New federal guidance issued on Thursday clears the way for Americans who are fully vaccinated against the coronavirus to drop mask wearing in most situations. But the guidance came with caveats and confusion, and it sent state and local officials, as well as private companies, scrambling to decide whether and when to update their own rules.
There was plenty of cause for celebration, too, for many Americans weary of restrictions and traumatized by more than a year of a pandemic that has killed more than 583,000 people in the United States and more than 3.3 million around the world.
“We have all longed for this moment,” Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said as she announced the shift at a White House news conference on Thursday. “If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic.”
Fully vaccinated people are still told to cover their faces when flying or taking public transit, or visiting health care facilities or congregate settings like prisons and homeless shelters.
The recommendations came as a surprise to many people in public health. They offered a stark contrast with the views of a large majority of epidemiologists surveyed in the last two weeks by The New York Times, who said that until many more Americans were vaccinated, there would be too many chances for vaccines, which are not 100 percent effective, to fail.
“Unless the vaccination rates increase to 80 or 90 percent over the next few months, we should wear masks in large public indoor settings,” said Vivian Towe, a program officer at the Patient-Centered Outcomes Research Institute, an independent nonprofit organization in Washington, D.C.
The new recommendations also caught state officials and businesses by surprise and raised a host of difficult questions about how the guidelines would be carried out. Some states lifted mask mandates immediately, while others took a more cautious approach.
Most of the state officials who responded immediately to the shift were Democrats, and they used the moment to stress the need to get vaccinated to take advantage of greater freedom. Half of the country’s governors — most of them Republicans — had already lifted mask mandates in some form.
On Thursday, the governors of Massachusetts, New Jersey, New York, North Carolina and Virginia, and the mayors of New York City and Washington, D.C., all Democrats, said that they were taking the new guidance under advisement before adopting it. Los Angeles County also said that it and the state of California were reviewing the new guidelines. In deference to local authorities, the C.D.C. said vaccinated people must continue to abide by existing state, local or tribal laws and regulations, and to follow local rules for businesses and workplaces.
After the new guidance was announced, at least seven states led by Democrats began to lift mask mandates: Connecticut, Illinois, Kentucky, Minnesota, Nevada, Oregon and Pennsylvania. Others had yet to weigh in publicly.
In Washington State, Gov. Jay Inslee, who usually wears a mask while speaking at his news conferences, began his gathering on Thursday by removing it. He said the state was immediately incorporating the new federal guidance.
“This is a heck of a benefit for people who have been annoyed by this mask,” Mr. Inslee said. “This is a really good reason to get vaccinated. That shot is a ticket to freedom from masks.”
Yet the C.D.C. guidance leaves a number of issues unaddressed. There was no specific language about masking in schools, for instance. And an even broader question remains unclear: Who knows who is justified in claiming the new freedoms?
“I think the challenge is that it’s impossible to determine who is vaccinated and who is not vaccinated,” said Gov. David Ige of Hawaii, where a mask mandate will stay in place.
About 64 percent of Americans are not fully vaccinated. And vaccination rates have been falling, although the campaign to inoculate 12- to 15-year-olds has just begun. Ohio has created a weekly state lottery that would give five people $1 million each in return for being vaccinated. People who receive a vaccine are issued a white paper card, but online scammers have sold forged versions of those.
The guidance seemed to catch many retailers by surprise. Macy’s, Target and the Gap said they were still reviewing it, while Home Depot said it had no plans to change its current rules requiring customers and workers to wear masks in its stores.
The United Food and Commercial Workers union, representing thousands of grocery store workers, criticized the C.D.C. for failing to consider how the new policy would impact workers who have to deal with customers who are not vaccinated.
Gov. Kate Brown of Oregon emphasized that the state would not be operating on an honor system. She said that the health department would soon provide fresh guidance for businesses, employers and others “to allow the option of lifting mask and physical distancing requirements after verifying vaccination status.”
BUENOS AIRES — For most of the past year, Uruguay was held up as an example for keeping the coronavirus from spreading widely as neighboring countries grappled with soaring death tolls.
Uruguay’s good fortune has run out. In the last week, the small South American nation’s Covid-19 death rate per capita was the highest in the world, according to data compiled by The New York Times.
As of Wednesday, at least 3,252 people had died from Covid-19, according to the Uruguayan Health Ministry, and the daily death toll has been about 50 during the past week.
Six out of the 11 countries with the highest death rates per capita are in South America, a region where the pandemic is leaving a brutal toll of growing joblessness, poverty and hunger. For the most part, countries in the region have failed to acquire sufficient vaccines to inoculate their populations quickly.
Contagion rates in Uruguay began inching up in November and soared in recent months, apparently fueled by a highly contagious variant first identified in Brazil last year.
“In Uruguay, it’s as if we had two pandemics, one until November 2020, when things were largely under control, and the other starting in November, with the arrival of the first wave to the country,” said José Luis Satdjian, the deputy secretary of the Health Ministry.
The country with the second-highest death rate per capita is nearby Paraguay, which also had relative success in containing the virus for much of last year but now finds itself in a worsening crisis.
Experts link the sharp rise in cases in Uruguay to the P.1 virus variant from Brazil.
“We have a new player in the system and it’s the Brazilian variant, which has penetrated our country so aggressively,” Mr. Satdjian said.
Uruguay closed its borders tightly at the beginning of the pandemic, but towns along the border with Brazil are effectively binational and have remained porous.
The outbreak has strained hospitals in Uruguay, which has a population of 3.5 million.
