Pennsylvanians can start leaving their masks at home on Monday, as the state lifts its universal masking mandate 439 days after it was enacted.
Overnight in April of 2020, masks went from garb reserved for medical professions to a staple of daily life in Pennsylvania. They quickly became the most visible sign of how the coronavirus upended all of our daily lives, preventing us from smiling at strangers in passing or clearly hearing one another speak. American retail quickly pivoted, stocking store shelves with masks ranging from the utilitarian to ones brandishing political and fashion statements.
Now, nearly 16 months after the first case was detected in Pennsylvania, the coronavirus vaccines are allowing us to ditch our masks. In Pennsylvania, more than 1.2 million people have been sickened and more than 27,600 have lost their lives since the first case was detected in March 2020.
Pennsylvania first mandated businesses to require masks on April 15, 2020. Then during July’s summer surge, the state required them whenever anyone left their home and couldn’t social distance. The mask mandate is the state’s final coronavirus restriction; other mitigation measures ended May 31.
The lifting of the masking mandate is largely symbolic for the vaccinated after the CDC in mid-May said the vaxxed could stop wearing masks in most settings. Many local and national retailers then followed suit, turning to an honor system where masks are optional for the vaccinated.
But it represents a major change for the unvaccinated, who are no longer required to wear a mask indoors. State health officials encourage them to still wear masks to protect themselves from the virus and encourage them to get vaccinated.
“As we shift to wearing masks less often, it is important to remain resilient in the fight against COVID-19, just as we have done together over the last year and a half,” Acting Physician General Dr. Denise Johnson said. “The COVID-19 vaccines are the best tools we have to defeat COVID-19. Pennsylvanians are aware of this and have been getting vaccinated. If you have not already been vaccinated, there are plenty of options available near you.”
Acting Health Secretary Alison Beam announced May 27 that the masking order would be lifted by June 28 or earlier if 70% of Pennsylvania adults became fully vaccinated.
The state is short of that goal as Monday arrives, with 59.4% of adults fully vaccinated as of Friday and 74.9% with their first shot.
“Even though the universal masking order will be lifted in a few days, businesses, organizations, health care providers and other entities maintain the option of requiring employees, guests or customers to wear a mask, regardless of their vaccination status,” Beam said.
Pennsylvania will continue to follow Centers for Disease Control and Prevention masking guidelines. Currently, the CDC requires masks on planes, buses, trains and other forms of public transit traveling into, within and out of the country.
About a dozen states nationwide still require masks for people who are not fully vaccinated in most indoor public settings, according to AARP tracking.
(Can’t see this map? Click here.)
Pennsylvania’s dangled lifting its mask mandate as an incentive to get more shots in arms over the spring. When Beam announced the June 28 deadline, Pennsylvania was averaging 1,143 new infections a day with 52.7% of the adult population fully vaccinated and 70% with at least one jab.
It was expected that by the end of June, everyone who only had their first shot in May would have had their second dose. Instead, almost 60% of adults are now fully inoculated, indicating some have skipped their second shots.
“We cannot identify a specific date that we will reach 70% of all adults fully vaccinated and we continue to make great progress in Pennsylvania vaccinating thousands of people every single day,” state health department spokeswoman Maggi Barton said. “We know that we have nearly 75% of adults partially vaccinated and hope that they will receive their second dose as encouraged.”
New Jersey is nearing 68% of adults fully vaccinated. Only, Vermont, Maine, Connecticut and Massachusetts have fully vaccinated 70% or more of adults, according to the CDC.
The vaccines are doing their job. Pennsylvania’s rate of daily new cases has dropped 84% since May 27 to 186 new cases a day over the last week on Friday. The majority of those cases are among the unvaccinated or asymptomatic people caught in surveillance testing, said Dr. Luther Rhodes, an infectious disease specialist at Lehigh Valley Health Network.
“It is a sustained steady decrease and it mirrors exactly the start of vaccination,” Rhodes said. “Everybody’s (coronavirus) risk is reduced, particularly vaccinated people, because of vaccines, but it is not zero.”
While Pennsylvania may not have hit 70% of adults fully vaccinated, almost 100% of adults 65 and up have at least one shot and 81% are fully vaccinated.
“So your highest risk people are well above that 70%,” Rhodes noted.
Many private businesses and healthcare providers are likely to continue to mandate masks for some time, he predicted. When more health systems and employers start mandating vaccination, likely after full federal approval, Rhodes anticipates vaccine rates will climb higher. The rates for measles, mumps and chicken pox are only so high because schools require them, and when rates fall in certain populations we do see outbreaks, he said.
“There comes a time when the legal requirement for immunization for the public health good is justified,” Rhodes said. “We are still in that process right now.”
The majority of Rhodes’ patients are more concerned about removing their masks too soon, he said. He advises anyone who is uncomfortable unmasking now to keep them on as it poses no harm to do so.
When the CDC first announced in May that the vaccinated could largely ditch their masks, it was such a shift that it took time for people to catch up to the latest scientific guidances, Rhodes said. Going forward it becomes a personal risk calculus based on community infection rates, he said.
“If I go to a supermarket, most people still have a mask on, but not all,” Rhodes said. “... Demasking is not easy, but it is a much better set of problems than we have a year or a year and a half ago, which was increasingly painful.”
