On today’s date, April 18, 2022, a federal judge in Florida declared an end to the mask mandate, on all forms of public transportation, that had been in place since the beginning of the Biden administration. This ruling affects not only planes, trains, buses, mass transit, paid transit on our roads (taxicabs, Uber, Lyft, etc.) but also shuttles and mass transit terminals and stations. The Centers for Disease Control and Prevention (CDC) rule, which was due to expire today, had been extended for two weeks to allow more time to assess the ramifications and the direction of the COVID-19 pandemic in light of the BA.2 Omicron variant increases. The judge ruled that the mask mandate exceeded the agency’s authority and that proper procedure for making administrative rules had not been followed. In response to the ruling The Whitehouse deferred to the Department of Justice for a decision regarding an appeal. The federal agency, Transportation and Safety Administration (TSA), which is responsible for administering the rule has declared that the mask mandate will not be enforced at this time. Most major airlines and transportation systems have stopped enforcement. The bottom-line from a medical standpoint is that each of us should consider our individual risks and the environment. At this point, if you have been fully vaccinated and are not of high risk, and the level of community spread is low, then it is probably safe to go without a mask indoors in public places and on public transportation. Some establishments such as Broadway theaters and houses of worship, based on their track record of safety, will choose to retain their indoor mask policies as the “price of admission”.
Another piece of good travel news is that the CDC today removed ALL countries from it’s “Do Not Travel “list. A system of Travel Health Notices (THNs) is used by the CDC to provide advice designed to be helpful to the public traveling around the world. There are four levels of notices for international travel in this system corresponding to, in ascending levels of COVID-19 severity, LOW, MODERATE, HIGH, SPECIAL CIRCUMSTANCES (Do Not Travel). There are no countries in the Level-4, as of today. No matter what the level of notice in the THN, even if the level in your intended destination is “unknown”, the first CDC recommendation is that your vaccination level be fully up to date. The remaining precautions and recommendations for your international travel is available at https://www.cdc.gov/coronavirus/2019-ncov/travelers/how-level-is-determined.html.
A look at the current COVID-19 trends can provide us background for some of these updated decisions. All of the counties in Cincinnati’s Tristate Area remain at a low level of community spread as far as the CDC classification is concerned. Although the number of daily new cases in the USA remains at its lowest level since the summer of 2021, there are portions of the country where the numbers are rising. The Northeast is most severely affected as cases have doubled in Rhode Island and Washington, D.C. since the beginning of April. The Midwest is not immune to these increases as Illinois, Michigan, and Wisconsin have experienced a forty percent spike over the last two weeks. Fortunately, COVID-19 deaths in the US are down to about 500 per day and hospitalizations are at a level (15,000 per day) not seen since the earliest days of the pandemic.
These increasing cases are being driven by subvariants of the Omicron strain. This BA.2 strain remains the dominant variant in the US. The great news continues to be that the vaccines continue to keep people out of the hospital, the hospitalized out of the ICUs, and people out of the morgue! Yet the fight against this coronavirus is not over. The World Health Organization is following cases worldwide of new subvariants, BA.4, BA.5, an XE. The more people get vaccinated, the less virus mutation, and the better the chance that the world avoids a vaccine-escaping variant.
These travel restriction changes demonstrate continual emergence from the pandemic. We can continue this progress if more of us become fully vaccinated. In the meantime, be comfortable protecting yourself according to your risk. Mask up in COVID-19 unsafe or unvaccinated environments. Socially distance when necessary and wash your hands!
Clyde E. Henderson, MD
Cincinnati Medical Association