











































2022, Vol. 2 (S1) 1-3 
https://doi.org/10.47488/dhrp.v2iS1.40 

 
http://dhrproceedings.org 1 © DHR Health Institute for Research and Development 

 

COMMENTARY 

Can We Abandon Our Masks? Deciphering 
CDC’s New Guidelines about Masking in the 
Era of COVID-19 Pandemic 
Sohail Rao, MD, MA, DPhil1, 2 , Khushboo Hemnani3, Carlos Arroyo4 and Manish Singh, MD, FACS5 

 1 Executive Vice President, DHR Health, 5501 S. McColl Road, Edinburg, Texas 78539 and President 
& Chief Executive Officer, DHR Health Institute for Research & Development, 5323 S. McColl Road, 
Edinburg, Texas 78539.  
ORCID: https://orcid.org/0000-0001-5027-9992  
2 Correspondence should be addressed to: Sohail Rao, MD, MA, DPhil., DHR Health Institute for 
Research & Development, 5323 S. McColl Road, Edinburg, Texas 78539. Tel: (956) 362-2387. E-mail: 
s.rao@dhr-rgv.com  
3Research Academy, DHR Health Institute for Research & Development, 5323 S. McColl Road, 
Edinburg, Texas 78539.  
ORCID: https://orcid.org/0000-0003-4830-4815   
4Research Academy, DHR Health Institute for Research & Development, 5323 S. McColl Road, 
Edinburg, Texas 78539. 
5Chief Executive Officer, DHR Health, 5501 S. McColl Road, Edinburg Tx 78539 and DHR Health 
Bariatric and Metabolic Institute, 500 Raphael Drive, Edinburg, TX 78539  
ORCID: Manish Singh: https://orcid.org/0000-0003-4146-3282  
 
Received 02/28/2022 
Accepted for publication 02/28/2022 
Published 02/28/2022 

Keywords:  COVID-19; SARS-CoV-2; CDC, FDA, EUA, Mask

SARS-CoV-2 has infected over 434 million and has claimed 
the lives of over 5.9 million people worldwide (1). In the 
United States, over 78.9 million have been infected with 
SARS-CoV-2 and over 948,000 people have died from 
COVID-19. Since the issuance of the first Emergency Use 
Authorization by the US Food and Drug Administration 
(FDA) for the use of Pfizer/BioNTech COVID-19 mRNA 
vaccine on December 11, 2020, over 215 million people have 
been fully vaccinated in United States and over 94 million 
have received a booster dose (2, 3). Despite of these 
accomplishments, in the last 28 days, in the United States, 
over 4.6 million people have been infected with this virus 
with over 61,000 deaths reported (1). COVID-19 is by far the 
worst pandemic that the world has witnessed and given the 
recent data, there appears to be no immediate reprieve in 
sight.  

In an attempt to mitigate the spread of COVID-19, CDC has 
issued several guidelines which included wearing of masks 
in public gatherings (4, 5). Despite of all the evidence that 
masks are critical to lessen the spread of respiratory viruses 

such as SARS-CoV-2, the wearing of face masks has become 
one of the most contentious issues in the United States (6-8). 
On May 18, 2021, Texas Governor Greg Abbott issued an 
executive order prohibiting government entities from 
mandating masks (9). Since then, with the exception of 
healthcare facilities, and despite CDC guidelines to the 
contrary, many organizations have abolished the mandate for 
indoor masking. Consequently, many states in the United 
States have or will in the very near future eliminate the 
mandate for indoor masks as well as in the schools (10). 

On Friday, February 25, CDC announced updated guidance 
on COVID-19 prevention and masking with a new 
framework for measuring community transmission of the 
disease. The new guidance means that a substantial portion 
of the U.S. population will no longer be advised to wear a 
mask in public and in indoor settings (11). Most of the 
CDC’s changes are based on its community level tool, which 
measures COVID risks in every US and Puerto Rican 
counties and helps individuals determine the amount of 
protection they should use depending on where they live, go 

https://orcid.org/0000-0001-5027-9992
mailto:s.rao@dhr-rgv.com
https://orcid.org/0000-0003-4830-4815
https://orcid.org/0000-0003-4146-3282


DHRP, 2022, Vol. 2 (S1) 1-3  CDC Mask Mandate 

 
http://dhrproceedings.org 2 © DHR Health Institute for Research and Development 
 

to work or school, and travel. Considering increasing 
immunity to the virus and variants like Omicron, the agency 
overhauled its benchmarks for three community levels: 
“high” (orange), “medium” (yellow), and “low” (green). 
Under the new system, 70 percent of Americans are outside 
of orange zones and can, in theory, stop masking up indoors 
(Figure 1). 