Rhodes is hopeful that now that the general public has caught on to the illness protection masks offer there’s more usage during flu season or when someone catches a cold.
The quickly spreading Delta (B.1.617.2) variant is a major reason public health officials are encouraging the unvaccinated and partially-vaccinated to keep masking in public spaces.
Both state and local health officials are carefully watching the spread of Delta in the U.S. and Pennsylvania, which first emerged in India in 2020. It’s projected it could account for 50% of U.S. COVID-19 infections by early to mid-July.
Delta’s quickly became the dominant variant in the United Kingdom accounting for 90% of new cases, and the CDC projects it represents about 20% of recent U.S. cases. The rapid spread in the U.K. led Prime Minister Boris Johnson to recently postpone a scheduled lifting of health restrictions.
Public health experts say Delta is particularly risky for people who are unvaccinated, as it is 50% more transmissible and associated with more severe illness. A recent analysis found faster Delta growth rates in counties with lower vaccination rates, making it less likely Delta will be as widely dominant in America as in the U.K due to differing public health policies and vaccination rates, Helix scientists reported. Vaccines are still highly effective against this variant.
“The potential threat of Delta and all other variants underlines the importance for all eligible people to get fully vaccinated,” Barton said.
Delta’s prevalence in the commonwealth remains very low -- just 0.9% of cases sampled and genomic sequenced -- as of June 5, the most recent CDC data available, she said. The CDC projects that Delta accounts for 13% of cases currently in the Mid-Atlantic.
“It is more contagious so you can have a reversal of a good trend if suddenly the few people who do walk around with it end up being more contagious,” Rhodes said. “That will cancel a declining case rate if every individual case is able to infect more people accidentally. The Delta variant is an example of why we can’t take the easy way out and let the vaccinated carry the weight for the unvaccinated.”
Almost all of the cases of COVID pneumonia Rhodes is now asked to consult on are unvaccinated people.
“Some say I planned to get vaccinated, but I couldn’t get the appointment, it wasn’t available or it cost too much,” he said. “None of those things are relevant now. It is readily available, it doesn’t cost anything.”
Nearly all COVID-19 deaths in the U.S. now are in people who weren’t vaccinated, a staggering demonstration of how effective the shots have been and an indication that deaths per day — now down to under 300 — could be practically zero if everyone eligible got the vaccine.
An Associated Press analysis of available government data from May shows that “breakthrough” infections in fully vaccinated people accounted for fewer than 1,200 of more than 853,000 COVID-19 hospitalizations. That’s about 0.1%.
And only about 150 of the more than 18,000 COVID-19 deaths in May were in fully vaccinated people. That translates to about 0.8%, or five deaths per day on average.
The AP analyzed figures provided by the CDC, which itself has not estimated what percentage of hospitalizations and deaths are in fully vaccinated people, citing limitations in the data.
Among them: Only about 45 states report breakthrough infections, and some are more aggressive than others in looking for such cases. So the data probably understates such infections, CDC officials said.
Still, the overall trend that emerges from the data echoes what many health care authorities are seeing around the country and what top experts are saying.
Earlier this month, Andy Slavitt, a former adviser to the Biden administration on COVID-19, suggested that 98% to 99% of the Americans dying of the coronavirus are unvaccinated.
And CDC Director Dr. Rochelle Walensky said on Tuesday that the vaccine is so effective that “nearly every death, especially among adults, due to COVID-19, is, at this point, entirely preventable.” She called such deaths “particularly tragic.”
Deaths in the U.S. have plummeted from a peak of more than 3,400 day on average in mid-January, one month into the vaccination drive. Pennsylvania is now averaging 11 deaths a day.
Rhodes called the development of the COVID MRNA vaccines a moonshot experience for the science of public health. He is excited to see how these advances spillover into other medical advances, perhaps a better flu vaccine.
“It is just stunning,” Rhodes said of the vaccines. “I look at that as a painful lesson. What a price we’ve had to pay for these lessons, but these lessons are not going to be forgotten. We were so lucky that the MRNA technology is a perfect fit for this peculiar virus.”
About 63% of all vaccine-eligible Americans — those 12 and older — have received at least one dose, and 53% are fully vaccinated, according to the CDC. While vaccine remains scarce in much of the world, the U.S. supply is so abundant and demand has slumped so dramatically that shots sit unused.
After a rocky start, Pennsylvania’s vaccination campaign quickly gained ground and climbed in national rankings. Now, the state’s reached the phase of the campaign where each shot is hard earned.
The Pennsylvania Health Department is reaching out to areas of the state with low vaccination rates to educate people on the safety and efficacy of the vaccines, often relying on trusted messengers to reach communities, Barton said. Its current media campaign aims to deliver messages that appeal to each community’s unique motivations and hesitancy concerns.
“The message we want all residents to know is there are safe and effective vaccines available,” Barton said. “The vaccines are the best way forward to protect you, your loved ones and neighbors from the virus and get back to their life and the things they may have missed over this past year.”
The Associated Press contributed to this report.
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Sara K. Satullo may be reached at ssatullo@lehighvalleylive.com.
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