prioritize those at highest risk of hospitalization and death due to COVID-19. They include people 60 years of age and older, those with underlying conditions and communities our color.
"Our decisions will be data-driven," Escott said Wednesday.
APH is working with a local coalition to arrive at a standardized approach for determining who is prioritized for vaccine access across different community providers.
"There simply isn't enough to go around right now, and there won't be for quite some time," he added.
It also appears unlikely that teachers and other school employees will have any particular priority based on their profession.
"A young, healthy 25-year-old teacher has a quite different risk profile than a 45-year-old teacher with diabetes," Escott explained.
I haven't felt so much joy since before the pandemic, watching the frontline receive such an amazingly effective va… https://t.co/T7iQr5eddp— Clay Johnston (@Clay Johnston)1608049298.0
How will I get vaccinated?
APH is one of more than 200 local providers that have registered to distribute the COVID vaccine in Austin and Travis County.
As the vaccine becomes more widely available, the local health department will focus on low-income and uninsured residents.
"Austin Public Health has always been a safety net provider to our community, and we will continue to be in that space," Hayden said.
Austinites with insurance are encouraged to go through their usual vaccine providers—whether that be pharmacies or primary care physicians—when the time comes.
Does the COVID vaccine control spread as well as prevent infection? What are the differences between the vaccines?
Experts are still working to understand the level of protection that COVID vaccines provide in terms of preventing spread.
For this reason, the CDC recommends that people continue to wear masks and social distance even after they have been vaccinated.
Both the Pfizer and Moderna COVID vaccines rely on a spike protein invented by a team of scientists led by Dr. Jason McLellan, an associate professor of molecular biosciences at the University of Texas at Austin.
The spike protein developed by McLellan's team mimics those found on the coronavirus. When injected via a vaccine, it signals the body to start creating antibodies, which then attach to the virus and lock it in place before it rearranges, preventing infection.
The Pfizer vaccine has been distributed in Texas. While the Moderna vaccine is scheduled to be reviewed by the U.S. Food and Drug Administration for an emergency use authorization on Thursday.
Two other vaccine candidates, from Johnson & Johnson and AstraZeneca, use adenoviruses to deliver DNA from the coronavirus to stimulate an immune response in the vaccine recipient, according to the University of Michigan Health Lab.
What does this mean for the upcoming holiday season?
Local health officials continue to advise Austinites to avoid gathering with people outside of their households and to recommit to precautions such as masking and social distancing.
"We have the possibility of having a miserable Christmas and a miserable New Year's if we allow this kind of transmission to continue," Escott said Wednesday.
Like Thanksgiving, officials recommend developing new traditions this holiday season to minimize risk—and ensure loved ones are around to celebrate in person next year.
"We must alter our holiday celebrations or we could face a real disaster here," Escott added.
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