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When Chatham County government employees returned to work this week, they did so under new masking guidelines for staff: as of Monday, both vaccinated and unvaccinated employees were required to wear face coverings within county facilities.
So far, visitors to county offices aren’t required to mask up. But with nationwide COVID-19 cases up 44% in the last week as the Delta variant surges, reports of “breakthrough” cases among the vaccinated gaining attention and masks mandates being reinstated around the country, the director of Chatham County’s Public Health Department is recommending “masks are for everyone when in a setting when you cannot physically distance, and not everyone is vaccinated.”
Meanwhile, Chatham County Manager Dan LaMontagne told the News + Record that he and county officials are eyeing N.C. Gov. Roy Cooper’s office as they consider new mandates in Chatham County.
“We will continue to evaluate the need for future steps consistent with what the Governor is requiring of his cabinet agencies, such as requiring proof of vaccination status and mandatory weekly testing for unvaccinated employees,” LaMontagne said. “As for other mandates, we have consistently followed the Governor’s guidance throughout the pandemic. I would anticipate that we would continue that practice during this unfortunate resurgence due to the Delta variant.”
The move toward masks in county facilities comes after what’s widely being described as “pandemic whiplash” — renewed frustration and skepticism within the last week or so after reversals from the Centers for Disease Control and Prevention about the use of face coverings for fully vaccinated people. As the highly contagious Delta variant surges and new scientific evidence emerges, a “dizzying jumble of news stories and divergent announcements” — as the New York Times described it — has created new confusion for the vaccinated (who are now being required to wear masks in more and more public places across the country) and rising anger among some at the stubborn refusal of the unvaccinated to follow months of pleading from health experts to take the vaccine.
Mike Zelek, the director of the Chatham County Public Health Department, said he agrees “the messaging could have been clearer” from the CDC.
“At the same time, we have had to adjust throughout the pandemic as circumstances changed and new data emerged, and now is no different,” he told the News + Record. “We saw case rates decline steadily through June as vaccination rates increased. However, with the arrival of the Delta variant, we are seeing those trends reverse. We must look to the current situation and current data for current guidance.”
Like most of its neighboring counties, the high levels of local transmission put Chatham County in the “significant” level of viral spread in N.C. —below the highest (“critical”) and next-highest (“substantial”) levels. Chatham’s 14-day case rate per 100,000 people is now at 80.6, according to the N.C. Dept. of Health and Human Services — up from well below 10 just a month ago — with 6.3% of coronavirus tests coming back positive, one of the highest rates seen in Chatham since the start of the pandemic. (Lee County’s community spread is the closest county at the “substantial” level, with a 14-day new case rate of 110.1 per 100,000 population. Hospital impacts within both Chatham and Lee counties are considered “slight.”)
“We are now seeing high levels of transmission in Chatham, like most of the state and country,” Zelek said. “Recent studies on the transmissibility of the Delta variant have shown that even fully vaccinated people who become sick can give the COVID-19 virus to others. So, the responsible thing to do is update the guidance, which in this case means everyone wearing masks indoors in public places, along with getting vaccinated.”
The CDC also reversed its guidance on masking in schools, saying that all schools should require universal masking for students and teachers, regardless of vaccination status. Following this announcement, Gov. Cooper announced the state’s guidance for schools was updated to reflect that guidance; previously, the state said K-8 schools should require masking for all students and teachers, along with any unvaccinated people in high schools.
On Monday, the Chatham County Schools Board of Education called a special meeting for Thursday, to discuss personnel issues and “consider matters related to the recent updates made to the StrongSchoolsNC Public Health Toolkit.” That meeting will take place at noon.
New cases in North Carolina are up nearly 10-fold over a month ago. In that same time period, Chatham County has seen a similar increase — from zero or one or two new cases reported for most days the first week of July to 12 new cases reported on Sunday. Fifty-one percent of Chatham residents have received at least one dose of the coronavirus vaccine; 48% are fully vaccinated. Chatham will likely record its 5,000th case of COVID-19 this week; 89 resident deaths have been linked to the virus.
