Beshear calls for universal masking in schools, following CDC; Stack calls Kentucky 'horribly inflamed' with coronavirus

State Department for Public Health map; for a larger version, click on it.

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear and Health Commissioner Steven Stack updated the state's mask guidance Thursday to call for universal masking in schools, regardless of vaccination status, following new federal guidance.

Beshear tacitly acknowledged that the move is controversial: "Now, I know that people are tired. I'm tired, too. I know that people are frustrated. I'm frustrated too. We're strong enough to do this. We are resilient enough to do this. And we are compassionate enough to where we know that we have to do this."

He said Kentuckians' decisions about masking will be critical, due to aggressive spread of a more contagious coronavirus variant. "Places that haven't taken steps are seeing results that we should know by now: widespread outbreaks, clusters, large amounts of quarantines," he said at his weekly briefing.  

Asked about school districts that have said they would not require universal masking, Beshear asked them to consider the science that clearly indicates such policies will limit Covid-19 cases and subsequent quarantines in both classrooms and extracurricular activities, including sports.

Beshear suggested that school districts could be liable for sickness and death if they don't follow guidance from the U.S. Centers for Disease Control and Prevention that is based on research showing that vaccinated people can acquire the virus and spread it without having symptoms. He called that "the game changer."

"You teach science in your classroom," he said. "You should have to consider it when making decisions."

Beshear said he isn't considering a mask mandate, but would act based on how the surge in cases goes. The difference between this surge and before, he said, is that people have access to vaccines that work.

Asked if he would require state employees to get vaccinated, as some states are doing, Beshear said he would not, but is looking at the possibility of requiring them to have regular tests. Wednesday, he required everyone in the vicinity of others in state offices to wear a face coverings. 

Beshear said the mask recommendations are temporary and will be removed when it is safe to do so, as he did before. He said there is a simple equation that will keep Kentuckians at work, school and play: "more people getting vaccinated, and when you need to, wear a mask."

Without such prevention efforts, Beshear said the more contagious Delta variant will spread through unvaccinated workplaces and classrooms, disrupting education and slowing economic growth through loss of productivity and frequent quarantines.

Stack displayed color-coded maps that showed on June 28 there were no "red zone" counties in Kentucky, but on July 28 there were 36. A red-zone county has more than 25 daily cases per 100,000 people over seven days and is considered to be at a "critical" level for transmission of the virus. 

“We have changed in the blink of an eye from a quiet, calm state to a horribly inflamed state,” said Stack. “We all know what we need to do . . . We all need to get vaccinated."

He said that since March 1, 94.5% of Covid-19 cases, 91.8% of Covid-19 hospitalizations and 88.8% of Covid-19 deaths in Kentucky were among unvaccinated or partially vaccinated or unvaccinated people.

Local health-department director Crystal Miller also spoke at the news briefing, encouraging Kentuckians to remember the beginning of the pandemic, when her home Harrison County had the first case and everyone had the same goal and was willing to do what it takes to protect themselves and their loved ones. 

“Somehow we’ve grayed those lines. We’ve gotten away from that mission," she said. "It’s been a long 16 months. It’s been frustrating. It’s exhausting. But the difference between March 6 and today is that we have a solution. We know exactly what works: vaccines and masking."

Stack and Miller asked Kentuckians to seek out reliable sources and trusted experts for information about the virus and the vaccines. Stack said, "Don't look to cable [TV] sources for your medical advice, period. Don't look to social media for your medical guidance, period. If we would do that, he said there would be no controversy or debate and we could get over this pandemic a lot faster." 

Republican pushback: Most Republicans who lead independent state agencies, three of whom may run for Beshear's job in 2023, said they would not enforce his mask mandate for state workers. Agriculture Commissioner Ryan Quarles' chief of staff, Keith Rogers, said they "will continue to leave it up to employees to decide for themselves whether to wear a mask while at work," Daniel Desrochers reports for the Lexington Herald-Leader. Treasurer Allison Ball said likewise, and so did State Auditor Mike Harmon, on Wednesday.

Mike Wynn, a spokesman for the Legislative Research Commission, said the legislative branch of government will continue enforcing the mask policy it implemented on May 23, which said vaccinated people do not need to wear a mask, Desrochers reports.

Beshear said he can't discipline employees who work for separate constitutional officers, but warned that they will face a greater risk of getting sick. He said it's more important to do the right thing than to "try to score political points," and noted that the new-case rate in Franklin County skyrocketed this month. 

