Fauci: Vaccines are 'highway to normalcy,' but masks still needed for now

WASHINGTON (SBG) — With half of American adults at least partially vaccinated against the coronavirus, pressure is growing for states to accelerate the lifting of mask mandates and business restrictions, but experts say some caution is still warranted for at least a little longer.

“We all want normalcy in America,” Dr. Anthony Fauci, the federal government’s top infectious disease expert, said at a White House briefing Monday. “The highway to that normalcy is vaccination... Every single day, as we get 3 to 4 million people vaccinated, we get closer and closer to that normalcy.”

As of Monday morning, 50.4% of the U.S. adult population had received at least one dose of a vaccine, and all Americans 16 and older were eligible to get a shot. Administering those shots remains a logistical struggle in many communities, though, and it might not be until early summer that everyone who wants a vaccine is fully protected.

In the meantime, many states are easing restrictions or repealing them completely, even as concerns rise about highly transmissible variants of the coronavirus spreading in some communities. The U.S. is still averaging more than 60,000 new virus cases a day, and average daily deaths are increasing.

“This is an interplay between how many people are vaccinated and how much disease is still out there,” said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.

According to federal officials, more vaccinations and fewer new cases are necessary before it will be safe for Americans to resume normal daily life. They have blamed the current uptick in infections partly on states relaxing restrictions, the public becoming less vigilant, and people traveling more within the country.

When President Joe Biden took office, he urged Americans to “mask up” for his first 100 days. With that milestone approaching later this month, health officials acknowledged Monday the recommendation to wear face coverings would likely extend beyond that point.

“You know one thing about President Biden, he follows the science, he listens to the scientists,” said Andy Slavitt, a senior White House coronavirus adviser.

In a “Meet the Press” interview Sunday, Fauci signaled changes to federal guidance could be coming in the near future. Pressed on whether Americans who have been vaccinated still need to wear masks, he suggested data might soon support some slackening of the rules.

“This is something that, as we get more information, it's going to be pulling back that you won't have to,” Fauci said of wearing masks, although he did not offer a specific timeline or benchmarks that need to be met.

At a House hearing last week, Fauci rebuffed aggressive questioning from Rep. Jim Jordan, R-Ohio, about when Americans could “get their liberties back.” He suggested a gradual rolling back of restrictions would be safe once most Americans are vaccinated and new infections are “well below 10,000 per day.”

With more than 60% of its population at least partially vaccinated, Israel lifted a mandate for people to wear masks outdoors Sunday, though the requirement remains in place for indoor public spaces. White House officials noted Israel’s infection rates are far lower than the case numbers in the U.S.

The CDC has issued recommendations for those who have been vaccinated, advising them that it is safe to visit unvaccinated relatives or to meet with other vaccinated people indoors without masks. Masks are still recommended when in public and around unvaccinated people, though, and the prospect of continuing to wear masks into the summer and beyond has generated some frustration and confusion.

In the year since the CDC first recommended Americans wear masks in public, face coverings have become a potent symbol of broader cultural and political disputes over the response to the pandemic. Republican-run states were slower to impose mask mandates and quicker to lift them, but even some Democratic states began scaling back restrictions last month as vaccination ramped up.

As of Friday, 26 states, the District of Columbia, and Puerto Rico still had mandates in place requiring masks in public, although the specific local rules vary. Thirteen states that previously had mandates have lifted them, despite criticism from health experts.

“Timing is really everything here,” said David Holtgrave, dean of the School of Public Health at the University at Albany. “In the weeks or months ahead, it may well be that such mandates can be relaxed, and we all look forward to that time. But right at this moment, mask use by the general public is still important as vaccination levels get to higher levels.”

In Texas, where a statewide mask mandate was lifted last month, case numbers have remained relatively stable, as infections rose in Michigan, where masks are required in most public settings. Many businesses in Texas have kept their own mandates in place, though, so it is difficult to judge how much impact relaxing the state rules has had.

