Even as the Centers for Disease Control and Prevention on Tuesday relaxed outdoor masking guidelines — recommending vaccinated people do not need to wear face coverings outdoors except in large gatherings — some vaccinated San Franciscans remained leery.
“People are delicate, so I am going to continue to use” the mask, explained Marta Jacinto, a tamale vendor on 22nd and Mission, in Spanish. Jacinto, who is vaccinated, had not heard the CDC’s Tuesday morning announcement. But, when given the update, she said: “It’s good, but also, you have to have caution.”
Ed, a 40-year-old worker at an auto body shop on 17th Street between Mission and Valencia streets, also said he has been fully vaccinated — for three months. But he shook his head when he found out about the new guidelines.
“That’s not really smart — that’s not a good choice,” he said. “People are getting hurt.”
Infectious disease experts, however, all agreed that outdoor Covid-19 transmission is extremely rare, and that the CDC guidance is long overdue. They said the distance people usually maintain outdoors, as well as outdoor conditions like breezes that dilute respiratory particles, greatly reduce the chances of infection.
Dr. Monica Gandhi, a UCSF infectious disease expert, made a clear recommendation on Tuesday: “We should all throw off our masks today and not wear [them] outside in San Francisco.”
The reasons are manifold, she said. For one, the data has long shown that Covid-19 transmission is 3,000 times lower in outdoor settings, compared to indoors. She also said that the city is reaching a 70 percent first-dose vaccination rate. Furthermore, she said, San Francisco case rates and hospitalizations remain extremely low.
Gandhi noted that San Francisco began its mask mandate in April of last year, and it would be somewhat poetic to lift it a year later. “There’s a really lovely symmetry to doing it around the same time,” she said, noting that indoor masking requirements should remain in place for a while longer.
In fact, because I like to model good and appropriate data-driven behavior as an ID MD & epidemiologist, I will try not to wear masks outside in San Francisco unless in large groups while awaiting @SF_DPH to update guidance from 4/17/20..please don’t glare at me! https://t.co/PPqsUBXkiV— Monica Gandhi MD, MPH (@MonicaGandhi9) April 27, 2021
Specifically, the CDC says that vaccinated people are safe unmasked when walking, running, hiking, biking, and dining outdoors either alone or in small groups. And even people who are not vaccinated are safe maskless while exercising outdoors with members of their family or participating in small outdoor gatherings. The guidelines do caution that unvaccinated people should wear masks while dining outdoors (between bites, presumably). And both vaccinated and unvaccinated people should wear masks at large gatherings, the guidelines say.
But it’s unclear how long it will take for the city to officially lift its local masking mandate. Dr. George Rutherford, a professor of epidemiology and biostatistics at UCSF, noted that CDC guidelines do not “have the force of law on states.”
And indeed, the San Francisco Department of Public Health said that the city must wait for the state to ease its restrictions. “We anticipate that we will adopt the guidelines as soon as the state allows,” a health department spokesperson said in an email.
“In the meantime, and because it is impossible to tell who is vaccinated and who is not, we recommend that those who are fully vaccinated (two weeks post final dose) continue to wear masks and practice physical distancing in public, and when gathering with unvaccinated people from more than one household,” the spokesperson added.
Rutherford said it would be wise for the state to conform to the new guidelines — but it will be a difficult balancing act because California’s many counties are facing different challenges. “You don’t want to issue something that works for San Francisco and makes things worse for farmers in the Central Valley,” he said.
“This is the time to be careful, not overly liberal,” he added. “You don’t want to spike the ball at the five-yard line.”
But in a place like San Francisco, where vaccination rates are high and infection rates are low, it might be time for residents to begin unwinding from their pandemic anxieties, said Dr. Jake Scott, an infectious disease specialist at the Stanford University School of Medicine. Though, he adds, it might take a while.
“We need to get back some sort of normal life, and people should understand there is a robust amount of data to support” the new CDC recommendations, he said. But recognizing that the pandemic was an unprecedented event in our lifetimes, “it’s going to take a long time to undo the psychological effects of all the mitigation strategies.”
Matt Pacheko, a 23-year-old DoorDash worker who was visiting a bank at 22nd and Mission streets on Tuesday morning, seemed to agree. He is from Brazil, among the countries hardest hit by the pandemic, and he said five of his friends have died from the virus.
He thinks masking will be woven into our culture for years to come. “It can even help us protect each other from other things,” he said.
But Jose Cabrillo, a butcher at the Evergreen Market on Mission Street near 21st, appeared ready to shed his mask outdoors. “I got used to the mask, but I can also get used to not wearing it again,” he said. “I am not surprised, it’s just more of a relief.”
“We knew that this was going to end someday,” he added, “and we have to slowly adapt again to what it used to be like.”
Update, April 27, 3:45 p.m.: The state will be following the CDC masking guidance, Gov. Gavin Newsom said Tuesday. “CA will be aligning with the new CDC guidelines,” he tweeted. “If you’re fully vaccinated, outdoors, and not in a large crowd — you do not need to wear a mask.”