"I care more about the people than my popularity," he said. "I've got the backbone to do what's right for them, and wish other people did too."

Vaccinations: Beshear noted the slight uptick in vaccinations in Kentucky. CDC data presented by The Washington Post showed 10,048 shots were given Wednesday, the most since July 11. The seven-day average is 7,563.

Beshear said he thought the state is having success with its vaccine lottery, which held its second drawing Thursday. The winners will be announced Friday; an adult will win $1 million and five youth will get full postsecondary-education scholarships. The final set of winners will be announced Aug. 27. 

Asked if the state was working on any other incentive programs to get more Kentuckians vaccinated, Beshear said they were looking at different options and noted that there were more and more private incentives being offered. "The Delta variant ought to encourage them to do more," he said. 

Daily numbers: The state reported 1,618 new cases of the virus Thursday, with 328 (20%) in people 18 and under. That raised the seven-day rolling average by nearly 100, to 1,120 -- the highest in six months. 

The percentage of Kentuckians testing positive for the virus in the past seven days rose for the 33rd straight day, to 8.55%. Two more Kentuckians have died from Covid-19, bringing the death toll to 7,327. 

The statewide rate of daily new cases over the last seven days is 23.63 per 100,000 residents, very near the "critical" level of 25. Counties with rates more than double the statewide rate are Clay, 113.4; Jackson, 82.5; Muhlenberg, 57.8; Laurel, 57.8; Letcher, 57.7; Floyd, 52.6; Webster, 51.9; and 

Hopkins, 47.3.

Hospitalizations for Covid-19 continued to rise. Kentucky hospitals reported 608 patients with Covid-19, with 189 of them in intensive care and 82 of those on mechanical ventilation.

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UK, Ashland hospital celebrate partnership that's been in effect since April 1; joint venture now holds hospital's assets

King's Daughters Medical Center in Ashland has 465 beds. (2011 photo)

The University of Kentucky's health-care system and King’s Daughters Health System in Ashland are now partners, they announced Wednesday in Ashland, with Gov. Andy Beshear and his top health official on hand.

The partnership, which was announced as a "joint venture" in January, "went live April 1," UK HealthCare said in a press release. "Together we created a joint venture, which holds the assets, and we have a management agreement in place for UKHC to operate the KDHS health system," said Allison Perry, the university's deputy public-relations director.

Kristie Whitlatch, president and chief executive officer of King’s Daughters, said in January that her hospital would have a new governing body, with its current chairman but equal representation for UK, and that she would be on the management team at UK HealthCare. That is now in effect, Perry said.

The press release said the joint venture "creates new opportunities for both organizations to better serve patients throughout Kentucky, southern Ohio and West Virginia by expanding the delivery of specialty health care services throughout the region."

Secretary Eric Friedlander (Photo
by Matt Jones, Daily Independent)

The hospital already had a partnership with UK's Markey Cancer Center. After Our Lady of Bellefonte Hospital in nearby Russell closed in April 2020, Eric Friedlander, secretary of the state Cabinet for Health and Family Services, told Beshear's senior adviser, Rocky Adkins, that there was an opportunity to create a partnership, Adkins recalled at Wednesday's announcement, Aaron Snyder reports for the Ashland Daily Independent: "Adkins pointed out Friedlander in the crowd, who gave him a rousing applause."

Whitlatch said Wednesday, “This partnership is an excellent example of how health care providers can successfully collaborate to share resources to facilitate patient care, physician recruitment and improve essential services. We are already seeing benefits of the collaboration as we are able to invest in our team members and our facilities.”

The UK release said, "The partnership will allow for expanded offerings in other needed health-care services for the area, including pediatric cardiology. Last week, the two organizations collaborated on their first pediatric echocardiogram read, and in the near future the Kentucky Children’s Hospital team will be providing onsite pediatric cardiology services at King’s Daughters."

King’s Daughters has 465 beds at its hospital in Ashland and 10 at King’s Daughters Medical Center Ohio, in Portsmouth. The system also includes a long-term care facility, seven urgent-care centers, and 30 primary-care and 36 specialty-physician practices.

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Vaccination rate of Kentucky Medicaid members is about half the overall rate; even $100 incentives seem to have little effect

One of the biggest obstacles to protecting Kentucky from the coronavirus is Kentuckians on Medicaid, who make up about a third of the state's population.

