Why Massachusetts isn’t following the CDC’s mask guidelines

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The entire state should now be masking up indoors, according to the CDC. But Charlie Baker isn’t budging.

Gov. Charlie Baker plays with children and staff at a summer school program in Revere. David L. Ryan / The Boston Globe

According to the Centers for Disease Control and Prevention’s guidelines, everyone in Massachusetts should now be wearing a mask in public indoor places due to the state’s increased COVID-19 transmission rates.

However, while a small number of towns have reimposed indoor mask mandates, Gov. Charlie Baker has rejected calls for a similar statewide requirement based on county-level COVID-19 rates. Even with the entire state now seeing “substantial” or “high” rates of COVID-19 transmission, the Republican governor isn’t budging.

“I’m not considering changing the mask guidance,” Baker said Monday, before quickly adding, “at this time.”

Why? The governor cites two main reasons.

The first is the fact that Massachusetts has one of the highest vaccination rates in the country, with over 75 percent of adults fully vaccinated and 85 percent with at least one shot.

The second is that the state’s COVID-19 rates, while rising, do remain relatively low; according to a New York Times survey of state health data, Massachusetts has the eighth-lowest rate of COVID-19 cases per capita in the country and the third-lowest per-capita hospitalization rate.

Given those metrics, Baker argues that the CDC’s national guidelines aren’t a good fit for Massachusetts.

“We pay a lot of attention to the data associated with case counts, and with hospitalizations, and the tragedies associated with the loss of life,” Baker said Monday. “But you can’t look at the commonwealth of Massachusetts — and look at our vaccination rate, our hospitalization rate — and compare it to where the rest of the country is.”

While the United States as a whole is averaging 23 hospitalizations due to COVID-19 per every 100,000 residents, the rate in Massachusetts is 5 per 100,000. The number of deaths per capita is twice as high nationally.

“The fact that so many people in Massachusetts have been vaccinated … has put us in a dramatically different place than many other states across this country,” Baker said, adding that he hopes residents of other states “move as aggressively as the people in Massachusetts have moved to get vaccinated.”

“Vaccinations are the pathway out of this pandemic, period,” Baker said.

The CDC, however, changed course last month and recommended that even vaccinated individuals should again wear masks indoors (when outside their home) in areas where COVID-19 transmission rates are substantial or high.

The new recommendation was based on research from a now-infamous Provincetown outbreak suggesting that vaccinated individuals can still transmit COVID-19 to others, even if the overwhelming majority are protected from the worst of the virus. Baker noted last week that the conditions leading to the Provincetown outbreak — a rainy, party weekend with lots of crowded, indoor gatherings — “was as big a test as you could possibly put a vaccine through.” With more than 1,000 cases in the cluster, only seven people were hospitalized and the one person who died “had a lot of complexities,” Baker said.

Those findings also help explain the Baker administration’s differing approach to mask guidelines.

Statewide, 73 of the 100 people in Massachusetts who died from COVID-19 despite being fully vaccinated had some type of underlying medical condition, according to the state’s Department of Public Health; their median age was also 82.5.

Late last month, DPH released new mask guidelines individually recommending that people who may be more vulnerable to COVID-19 wear a mask. The recommendations apply to people with a weakened immune system, underlying medical condition, or who are elderly (though it does not specify how old). They also apply to anyone who lives with someone who is vulnerable or unvaccinated (all unvaccinated people are also asked to wear masks indoors).

Baker said Monday that his administration is working to ensure immunocompromised residents have access to the third COVID-19 vaccine booster shots that were recently authorized for them once “the rules become more available and clear.”

He also defended the decision not to follow the CDC’s recommendation that all all staff, students, and visitors, regardless of vaccination status, wear masks inside at schools. Rather, the Baker administration issued a strong recommendation that younger students who remain ineligible for the vaccine and anyone else who is unvaccinated wear a mask. But they issued no rules requiring individuals or school districts to enforce those recommendations.

“We let the locals make the call that makes the most sense for them,” Baker said Monday. “And we believe that has a lot to do with why Massachusetts has been so successful in managing the virus over the course of the past year-and-a-half.”

Officials in several dozen school districts, including Boston and Worcester, have already decided to require masking in schools this fall. In response to the Delta variant, Lexington, Belmont, and Provincetown have issued mask mandates for the general public, too. Somerville is also poised to become the first city in Massachusetts to reimpose a mask mandate this week, which officials say is a “simple” way to stem the rise in cases without imposing harsher restriction on businesses or gatherings.

“Putting on a mask indoors in public is easy to do,” Somerville Mayor Joe Curtatone said in a statement last week.

Baker says municipalities are free to go further than the state’s guidelines.

“Giving locals the opportunity to own the decisions they make is a big and important issue,” he said Monday, knocking the Republican-run states that have banned cities and towns from enforcing their own school mask mandates.

“If you look at what’s playing out in other states right now where state government has taken away the authority for locals to make their own decisions, that’s not the right way to play this game,” Baker said. “It’s just not.”

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