Figure 1: State and County-level COVID-19 Community Levels Interactive 
Tool Published by the CDC on February 24, 2022 and Updated on February 
25, 2022 (https://www.cdc.gov/coronavirus/2019-
ncov/science/community-levels.html) 

The CDC’s guide now only recommends widespread mask 
use, regardless of vaccination status, in high-risk areas. 
Previously, this advice also applied to the “substantial” 
COVID community level, which fell between high and 
medium. Substantial is no longer marked as a level on the 
tool. When the community level tool was first launched in 
early 2021, the categories were defined by case numbers and 
transmission rates in counties and states. Now the metrics 
only draw from COVID hospitalizations and occupied 
inpatient beds in a locality. According to Rochelle Walensky, 
Director of the CDC “This new framework moves beyond 
just looking at cases and test positivity to evaluate factors 
that reflect the severity of disease, including hospitalizations 
and hospital capacity, and helps to determine whether the 
level of COVID-19 and severe disease are low, medium, or 
high in a community. The COVID-19 community levels we 
are releasing today will inform CDC measures like masking 
… This updated approach focuses on directing our 
prevention efforts toward protecting people at high risk of 
severe illness and preventing hospital and health care 
systems from being overwhelmed.” 

But even with relaxed precautions, the CDC states that 
people should take personal risk into account when deciding 
whether to mask up in public. For example, under the 
medium community level guidance, the agency says: “If you 
are immunocompromised or at high risk for severe illness, 
talk to your healthcare provider about additional precautions, 
such as wearing masks or respirators indoors in public.” 

However, it doesn’t identify extra masking protocols for 
adults and older kids who haven’t been vaccinated. To date, 
nearly 14 percent of the US population has not received a 
single COVID-19 vaccine shot. Despite the shifting 
guidelines from the CDC and states, masks are always an 
option for individuals looking to protect themselves and 
others from the virus. It is important to note that healthcare 
facilities, businesses, school districts, transit authorities, and 
workplaces might have their own indoor masking 
requirements independent of state mandates that need to be 
followed. 

It must be recognized that all four counties (Hidalgo, 
Cameron, Willacy, and Starr) in the Rio Grande Valley are 
considered high risk for COVID-19 transmission. In fact, the 
four surrounding counties of Kenedy, Brooks, Jim Hogg and 
Zapata are also considered high risk (Figure 1). For people 
living in high-risk areas such as the South Texas, CDC has 
recommended the following (12): 

• Wear a well-fitting mask indoors in public, 
regardless of vaccination status (including in K-12 
schools and other indoor community settings) 

• If you are immunocompromised or high risk for 
severe disease: 

o Wear a mask or respirator that provides 
you with greater protection 

o Consider avoiding non-essential indoor 
activities in public where you could be 
exposed 

o Talk to your healthcare provider about 
whether you need to wear a mask and take 
other precautions (e.g., testing) 

o Have a plan for rapid testing if needed 
(e.g., having home tests or access to 
testing) 

o Talk to your healthcare provider about 
whether you are a candidate for treatments 
like oral antivirals, pre-exposure 
prophylaxis, and/or monoclonal antibodies 

• If you have household or social contact with 
someone at high risk for severe disease: 

o consider self-testing to detect infection 
before contact 

o consider wearing a mask when indoors 
with them

https://www.cdc.gov/coronavirus/2019-ncov/science/community-levels.html
https://www.cdc.gov/coronavirus/2019-ncov/science/community-levels.html


DHRP, 2022, Vol. 2 (S1) 1-3  CDC Mask Mandate 

 
http://dhrproceedings.org 3 © DHR Health Institute for Research and Development 

• Stay up to date with COVID-19 vaccines and 
boosters 

• Maintain improved ventilation throughout indoor 
spaces when possible 

• Follow CDC recommendations for isolation and 
quarantine, including getting tested if you are 
exposed to COVID-19 or have symptoms of 
COVID-19 

We strongly endorse CDC’s recommendations and request 
that people in the Valley use their personal discretion in the 
use of mask in indoor and public settings. This is particularly 
important for individuals who are unvaccinated and/or 
immunocompromised and are at high risk for getting infected 
with SARS-CoV-2.    

Diclosures 

SR declares no conflicts of interest.  

KH declares no conflicts of interest. 

CA declares no conflicts of interest. 

MS declares no conflicts of interest. 

Funding 

The project is funded by a Seed Grant from the DHR Health 
Institute for Research & Development 

References 

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8. How did face masks become a political issue in 
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10. Soon only one U.S. state will still have an indoor mask 
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