"Of the 1.6 million people in Kentucky covered by the government health plan, only 27% of those eligible have received at least one dose of the vaccine, compared to about 51% of Kentuckians overall," based on state data, reports Deborah Yetter of the Louisville Courier Journal.

"That means more than 870,000 adults and children 12 or older covered by Medicaid remain unvaccinated," Yetter reports, using figures from the state Cabinet for Health and Family Services. "The current COVID-19 vaccines are not approved for children under 12. A little more than 320,000 Medicaid enrollees have received the vaccine, according to the cabinet."

Most Medicaid members' care is overseen by insurance-company subsidiaries known as managed-care organizations, or MCOs. The other 141,500, including nursing-home residents and people with certain disabilities in special programs, have a 55% vaccination rate. Nursing homes were the top priority for vaccination.

Cabinet Secretary Eric Friedlander has warned the MCOs that "I expect them to do better," he told Yetter. "The MCOs, in the most important public-health crisis of our time, are underperforming."

The six MCOs "say they are trying through outreach, incentives and other efforts to increase vaccinations," Yetter reports. "They say they are calling, texting and mailing information to try to reach members and offering incentives including gift cards."

Joseph Goode, a spokesman for for CVS Health, told Yetter that its Aetna subsidiary was the first MCO in Kentucky to offer $100 gift cards for getting vaccinated, but only 22% of members 12 or older have received at least one dose of a vaccine.

Anthem is also offering a $100 incentive, and has a vaccination rate of about 25%, it told Yetter. Louisville-based Humana, has a 28% rate, she reports, and "The other companies, Wellcare, United Healthcare and Passport by Molina report similar efforts and said they are continuing to try push vaccination numbers higher." 

But "in areas where skepticism remains high about the vaccine and misinformation abounds," people on the front lines of health care said the MCOs impact will be limited. Yetter reports. She quotes Dr. John Jones, who treats Eastern Kentucky Medicaid patients, some of whom continue to refuse a corinavisus vaccine: "I don't know how much sway some insurance company's going to have over the phone. It usually takes someone you know to persuade you."

Also, in the counties of Perry, Leslie and Knott, where Jones works, "There's just a distrust of outsiders in general," he told Yetter.

"That distrust isn't limited to rural Kentucky, said E. Ann Hagan-Grigsby, CEO of Park DuValle Community Health Center, which is based in west Louisville and sees a large share of Medicaid patients," Yetter reports, quoting her: "We've hit a wall. The people who really wanted the vaccine have found where to get it and are getting it. The others who have not gotten it need some convincing."

"Friedlander said the state hired the MCOs to oversee health care and improve outcomes for Medicaid enrollees and he expects better results when it comes to the COVID-19 vaccine," Yetter reports.

"The MCOs ought to be really pushing hard to get these folks," Ben Chandler, president of the Foundation for a Healthy Kentucky, told Yetter. "You'd think it would be in their interest to get everybody vaccinated."

The chair of chairman of the legislature's Medicaid oversight committee, said he was disappointed by the low vaccination rate of Medicaid enrollees. "I thought they would have been reasonably close to the state's average," Sen. Steve Meredith, a Republican from Leitchfield, told Yetter.

Jones told Yetter that vaccine demand at his clinic had dwindled in recent weeks, "with unvaccinated patients expressing doubts or worries about the vaccine," she reports. "Often, they report anecdotal information shared by others or seen on social media, such as one patient who cited a case of a healthy young adult dying after being vaccinated, a report Jones said he could not verify."

"Some of it's directly linked to social media," Jones said. "The stories, there's no way to confirm them."

Jones told Yetter that he has persuaded some patients to get vaccinated, but "Sometimes, they refuse to talk about it."

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UK HealthCare again best Ky. hospital in U.S. News & World Report rankings; Baptist Health has two of top six in the state

By Melissa Patrick
Kentucky Health News

Six Kentucky hospitals have been named among the nation's "Best Regional Hospitals" in the annual ranking by U.S. News & World Report magazine.

They are, in order: the University of Kentucky hospital; hospitals in Covington and Edgewood; Baptist Health Lexington; Baptist Health Louisville; and Louisville's Norton Hospital and UofL Health-Jewish Hospital.

Dropping off the list this year is Saint Joseph Hospital-Lexington.

