What to Know
- NYC's rolling new case average is up more than 64% the past seven days over the weekly average for the previous four weeks; delta has become the dominant strain and is fueling the latest spread
- The trend is similar at the national level, where cases of COVID-19 last week increased by 17,000 nationwide over a 14-day period for the first time since late fall
- Los Angeles became the nation's most populous county to reinstate indoor mask mandates over the weekend because of the spread. Some in other major cities, including New York, have called for the same
Everyone older than age 2 should wear masks, regardless of vaccination status, when schools reopen in the fall, according to updated guidance from the American Academy of Pediatrics released Monday.
The leading national pediatrician group said it recommends universal masking because so much of the student population isn't yet eligible for vaccination. It's not clear how quickly that will change, or how likely parents will be to get their younger children dosed when the federal government approves shots for kids under 12.
Research consistently shows opening schools in person doesn't generally increase community COVID transmission when masks and other protocol are employed, AAP says, and the emergence of more contagious variants, some of which are linked to more severe outcomes, poses a particular threat to people who aren't vaccinated.
“There are many children and others who cannot be vaccinated,” said Sara Bode, MD, FAAP, chair-person elect of the AAP Council on School Health Executive Committee. “This is why it’s important to use every tool in our toolkit to safeguard children from COVID-19. Universal masking is one of those tools and has been proven effective in protecting people against other respiratory diseases, as well.
"It’s also the most effective strategy to create consistent messages and expectations among students without the added burden of needing to monitor everyone’s vaccination status," Bode added.
The updated guidance from the leading pediatric professional group comes as the rapid spread of the COVID-19 delta variant in under-vaccinated neighborhoods threatens to undercut the nation's -- and New York City's -- pandemic progress.
Calls have grown in the last few weeks for elected officials to reinstate indoor mask mandates to shield the millions of Americans who haven't yet been immunized.
For more than a month straight, New York had reported sustained declines in new COVID infections as well as fewer hospitalizations and deaths, but lately, new daily case counts have surged past 1,000, up significantly from the roughly 300 to 400 new cases a day that Gov. Andrew Cuomo was reporting just a month ago.
In New York City, the rolling new case average is up more than 64% over the weekly average the four weeks prior as of Monday -- a jarring increase fueled by the delta variant, which is now the dominant strain in the five boroughs and nationwide.
Asked about the masks in schools issue as recently as Friday, New York City Mayor Bill de Blasio said the expectation at this point was for the mandate to remain in public schools throughout the city. The CDC still recommends the same, though de Blasio says that may very well change by September. If it does, he'll reevaluate -- the mayor reiterated the same approach on both counts when asked about it Monday.
Beyond the classroom, de Blasio has hedged when asked whether mask rules should be more fully reinstated, including for vaccinated adults. On Sunday, he said there's no plan to do so "at this point," but stresses city officials are closely monitoring the situation and are prepared to pivot viral strategy as needed.
On Monday, the mayor said he does not plan to reinstate a citywide mask mandate even as COVID-19 cases increase, opting instead to focus on vaccinating more residents. De Blasio, like others, says the latest case increases are by and large among non-immunized people. He also pointed to sustained declines in new hospitalization and death rates as a testament to the power of vaccination to curtail worse outcomes associated with the respiratory disease that first emerged in Wuhan in 2019.
"A mask doesn't arrest the progress of the variant," de Blasio said Monday. "Vaccination does. We're going to go where the real impact is, bottom line."
There have been calls for New York City to follow the lead of Los Angeles County, which announced last week that it will require masks be worn indoors amid a sharp increase in virus cases. And the mayor disagrees with the New York City Council Health Committee Chairman Mark Levine, who has pitched a return to indoor mask mandates.
"I think there's something to be said for mask solidarity — if we are all doing it, it becomes the natural thing. But of you leave it up to an honor system, pretty soon no one is wearing a mask," Levin said Monday. "We need to act now to slow what could be another wave. Before we see hospitalizations and heaven forbid, deaths."
But de Blasio insisted vaccinations are a better strategy for the nation's most populous city, where 4.8 million residents have at least one dose.
“Masks have value, unquestionably, but masks are not going at the root of the problem. Vaccination is,” the mayor said during an livestreamed press briefing. “So we do not intend a mask mandate. We do intend to double down on vaccination.”
