Washington residents won’t be required to wear masks inside many public areas starting March 12. But experts advise not to throw out those masks yet in anticipation of a pre-pandemic, devil-may-care reality. Some places will still require covering up — and certain vulnerable groups are still at high risk of infection from COVID-19.

With the omicron variant pushing numbers up in recent months, many say they are just more comfortable keeping those masks close at hand for a while longer.

To say that infections spiked in January would be a dramatic understatement. The state’s seven-day rolling average number of cases reached all-time peaks over 19,000 in mid-month, compared to around 1,100 toward the end of November.

Then, in February, a fast decline in numbers of cases, hospitalizations and deaths encouraged decisions to end mask mandates in schools, restaurants, bars and gyms. Healthcare facilities, public transit and ridesharing services will still require masks, and private businesses may continue to require customers to mask in their establishments.

Where’s the highest risk?

Of the 39 counties in Washington state, only nine have 65% or more of their residents vaccinated with two or more doses. San Juan (80%), Whatcom (68%) and Skagit (65%) are among them.

Neither San Juan nor Skagit counties break down vaccination rates by subareas. Whatcom County compiles vaccination rates by school districts, and sees rates that vary widely among districts. However, Whatcom County’s Department of Health says it’s not clear whether traveling between districts impacts overall infection numbers. 

“People living in one part of Whatcom County often travel to other areas within and outside the county, and many people are no longer limiting their travel as was the case earlier in the pandemic,” said Scarlet Tang, health department communications specialist. That ongoing mobility makes it difficult to say whether travel affected risk of infection.

Skagit County’s vaccination rate is lower than in San Juan and Whatcom counties, but recent community outreach and testing have pushed vaccination rates up and kept cases down.

Given the very high level of community infection with omicron over the past two months and strong vaccination rates, the county doesn’t anticipate another January-level spike in infections and hospitalizations, said Danica Sessions, Skagit County communications coordinator — “assuming that we don’t see a new variant of concern that challenges our current level of protection.” 

The ‘now normal’ risks

For San Juan County Health Officer Frank James, lifting the mask mandate won’t mean a return to normalcy, but rather a change in priorities. 

Unless one is 65 or older, a COVID-19 infection for a fully vaccinated individual will usually result in minor cold-like symptoms, James said. But at-risk individuals and those in close contact with them should all continue to maintain preventative measures. 

“If someone in these risk categories is in your life, you’re going to have to mask more and you’re going to have to test more. I mean, those are just the realities of it,” James said. “Most cases are transmitted in either outbreaks or household settings … I’m 70 years old; I would appreciate it if everybody tested before they came around me.” 

The largest at-risk groups continue to be the unvaccinated, particularly young children; people with certain health conditions; and vaccinated older adults. 

Children 5 and under are currently ineligible for vaccination, and 5- to 11-year-olds currently have the lowest vaccination rates of any age group in Washington (30.2%).

Obesity, disability, pregnancy, diabetes, cystic fibrosis and heart conditions also put people in an at-risk category.

Of the nearly 75,000 people 65 and older living in Whatcom, Skagit and San Juan counties, 86% are fully vaccinated. However, even vaccinated, James said, they still run the risk of severe outcomes from infections. According to the Centers for Disease Control and Prevention, people 65 and older comprised 73% of total COVID-19 related deaths in the United States.

“With people over 65, even though they’re immunized their immune systems are getting old and tired. And it goes up with age,” James said. “So, at 65 it begins to wander up, and by the time you’re 80 there’s a significant increase in hospitalization rate and severe illness, a really big difference.” 

Cautiously stepping into the future

“Going forward, there’s really a lot that we can do and should do,” James said. “So many people think, ‘Oh, great, I’m going to burn my mask and go back to life as I’ve always had it.’ It’s actually not going to be like that.” 

Infections can suddenly increase as happened with the delta variant in the San Juans. James lifted a local business-only masking order on June 21, 2021, following a complete drop in COVID-19 infections throughout the county. But after an increase in cases throughout the summer, the order was reinstated on August 12, 2021. 

“We went 52 days without a single case. And basically, you have eradicated a disease from a population if you go two reproductive cycles without a virus,” James said. “We had eradicated it entirely from our county with the masking, isolation, quarantine. So, it seemed reasonable to let it go.”            

Local health jurisdictions are still allowed to impose health mandates even with the state lifting its own, but neither Skagit nor Whatcom counties have plans to require local mandates, according to county representatives.

“It is unlikely that our guidance will differ significantly from the statewide guidance unless Whatcom County has unique circumstances that are significantly different from the statewide situation,” said Whatcom County Co-Health Officer Greg Thompson. 

That’s not to say it’s off the table. Various jurisdictions in the state have already decided to keep their own rules in place, with Western Washington University requiring masks to be worn indoors until April 11.

Keep that mask at hand

The indoor mask mandate is lifting but the effectiveness of masking as a public health strategy has been demonstrated by the dramatic drop in flu deaths during 2021 due to measures keeping COVID-19 infections in check, a Johns Hopkins study reported,

“I think it will do us well to have a general approach to recommendations about masking.  And that’s masking everybody in the population.” James said. “That we didn’t have 30,000 people a year dying from influenza the past two years is an impressive accomplishment, and a total accident.”

Even with what feels like a huge step towards normalcy, taking proper preventive steps is still necessary for keeping infection, hospitalization and death rates in check, experts emphasize.  Personal responsibility, however small, is still one of the best ways to protect oneself and others, moving forward. 

Whatcom County “will be watching the situation closely,” Thompson said. “We urge our fellow residents to continue to be responsible and take the steps we know work. Use high-quality, well-fitting masks, get vaccinated or boosted if eligible, isolate and get tested when sick. Together we are making our community safer.”

COVID-19 poses a lower risk for those outside the at-risk categories, and their responsibility is to protect those at risk from severe infectious outcomes, James said.

“I believe it is most likely that our immunity and the medical tools and medications that also help protect people will reduce the case rate and hospitalization rate over the next few weeks,” he said. “However, this will not be the case for the youngest kids, the elders, the unvaccinated or those that are immune-compromised. The question for our community is, how can we protect them?”

— Reported by Kenneth Duncan

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