To make the list, a hospital must:

• Offer a full range of services;
• Rank nationally in one of 11 measured specialties, or have six or more high-performance rankings for procedures and conditions; and
• Have at least three more "high performing" than "below average" rankings for procedures and conditions. 

The report offers an overview of 122 Kentucky hospitals with a breakdown of each of the measured categories, according to the services a hospital provides.
UK HealthCare, for the sixth straight year, is No. 1 with Albert B. Chandler Hospital. It ranked in the top 50 for cancer care for the fifth consecutive year. Its Markey Cancer Center is the only National Cancer Institute-designated cancer center in the state, and one of only 71 in the nation. 

“These rankings recognize UK HealthCare as the major health system best equipped to meet the needs of patients across Kentucky, and they recognize the incredible work and dedication of our physicians, nurses and health care providers across our academic health system,” Dr. Mark F. Newman, UK executive vice president for health affairs, said in a news release. “At UK HealthCare, our commitment has been and always will be to provide the most advanced specialty care to the citizens of the commonwealth, without the need to travel far from home.”

UK also ranked as high-performing in gastroenterology and gastrointestinal surgery; geriatrics; orthopedics; and urology.

The 32nd annual rankings compared more than 4,750 medical centers nationwide in 15 specialties and 17 procedures and conditions. This year's report expanded to cover seven new procedures and conditions. It also added a new health-equity measure. Of the 4,750 hospitals, 175 were nationally ranked in at least one specialty and 531 were ranked among the Best Regional Hospitals in a state or metro area, according to a news release. 

Baptist Health Louisville was the top rated hospital in Louisville. Baptist CEO Gerard Coleman said in a news release, that the rankings "reflect the unrelenting dedication of our physicians, staff and support teams in providing exceptional and compassionate care to our patients. I am proud of the work that we do. We’ve been tested by the pandemic, which has made us more mindful of what’s important and that our mission to serve the needs of our communities has never been more vital."

The report recognizes hospitals that are "high-performing" for 17 common adult procedures and conditions, including abdominal aortic aneurysm repair; aortic valve surgery; back surgery (spinal fusion); chronic obstructive pulmonary disease; colon cancer surgery; congestive heart failure; diabetes; heart attack; heart bypass surgery; hip fracture; hip replacement; kidney failure; knee replacement; lung cancer surgery; pneumonia; stroke; and transcatheter aortic valve replacement.

UK HealthCare ranked high-performing in all those categories except abdominal aortic aneurysm repair,  aortic valve surgery, transcatheter aortic valve replacement, diabetes, back surgery (spinal fusion), knee replacement, hip fracture. It ranked average in each of these categories. 

St. Elizabeth in Edgewood and Covington ranked high performing in all the categories except aortic valve surgery, heart bypass surgery, transcatheter aortic valve replacement, back surgery (spinal fusion), hip fracture. It ranked average in each of these categories.

Baptist Health Lexington ranked high performing in all categories except aortic valve surgery,  transcatheter aortic valve replacement, diabetes, kidney failure, knee replacement, hip replacement, and pneumonia. It ranked average in each of these categories. 

Baptist Health Louisville ranked high performing in all categories except lung cancer surgery, heart failure, transcatheter aortic valve replacement, kidney failure, back surgery (spinal fusion), hip replacement, hip fracture and pneumonia. It ranked average for each of these categories.

Norton Hospital ranked high performing in all categories except colon cancer surgery, lung cancer surgery, abdominal aortic aneurysm repair, aortic valve surgery, heart bypass surgery, transcatheter aortic valve replacement, back surgery (spinal fusion), hip fracture and pneumonia. It ranked average for each. 

UofL Health-Jewish Hospital ranked high performing in all categories except colon cancer surgery, lung cancer surgery, abdominal aortic aneurysm repair, aortic valve surgery, heart bypass surgery,  transcatheter aortic valve replacement, knee replacement, hip replacement, hip fracture, and pneumonia, ranking average for each of those; and back surgery (spinal fusion), where it ranked below average.

Click here for a list of frequently asked questions about how the magazine ranks the hospitals. 

Nationally, the Mayo Clinic in Rochester, Minn., claimed the No. 1 spot, followed by Cleveland Clinic and UCLA Medical Center in Los Angeles.

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With state nearing 'critical' level of virus spread, and some places much higher, Beshear requires all in state buildings to mask up

Gov. Andy Beshear is requiring all state employees and visitors to state buildings to wear face coverings, even if they are fully vaccinated against the coronavirus, which continues to surge in Kentucky.