On March 1, Uruguay had 76 Covid-19 patients in intensive care units. This week, medical professionals were caring for more than 530, according to Dr. Julio Pontet, president of the Uruguayan Society of Intensive Care Medicine who heads the intensive care department at the Pasteur Hospital in Montevideo, the capital.
That number is slightly lower than the peak in early May, but experts have yet to see a steady decline that could indicate a trend.
“It is still too early to reach the conclusion that we’ve already started to improve, we’re in a high plateau of cases,” Dr. Pontet said.
Despite the continuing high number of cases, there is optimism that the country will be able to get the situation under control soon because it is one of the few in the region that has been able to make quick progress on its vaccination campaign. About a quarter of the population has been fully immunized.
“We expect the number of serious cases to begin decreasing at the end of May,” Dr. Pontet said.
Once Americans return to crowded offices, schools, buses and trains, so too will their sneezes and sniffles.
Having been introduced to the idea of wearing masks to protect themselves and others, some Americans are now considering a behavior scarcely seen in the United States but long a fixture in other cultures: routinely wearing a mask when displaying symptoms of a common cold or the flu, even in a future in which Covid-19 isn’t a primary concern.
Such routine use of masks has been common for decades in other countries, primarily in East Asia, as protection against allergies or pollution, or as a common courtesy to protect nearby people.
Leading American health officials have been divided over the benefits, partly because there is no tidy scientific consensus on the effect of masks on influenza virus transmission, according to experts who have studied it.
Nancy Leung, an epidemiologist at the University of Hong Kong, said that the science exploring possible links between masking and the emission or transmission of influenza viruses was nuanced — and that the nuances were often lost on the general public.
SINGAPORE — Singapore said on Friday that it would ban dining in restaurants and gatherings of more than two people to try to stem a rise in coronavirus cases, becoming the latest Asian nation to reintroduce restrictions after keeping the illness mostly in check for months.
The new measures came after the city-state recorded 34 new cases on Thursday, a small number by global standards, but part of a rise in infections traced to vaccinated workers at Singapore Changi Airport.
The airport outbreak began with an 88-year-old member of the airport cleaning crew who was fully vaccinated but who tested positive for the virus on May 5. Co-workers who then became infected later visited an airport food court, where they transmitted the virus to other customers, officials said.
None of the cases linked to the airport outbreak are believed to have resulted in critical illness or death, according to officials.
In all, 46 cases have been traced to the airport, the largest of about 10 clusters of new infections in the country.
“Because we do not know how far the transmission has occurred into the community, we do have to take further, more stringent restrictions,” said Lawrence Wong, co-chair of Singapore’s coronavirus task force. The measures will be in effect for about one month beginning on Sunday.
According to preliminary testing, many of those infected were working in a zone of the airport that received flights from high-risk countries, including from South Asia. Several have tested positive for the B.1.617 variant first detected in India, which the World Health Organization has said might be more contagious than most versions of the coronavirus.
Singapore health officials said that of 28 airport workers who became infected, 19 were fully vaccinated with either the Pfizer or Moderna vaccines, the only two approved for use in Singapore.
“Unfortunately, this mutant virus, very virulent, broke through the layers of defense,” Transport Minister Ong Ye Kung told a virtual news conference on Friday.
Mr. Ong also said that the rise in cases “very likely” means that a long-delayed air travel bubble with Hong Kong would not begin as scheduled on May 26.
Singapore, a prosperous island hub of 5.7 million people, saw an explosion of infections among migrant workers living in dormitories, but a two-month lockdown and extensive testing and contact tracing contained the outbreak. Although Singapore has kept much of its economy open, its vaccination effort has not moved as quickly as many expected: less than one-quarter of the population has been fully inoculated.
Changi Airport, which served more than 68 million passengers in 2019, is operating at 3 percent of capacity as Singapore has paused nearly all incoming commercial traffic. Employees there work under strict controls, wearing protective gear and submitting to regular coronavirus tests.
Singapore joins Japan, Thailand and other Asian countries that have struggled to contain new outbreaks fueled in part by variants. But Paul Ananth Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection, said that the rise in cases was not overly worrying.
“The reason for my optimism is that we now have effective vaccines, better diagnostics, proven treatments and even potential prophylactic agents,” he said. “If these are employed in a targeted approach, it is unlikely that we will end up with the same problems we had last year.”
Gov. Ron DeSantis of Florida said on Wednesday that he would pardon “any Floridian” who violated mask or social distancing mandates.
Mr. DeSantis, a Republican, made the announcement during an appearance on the Fox News program “Ingraham Angle,” just a day before the Centers for Disease Control and Prevention shifted its guidelines to allow vaccinated people to skip wearing masks in most places.
The show’s host, Laura Ingraham, first interviewed Mike and Jillian Carnevale, the owners of a Broward County gym, who said they had been arrested for violating a county mask mandate. Mr. DeSantis then said their case was “a total overreach.”
Widely seen as positioning himself as a 2024 Republican presidential nominee, Mr. DeSantis throughout the pandemic has criticized coronavirus restrictions and mandates.
Mr. Carnevale said he and Ms. Carnevale were arrested three times after violating Broward County’s mask mandate. Mr. Carnevale was charged with two second-degree misdemeanors and if convicted would face a 120-day jail sentence, and Ms. Carnevale was charged with one second-degree misdemeanor, facing 60 days in jail, said Cory Strolla, a lawyer representing the couple.
Last month, Mr. DeSantis issued an executive order prohibiting businesses from requiring patrons or customers to show vaccination documentation, or risk losing grants or contracts funded by the state. Norwegian Cruise Line, which is requiring all guests and crew members to be vaccinated, said it was considering skipping Florida ports over the order.