Dr. Andy Hannapel, the chief medical officer at Chatham Hospital, reiterated that the unvaccinated are at the greatest risk, as well as a call for the use of masks “for everyone when in a setting when you cannot physically distance, and not everyone is vaccinated.”
Zelek said those not fully vaccinated should wear masks “when around others indoors,” and that the fully vaccinated should consider the risks of going unmasked. The more time spent around more people in smaller spaces with poorer ventilation significantly heightens the risk for the vaccinated — particularly when the unvaccinated are there, too.
The reason: the Delta variant.
“Delta is a game changer,” Hannapel said, citing the statistics showing the variant in “80-plus% of all new cases” in the United States.
“It is 50% more transmissible than the Alpha variant, which was 50% more transmissible than the original strain of COVID-19,” he said. “Currently, 99.5% of deaths in the U.S. from COVID-19 are in the unvaccinated.”
Which places, he said, undue risks among those who have not been vaccinated — who, in turn, threaten the vaccinated.
“The unvaccinated are at greatest risk,” Hannapel said. “Although we know that vaccinated are protected from the most severe disease, hospitalizations and death, we do not know the full extent to which of the vaccinated, when exposed to COVID-19 — specifically the Delta variant — are likely to get infected and spread the virus in an asymptomatic state.”
So at a minimum, he said, it’s “time to mask up when in groups where you are inside and unable to maintain physical distance.”
“We lack the certainty to be more exact at this time about when are the truly safe times to be maskless in any size group that you do not know their circle of contacts and exposure,” Hannpael said. “In North Carolina, we are not nearly at a point in vaccination rates to be recommending anything less. Mask on and mask up. And get yourselves vaccinated.”
Zelek agreed that Delta has been a game-changer.
“Also,” he said, “if you are immunocompromised or a caregiver of someone who is higher risk, it is even more important to be careful about the spaces you are in and wearing a mask. For me, as the parent of an 11-month-old, I am cautious about the places I spend time indoors, and more cautious than I was a month ago. That is because we are seeing cases rise to levels we have not seen in some time due to the infectiousness of the Delta variant.”
Even with the CDC’s updates about risk, and new questions about CDC data and research and criticism of the agency, Zelek recommended following the advice for those fully vaccinated to mask up in indoor public places simply given Chatham’s high rates of transmission. And when it comes to testing, he cited the CDC, saying fully vaccinated people who have a known exposure to someone with suspected or confirmed COVID-19 should be tested three to five days after exposure, and wear a mask in public indoor settings for 14 days or until they receive a negative test result.
When it comes to breakthrough infections — positive cases among the fully vaccinated — Zelek pointed out that vast majority of new infections, as well as hospitalizations, continue to be among those not fully vaccinated.
“That is why it is so important to get vaccinated,” he said. “That said, breakthrough infections do occur and there is growing evidence that these infections can spread to others. Simple actions can alleviate our concerns. Namely, wearing masks can help prevent spread while allowing us to engage in many normal activities.”
Zelek’s emphasis, though, continued to be on getting vaccinated.
“The Delta variant has certainly created challenges, but this is not the first time during the pandemic we have faced a challenging situation,” he said. “And, unlike in the beginning of the pandemic, we have tools at our disposal to slow the spread of the virus. We have three authorized, safe and effective vaccines against COVID-19 that are widely available. We know masks add another layer of protection. This is much different from March 2020 and is very positive news.”
The vaccines remain the best protection against the virus, Zelek said, including getting infected, spreading it and dying from it.
“Think of the seatbelt analogy,” he said. “Some who get into car crashes while wearing a seatbelt will get injured or pass away, but that does not mean seatbelts don’t work. You should wear a seatbelt and drive responsibly. That is where we are with COVID-19 vaccines: Get the vaccine and wear a mask in higher risk settings.”
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