Beshear said in a two-minute video that he took the action to protect state workers "and those they interact with." It takes effect Thursday, July 29.

The rule "came on the heels of a shift in guidance from the U.S. Centers for Disease Control and Prevention, which on Tuesday said everyone in the United States, including fully-vaccinated people, should resume wearing masks in public indoor settings in parts of the country where spread of the Covid-19 Delta variant is considered dangerously 'high' or 'substantial'," the Lexington Herald-Leader notes.

Dept. for Public Health map, adapted by Ky. Health News; click to enlarge

That could apply to 36 of Kentucky's 120 counties, which appear in red on the state's infection map because virus transmission there is considered "critical." That applies to counties with 25 daily cases per 100,000 residents over the last seven days; the statewide rate is not far from that, 21.58. 

Counties with rates more than double the statewide rate are Clay, 82.6; Jackson, 76.1; Floyd, 59.4; Laurel, 52.4; Muhlenberg, 49.5; Webster, 48.6; Letcher, 47.7; Hopkins, 45.7; Simpson, 44.6; and Whitley, 44.5. All but Simpson are in the state's eastern or western coalfields.

The state reported 1,693 new cases of the virus Wednesday, raising the daily average for the last seven days by 104, to 1,022. That's the highest it has been since March 2.

Hospitalizations for Covid-19 also jumped, rising to 571, almost 10% more than Tuesday. Intensive-care units has 185 of those patients, and 83 of them were on mechanical ventilation.

The share of Kentuckians testing positive for the virus rose for the 32nd day in a row, to 8.29%. The state reported two more Covid-19 deaths, raising the total to 7,325.

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McConnell will use campaign funds to run pro-vaccine ads

McConnell (Reuters photo by Joshua Roberts)

U.S. Sen. Mitch McConnell will use funds from his campaign to run 60-second advertisements on more than 100 radio stations in Kentucky to promote vaccination for the coronavirus, Reuters reports.

McConnell, the leader of Senate Republicans, has blamed misinformation for the low rate of vaccination among Americans, "which are fueling a rise in coronavirus cases, particularly in Republican-dominated states," Reuters notes.

"There is bad advice out there," he told Reuters. "Apparently you see that all over the place: people practicing medicine without a license, giving bad advice. And that bad advice should be ignored."

In Kentucky, the daily average of vaccinations is 28 percent higher in the last seven days than the previous seven, but remains below the level seen at the start of the month, and that was lower than June. Just under 52% of Kentuckians have received at least one dose of vaccine; the U.S. figure is 57%.

"Not enough people are vaccinated," said McConnell, 79. "So we're trying to get them to reconsider and get back on the path to get us to some level of herd immunity."

McConnell has promoted vaccinations since he was vaccinated in December, but has stopped short of criticizing other Republicans who have refused to say whether they've been vaccinated and "attacked the shots as unnecessary or dangerous," as Reuters puts it. But he endorsed recent remarks by Alabama Gov. Kay Ivey, who told reporters last week that it is "time to start blaming the unvaccinated folks" for the surge in cases, as well as criticizing people spreading misinformation about the vaccines.

Ivey wrote in The Washington Post that those "pushing fake news and conspiracy theories about this vaccine are reckless and causing great harm," adding that many of the unvaccinated are "being lied to."

McConnell, a native of Alabama, told Reuters, "I was encouraged by what the governor of Alabama said."

Reporter David Morgan of Reuters notes, "About 40% of Republicans are uncertain about the vaccine or are unwilling to be vaccinated, polling data published by the Morning Consult showed. That is more than double the 16% of Democrats who voiced those concerns."

Frank Luntz, a Republican pollster advising the Biden administration on vaccine persuasion, said he has been warning for months about politics being an obstacle to vaccination.

"The key here is to ensure that no one feels like they have to do it," Luntz told Morgan. "They have to want to do it. So, insulting them or mandating them won't work. Political messages won't work, unless you're Donald Trump. If Trump were to say to them: 'Hey, get the vaccine.' That would make a difference. But he doesn't do that. All he does is complain about the election."

Last week, Trump said, "People are refusing to take the vaccine because they don't trust (Biden's) administration, they don't trust the election results."

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Citing research, CDC recommends universal masking in schools, and in high-transmission areas indoors when away from home

State Dept. for Public Health map, relabeled by Ky. Health News; to enlarge, click on it.

