Two years into a global pandemic, states and cities are struggling to answer a critical question: How do you know when to return to normal life?
The question is dividing politically aligned regions that had been in near-lockstep on other COVID-19 mitigation measures earlier in the pandemic. As New Jersey, for example, dropped a mask mandate in schools, neighboring New York signaled it would keep masks until at least March. Meanwhile, it let vaccinated adults go maskless in other indoor spaces.
Experts find little consensus over which metrics should drive public health policy, and often politics dictate critical COVID benchmarks as much as science. For many people, this has created uncertainty on how to go about daily life as it becomes clear that the virus is here for the long haul.
In recent weeks, confusion has played out in particular over masking. A dip in COVID cases and hospitalizations prompted states with some of the most stringent mask rules, including New York and California, to pull back mandates. At the same time, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Centers for Disease Control and Prevention Director Rochelle Walensky have both continued to urge caution.
“Some of the efforts that have been put forward to try to reduce transmission can surely be put aside,” said Michael Osterholm, who served on President Joe Biden’s COVID-19 task force and is head of public health at the University of Minnesota’s Center for Infectious Disease Research and Policy. But he cautioned that there are still too many unknowns about the virus—and potential variants—to just drop all guardrails.
“We have to be humble, we don’t know what the future brings,” he said.
Ground level
There are no clear data points for exactly when it’s appropriate to take off masks, return to the office or even resume international vacations. Nationally, vaccines are widely available and infection rates are finally dropping after a record surge driven by the Omicron variant. But COVID risk is mostly determined at the local level. And in some regions, infection rates are still high while vaccination rates remain low. There is no one-size-fits-all formula for determining how and when to roll back pandemic restrictions. The result is a confusing patchwork of ever-changing rules.
In the absence of clarity, states have taken different courses. Several Republican-controlled states banned mask mandates during the pandemic, most of which still lag behind in vaccination rates. For example, in Tennessee, where mask and vaccine mandates were banned last November, just 53% of eligible people in the state have received two doses of the vaccine. And in Georgia, where Republican Governor Brian Kemp banned mask requirements in August, two-dose vaccination rates also hover at 53%.
On the other hand, some Democratic-leaning states with much higher vaccination rates held on to pandemic precautions for far longer. New York state, which has fully vaccinated 75% of residents, eased its mask requirements for indoor businesses only last week and is still requiring masks in some high-risk settings, like nursing homes.
General fatigue
“Democratic governors felt all along that they were following the science, and they see themselves as doing the same thing now,” said John Kincaid, a professor of government and public service at Lafayette College in Pennsylvania. “The two sides just see the science differently.”
That may now be changing, as recent polls have found that Americans of all political persuasions are increasingly frustrated and fatigued by the pandemic.
“The political winds are really shifting,” Kincaid said.
For now, the CDC is holding firm.
“At this time, we continue to recommend masking in areas of high and substantial transmission, that’s much of the country right now, in public indoor settings,” Walensky said during a White House briefing last week. The current guidance, she said, is based on the CDC’s surveillance of wastewater, case counts, hospitalizations, and deaths.
Chicago balks
Even as some regions begin to consider how to live with the virus long-term, others are still keeping restrictions in place.
In Illinois, Democratic Governor J.B. Pritzker has announced plans to do away with the state’s mask rules by Feb. 28. Meanwhile, Chicago will continue to enforce mask-wearing until transmission levels are lower. It relies primarily on four metrics: cases diagnosed per day, positivity rate, hospital beds occupied by COVID patients and intensive-care beds occupied by COVID patients.
Even though those infected with Omicron are less likely to be hospitalized or end up in the ICU than with past variants, the city’s policy has remained the same.
“Chicago’s policy is good, because we have guardrails, which aren’t really in effect in all places,” said Katrine Wallace, an epidemiologist at the University of Illinois at Chicago. She said it’s crucial to look at several different metrics together to determine risk. “It ends up getting political when a governor or a mayor, or whoever, just does things that aren’t based in public health science.”
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