His health commissioner, Dr. Dave Chokshi, echoed his statements Monday, saying, "It is true that there is more risk for any individual person but that risk is highest for people who remain unvaccinated."
Chokshi said "it's actually a more dangerous time to be unvaccinated" now than it was a few months ago because of delta's heightened transmissibility.
To date, nearly 65% of New York City adults are fully vaccinated, while more than 70% have received at least one dose. Statewide, those numbers are 67.3% and 74.%, respectively, though immunization rates decline extensively by age.
According to the latest data, about 31% of kids age 12 to 15 are fully vaccinated, compared with 48.9% and 54.2% of the next two older age cohorts, which respectively cover people age 16 to 25 and 26 to 34. Students in Grade 6 and younger aren't even eligible for shots yet and it's yet clear when they will be.
Case trends are similar at the national level, where cases of COVID-19 last week increased by 17,000 nationwide over a 14-day period for the first time since late fall. An increase in hospitalization and death historically follows a spike in illness.
U.S. Surgeon General Surgeon General Vivek Murthy has said it would be appropriate for local governments to reinstate mask mandates while former surgeon general Dr. Jerome Adams took a more urgent tone on Sunday.
More on COVID-19
Murthy called easing mask guidelines "premature" and "harmful' in the face of the delta variant and urged everyone to wear masks regardless of vaccination status.
Masks are still required for vaccinated people in certain scenarios, including on mass transit, in airports, in schools and other places deemed to be higher risk. But that rule has been lifted for vaccinated people in the vast majority of cases.
While U.S. case numbers and hospitalizations are still far below levels from the worst of the pandemic early this year, Murthy said the worsening situation shows the need to convince more people to get inoculations.
“It is our fastest, most effective way out of this pandemic,” he said.
About 186 million Americans have received at least one shot to date, but another 90 million eligible Americans haven't. Officials are trying to overcome hesitancy or outright refusal among some — particularly conservative, rural white people — to get vaccinated, but it's unclear how to do that successfully. So, as an interim stopgap, some places have reverted to health precautions that had been cast aside.
Meanwhile, four of New York's mass vaccination sites are set to close on Monday as the state plans to redistribute resources into more localized operations. The sites at The Conference and Event Center Niagara Falls, Plattsburgh International Airport, SUNY Polytechnic Institute - Utica, and Jones Beach will close.
Cuomo has cited decreasing demand and "milestone" achievements in vaccinations for shuttering the mass vaccination sites.
Gov. Phil Murphy has done the same regarding mass vaccination sites in New Jersey, where new daily case totals are also seeing a significant increase in the last few weeks despite relatively stable hospitalization and death rates.
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Data: City of New York, State of New Jersey • Nina Lin / NBC
New Jersey's daily case numbers are up more than 100% in the last 14 days, according to New York Times data. As appears to be the case in New York and elsewhere across the country, the delta variant seems to be fueling the spread.
That strain is the most dominant one in the Garden State. Health department data shows it accounts for 40.7% of samples sequenced in the last four weeks, up from 26.8% a week ago and 7.3% two weeks before that.
New data unveiled by Murphy Monday shows the state's rate of transmission is 1.37, the highest it has been in three months. Nearly all of the new and severe cases are among people who aren't vaccinated and a fraction represent so-called breakthrough cases among already vaccinated people, the governor says.
"These numbers speak for themselves. We only have a pandemic among the unvaccinated. Everyone ages 12 and up who is eligible should go and get vaccinated," Murphy noted Monday.
The New Jersey governor said in late June that masks would not be mandatory in public schools within his state for the upcoming school year barring an unexpected development. He reiterated that point again Monday as well.
“We continue to be comfortable where we are,” Murphy said. "We watch this like a hawk. I don’t want to go back, but if we think that’s the right thing to do, we’ll do what the public health experts suggest.”
State health commissioner Judy Persichilli said the rate of positive test results has risen recently for children up to age 13, and most sharply in children 4 and under. She added that overall cases, the rate of hospitalization and the percentage of patients in intensive care has remained low.
Murphy and Persichilli provided an update on the number of fully vaccinated people in the state who have tested positive for COVID-19, referred to as “breakthrough” infections. Through June 28, they found about 3,500 positive cases, 84 requiring hospitalization and 31 deaths among the state’s 4.4 million vaccinated people.