By Melissa Patrick
Kentucky Health News

Federal officials offered new guidance Tuesday recommending that everyone in schools wear masks, even those who have been vaccinated; and that people living in areas with widespread transmission of the coronavirus wear masks indoors when away from home. 

Photo from USNews.com

Centers for Disease Control and Prevention  Director Rochelle Walensky said at a news conference that the new guidance was prompted by new research that found vaccinated people who contract the much more contagious Delta variant of the virus can spread it to others. "This new science is worrisome," she said. 

The guidance comes as the virus surge in Kentucky increased and school boards wrestled with the contentious masking issue -- and just one day after Gov. Andy Beshear announced the state's recommendations for in-school masking, which did not go as far as the CDC now has. 

The state recommended that unvaccinated students and staff wear masks in schools, and schools that want to "optimize safety" should require everyone to mask up. 

Beshear's guidance followed CDC recommendations earlier this month that said fully vaccinated people did not need to wear mask in schools. Not long after that announcement, the American Academy of Pediatrics called for everyone older than 2 to wear a mask, regardless of their vaccination status. 

A spokeswoman for the Kentucky Department of Education, Toni Konz Tatman, said the agency would review the CDC's latest guidance "in consultation with our partners at the Kentucky Department for Public Health, and will share it with our districts and families."

Mask requirements in Kentucky schools vary

On Monday, Lexington-Fayette County Public Health Commissioner Kraig Humbaugh recommended universal masking for staff and students in schools that have students under 12, because they are not yet eligible for vaccinations, Valarie Honeycutt Spears reports for the Lexington Herald-Leader. 

Honeycutt Spears reports that 17 people signed up to speak at the county school board meeting Monday, mostly to oppose mask wearing and other restrictions in schools. The school board met with the health department Tuesday to discuss plans for the fall, WKYT-TV reports.

Jefferson County Public Schools Supt. Marty Pollio said he would recommend to his board Tuesday that it require universal masking, and WLKY-TV reported that four of the seven members agree with him.

The board of Frankfort Independent Schools, meeting Monday, accepted Supt. Houston Braber's recommendation to begin the school year with universal masking, Linda Younkin of The State Journal reports. Barber said he would revisit the issue every two weeks, with decisions based on data.

Last week, Boone County Schools said it would not mandate masks for students and staff, though they are recommended regardless of vaccination status. The school board said it reserved the right to change its mind based on the levels of infection in the school and community, Fox19 Now reports.

The Bowling Green Independent Schools and the surounding Warren County Pubic Schools will also not require masks for students, Aaron Mudd reports for the Bowling Green Daily News. Logan County Schools say likewise, though the county has a high infection rate and is only 40% vaccinated.

Statewide, just over half of Kentucky's population has received at least one dose of a vaccine. Vaccinations are picking up, rising to 7,579 per day over the last seven days. That's a 28% increase from the previous week, according to CDC data processed by The Washington Post.

Daily numbers keep rising

Vaccinations aren't rising as fast as cases of the virus. Kentucky reported 1,273 new cases Tuesday, the biggest daily number since Feb. 23, when the winter surge was winding down. That raised the seven-day average to 918, the highest since March 5. The positive-test rate is 8.11%, the highest since Feb. 5.

Kentucky hospitals reported 520 Covid-19 patients, the most since March 12; 175 are in intensive care and 83 of those are on mechanical ventilation.

The number of counties in Kentucky with transmission rates considered critical has been increasing daily; 28 of the 120 counties are in the "red zone," for counties with more than 25 daily cases per 100,000 residents over the last seven days.

Vaccines still offer much protection

While vaccinated people can get infected and spread the virus to others, many more infections are in unvaccinated people, Walensky said. 

"The highest spread of cases and severe outcomes is happening in places with low vaccination rates and among unvaccinated people," she said, making it more important than ever for people to get vaccinated.

The CDC eased masking rules in May, saying fully vaccinated people no longer needed to wear a mask in most settings. But the  new guidance says in areas of high transmission, fully vaccinated people do need to mask up. 

Walensky noted that the Delta variant only represented 1% of cases in May, but now represents at least 83% of them. The guidance issued in May was also made at a time when cases were dropping and more people were getting vaccinated. 

The CDC's latest guidance also recommends that community leaders encourage vaccination and mask-wearing to prevent further outbreaks in areas of substantial and high transmission. 

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