Florida Gov. Ron DeSantis suggested Friday requiring those who are vaccinated to wear masks undermines the arguments health officials have been making for getting a shot. If people still need to comply with onerous restrictions once inoculated, they might see little benefit in doing so.

"If the vaccine is effective, why would you be wearing two masks, like some of these folks are doing?” DeSantis said at a news conference. “It doesn't make sense."

However, Fauci stressed there are still good reasons for vaccinated people to wear masks. Virus transmission by those who have been fully vaccinated so far appears to be even rarer than early trials indicated, but it could happen.

“What happens is that you might get infected and get absolutely no symptoms, not know you're infected and then inadvertently go into a situation with vulnerable people,” Fauci told NBC’s “Meet the Press.” “And if you don't have a mask, you might inadvertently infect them. Now, there's a small risk of that, but it's there.”

The National Institutes of Health is conducting a study of 12,000 college students designed to determine whether the vaccines prevent asymptomatic transmission, but results will not be available for five months. The data that is available from other real-world research indicates the vaccines may reduce the risk of infection by at least 90%, but they do not eliminate it.

“The most recent data suggest that some vaccinated people are less likely to spread the disease, but studies are continuing,” said Lisa Lee, a public health expert at Virginia Tech and former CDC official. “This means there is still a possibility that a vaccinated person with asymptotic infection can infect an unvaccinated person.”

The vaccines also appear to be somewhat less effective against variants of the virus, which are becoming more prevalent, and nobody knows how long the protection conferred by the shots lasts. Pfizer’s CEO said last week recipients would likely need a booster shot in a year.

That uncertainty coupled with the spread of variants makes any step toward a return to normal a gamble, but the risk might never fully recede. In a Washington Post op-ed, Michigan emergency room physician Rob Davidson described backing off precautionary measures at this point as tempting fate.

“Because I know we’re a long way from being safe, I want to communicate a shared commitment to everyone’s safety by wearing a mask, by signaling to everyone that regardless of whether I’ve been vaccinated or not, I’m taking the basic action of protecting myself and others around me,” Davidson wrote.

Easing restrictions on the vaccinated while much of the population is still unprotected also presents some practical challenges. Resistance to any sort of government-backed “vaccine passport” or a requirement of proof of vaccination has been strong, so enforcing rules that only apply to the unvaccinated could prove difficult.

“We still have more people who are not fully vaccinated than who are,” Holtgrave said. “So for right now, a community response in which we all tend to engage in precautionary behaviors like public mask use for just a bit longer in time is prudent.”

How much longer is hard to say. Officials have frequently cautioned the progress the nation has made toward ending the pandemic could be lost if variants manage to outpace inoculation, and that race is entering a critical period as vaccine eligibility expands.

“My hope is that we can continue the strong rollout of vaccines, get to herd immunity before fall, and continue to assess how and when we can get back to—or at least closer to—our normal living as soon as possible,” Lee said.

Although half of adults have now received at least one shot, full protection from infection does not kick in until two weeks after the second shot for Pfizer and Moderna, and it will be several more weeks before a majority of Americans reach that point. It is also not clear how much of the remaining population wants to get vaccinated, as hesitancy persists in some demographics.

In recent polls, nearly 30% of Americans said they were unwilling to get vaccinated, including almost half of Republicans. If those numbers hold, it could become a significant impediment to reaching a level of herd immunity that experts believe would justify lifting all mask mandates and restrictions on activity.

“One of the most important things we can do to get back to doing the things we love is to get vaccinated,” Walensky said Monday.

President Biden has set a goal of Americans being able to safely gather with family and friends for July 4 celebrations. Republican lawmakers from states that have already relaxed restrictions on social gatherings mocked the announcement, but Holtgrave said concrete near-term benchmarks are vital for preventing those who are still following public health guidance from growing disillusioned.

“We are getting very close to a return to some sense of normalcy in the U.S.,” he said, “but we have some hard work to do in the weeks ahead.”