The president of the N.C. Medical Society and a leading expert on infectious diseases are urging the public to remain cautious in the wake of a decision by the Centers for Disease Control and Prevention saying that people who are fully vaccinated against COVID-19 may go without masks.
 
Philip Brown, president of the N.C. Medical Society and chief community impact officer at Novant Health who is based in Wilmington, and Paul Kamitsuka, an infectious disease and internal medicine physician at Wilmington Health, said no one should believe that the country’s more than year-long health crisis is suddenly over.
 
On Thursday, the CDC announced updated guidance allowing fully vaccinated individuals to dispense with masks outdoors and, for the most part, indoors.
 
“Anyone who is fully vaccinated can participate in indoor or outdoor activities, large and small, without wearing a mask or physical distancing,” said Rochelle Walensky, the agency’s director.
 
Taking a cue from the CDC and pointing to sustained reductions in COVID cases, hospitalizations and deaths, Gov. Roy Cooper on Friday lifted most mask mandates along with all size limits on public gatherings and physical distancing requirements for the state.
 
Some masking will still be required when people use public transport such as planes and buses, visit hospitals or nursing homes or when inside homeless shelters or correctional facilities, the CDC’s Walensky said. Cooper has announced his own list of required masking that also includes schools and childcare centers. 
 
According to the governor’s announcement, 46% of all North Carolinians 18 and older are now fully vaccinated.
 
Consistent with the governor’s order, New Hanover County has ended gathering limits and distancing requirements on county property, and mask requirements are gone at county facilities except at the health clinic and the jail’s incarceration area.
 
“I think there are great societal pressures to go back to normal, and I think that can’t be underestimated,” Brown said of the CDC’s announcement.
 
But Brown, who also recently served as chief physician executive for NHRMC, said he was wary of scuttling the use of masks indoors without regard to group size and social distancing.
 
“I do believe that in terms of outside when you’re able to distance, I believe no mask is needed, certainly if you’re vaccinated, so I think that was a very appropriate change, but the other one will not change my current behavior at this point in time,” he said. “In places where I cannot distance that are inside, you will find me wearing a mask and you will find my family wearing a mask because I believe that’s still the safest at this point.”
 
“The caveat I would have for indoors would particularly apply to patients who have underlying immune-compromising conditions because some of those patients may not respond as well to the vaccine … and so for those patients, I would still recommend masking and distancing” in indoor settings, Kamitsuka said.
 
The N.C. Department of Health and Human Services continues to recommend that those who are unvaccinated wear masks in public settings.
 
That advice may prove more useful as it becomes more difficult to determine whether an unmasked person is fully vaccinated, asymptomatic or simply doesn’t don a mask as a result of the new guidance from the CDC.
 
“It’s going to be a practical difficulty in terms of how do you know who has been vaccinated and who hasn’t, but I think the overall thrust is to really try to provide a carrot for people to get vaccinated so that they can go on ahead and enjoy more freedom,” Kamitsuka said.

Businesses reaction

In the private sector, businesses still have the right to require customers and other guests to wear a mask and to engage in social distancing.
 
Throughout most of the pandemic, many businesses have prominently posted mask requirements, although the level of enforcement has varied from business to business.
 
In the wake of last week’s revised guidance, retailers such as Walmart, Trader Joe’s, Target and Publix have now dropped in-store mask requirements for the fully vaccinated while others including Home Depot and Kroger – including its Harris Teeter brand – as of Monday continue to require all visitors to wear masks.
 
Local business owners also are figuring out how to adjust to the recent CDC and state changes, both for customers and employees.
 
At Elijah’s restaurant on the Riverwalk in downtown Wilmington, management has now dropped its mask requirement for all guests both inside and on its deck but is maintaining it for all employees. The restaurant is still requiring social distancing. 
 
At Tidal Creek Co-Op, co-general manager Anthony Garguilo said “fully 25%” of customers have come in unmasked since the co-op adjusted its policy late last week to allow fully vaccinated individuals to enter mask-free. Staff members, he said, are “almost completely vaccinated” and are still required to wear masks.
 
As health care workers continued to conduct outreach campaigns to boost the number of vaccinated, the state medical society, led by Brown, was fighting House Bill 558 in the current session of the General Assembly. The bill required written consent before the vaccination status of individuals could be entered into databases such as the N.C. COVID-19 Vaccine Management System and the N.C. Immunization Registry.
 
The proposal “risks making accurate tracking of what’s actually going on in terms of vaccination very difficult,” Brown said late last week. But the bill did not cross over to the state Senate to be considered for a vote this session.
 
“The only way we’re going to get out of this pandemic and its effect on our society is for people to get vaccinated so that we are able to reach herd immunity,” Kamitsuka said, acknowledging that less than half of the state’s population is fully immunized. He called vaccination “quite a liberating thing because you can then socialize with friends and family without fear of contracting COVID or somebody becoming sick or dying of COVID.”
 
“Let’s get another 15, 20% of the people vaccinated, get the kids vaccinated that are 12 to 15 and really beat this disease back and not take any silly chances just because we’re kind of tired of doing the masks and things like that,” Brown said.