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At a grocery store in Norfolk, customers mill the aisles, same as they have for the past year, virtually all wearing masks.
At a restaurant just a few blocks away, no one outside or gathered around tables inside the dining has a face covering on, in stark contrast with the masked-up staff.
A bustling park in Virginia Beach brims with families at picnic pavilions and pushing children on swings, with sunshine kissing their bare cheeks.
For the past week, Virginians have begun to show their faces, following Gov. Ralph Northam’s decision to lift the universal indoor mask mandate. But many say they are reluctant to change the status quo, feeling naked without that extra layer of protection between them and the world.
The policy decision, prompted by new U.S. Centers for Disease Control and Prevention guidance, signals an effort to return to life prior to the COVID-19 pandemic. Yet many epidemiologists, doctors and scientists have been surprised by the quick turnabout, concerned that removing masks now, with the virus spreading through more contagious variants, will lead to a resurgence of infections.
“What I hope will happen is that a bunch of people will decide to go out and get vaccinated who were a little bit hesitant before,” said Dr. Patrick Jackson, assistant professor of infectious diseases and international health at the University of Virginia. “What I fear might potentially happen is that, in communities where the rate of vaccination is particularly low, and where the rate of mask-wearing is low, we could start to see some localized outbreaks of COVID-19 continuing.”
Infectious disease experts have often referred to herd immunity as the threshold to defeat the pandemic. Thought to be met when 75% to 80% of the population have either been vaccinated or previously infected, it is the level of immunity needed to nearly wipe out the chances of vulnerable people coming in contact with the coronavirus.
Only 38% of state residents have been fully vaccinated, according to the Virginia Department of Health. Depending on the locality, that rate could be closer or farther from the target. In South Hampton Roads cities, the proportion of vaccinated people is even smaller, between 25% and 33%. Higher rates are found on the Peninsula, particularly in James City County, which has 46% vaccine coverage.
Many experts have said they expected masks to come off soon — but perhaps not this soon. Some said they believed it would occur later in the summer, or that masks would gradually be phased out, giving individuals and businesses time to prepare.
Linsey Marr, an engineering professor at Virginia Tech with an expertise in airborne transmission of viruses, was one of them. She believes people should trust the science that advises removing masks, just like they followed the science when they put their masks on last spring.
But she wasn’t expecting such an abrupt sea change. Public spaces still need adequate ventilation and air-filtering systems, she said.
She took to Twitter to express her concerns.
“CDC guidance caught me by surprise, and my initial reaction was supportive,” she said. “But the more I think about it, I wish they had said, ‘Let’s do this on July 1. If you aren’t vaccinated yet, this is your chance to go do it.’ Give people time to plan.”
The CDC said people who are fully vaccinated no longer need to wear a mask indoors or outdoors and can stop distancing 6 feet from others in most situations. People are considered fully vaccinated either two weeks after their final doses of Pfizer or Moderna’s shots, or two weeks after a single dose of the Johnson & Johnson shot.
Masks are still required for public transportation, like buses and planes, and health care settings, prisons and homeless shelters. Some stores and offices are revising their mask rules for fully vaccinated people, while others are keeping them intact, causing confusion for the public.
But the relaxed masking policy could be perilous for people with compromised immune systems or those who take immune-suppressing drugs because the vaccines might not help them produce coronavirus-fighting antibodies. Children under 12, who aren’t eligible for shots, also don’t have the option to get a COVID-19 vaccine, leading some parents, even those vaccinated, to be more careful.
Scientists don’t know how many people fall into the category of having compromised immune systems. The CDC estimated 3% of U.S. adults have immunosuppression, according to research based on the 2013 National Health Interview Survey.
Dr. Melanie Brown, an infectious disease specialist with Sentara Internal Medicine Physicians in Norfolk, said those people include organ transplant recipients, people with autoimmune disorders like rheumatoid arthritis and lupus, and cancer patients receiving chemotherapy or radiation treatments.
And if you factor in the people who share a household with someone who has a weakened immune system, the number of people who might need to be more cautious before removing their masks only multiplies.
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“It probably is a substantial amount of the population these days,” Brown said.
She strongly encourages those patients to talk to their physicians to determine whether they should wear masks, even if they’ve been vaccinated.
Despite skepticism about the rush to remove masking orders, many experts say people can feel confident that the vaccines are highly effective at preventing serious illness and death from the coronavirus among people with normal immune function. A large recent CDC study found the Pfizer and Moderna two-dose series were 94% effective at reducing symptomatic illness. In clinical trials, J&J’s vaccine was 66% effective at preventing lab-confirmed COVID-19.
“The first time I saw the graph for the Pfizer vaccine showing the separation between people who got the vaccine and people who got the placebo, I’m always going to remember that as being the moment when I realized we could get past this,” Jackson said. “And I hope that people see these vaccines for the gifts that they are.”
Carrie Dolan, a William & Mary epidemiologist and director of Ignite Global Health, says masks have become a flashpoint in our culture, which might put undue pressure on people who need to continue wearing them. She hopes the general public will offer “grace” to those who can’t take off their masks or choose not to. Wearing a mask or other protective gear isn’t necessarily a reflection of a person’s political leanings.
“If you see people come into a baseball game wearing a mask, you don’t need to ask them why or remind them that they don’t have to. Instead, just accept them for where they are with that,” Dolan said. “Likewise, if you hear about somebody having a poker night, we don’t need to judge that because it’s probably a group of people who are vaccinated. We just got to come together with a culture of acceptance.”
Elisha Sauers, 757-839-4754, elisha.sauers@pilotonline.com