On Tuesday, Texas became the largest US state to lift its COVID-19 mask mandate, as a number of states have begun loosening restrictions.
Mississippi, Louisiana, and Michigan also announced easing some restrictions this week, while Iowa, Montana, and North Dakota ditched state-wide mask mandates earlier this year.
The drop in coronavirus cases has been cited in decisions to lift restrictions, and, indeed, most states are down from their fall and winter peaks. However, the nationwide decline in case counts seems to be stalling at numbers that public health officials have said are still too high, prompting warnings that it's too soon to drop restrictions.
Infectious-disease experts told Insider that while the dropping case counts were promising, it's too soon to make dramatic changes in restrictions, especially when it comes to masks.
"It's completely too soon," Dr. Peter Chin-Hong, an infectious-disease specialist at the University of California at San Francisco, told Insider.
"It goes against the grain of what President Biden is trying to do, which is a national strategy that we never had," he said. "COVID doesn't restrict itself by state borders."
Chin-Hong said individual states' lifting mask mandates echoed the situation in the US last year, when he said the lack of a national strategy hindered efforts to restrict coronavirus transmission.
Even as President Joe Biden's administration has ramped up vaccinations, Chin-Hong said coronavirus variants were a big concern.
"The vaccine rollout is progressing everywhere, but it probably won't be able to protect the population fast enough," he said.
The experts Insider spoke with all said there were encouraging signs, but that the US was still in a race to vaccinate before virus variants spread more widely.
The uncertainty of the variants
Chin-Hong said some states lifting restrictions are dealing with virus variants, including the more transmissible B.1.1.7 variant. Several cases of that variant have been discovered in states dropping restrictions, including a growing number in Texas.
But he called those cases only "the tip of the iceberg," given the limited work being done to identify the variants.
The B.1.1.7 variant, first identified in the UK, is known to be more transmissible than the original strain. British scientists have also become increasingly convinced the variant could be deadlier as well.
The variant has been detected in 46 states, and Chin-Hong said it would most likely be the country's dominant strain by the end of March. If states continue to lift restrictions like mask mandates, it will increase the likelihood for B.1.1.7 to spread.
In states that have dramatically lifted restrictions, which now includes Texas, Chin-Hong said the virus was "probably having a party right now."
B.1.1.7 is just one of many coronavirus variants circulating in the US and it's possible more will emerge, making it an evolving issue with lots of uncertainty.
"We're entering a phase where it's harder to know what the near-term future is like," Andrew Noymer, an infectious-disease specialist at the University of California at Irvine, told Insider.
He said his expectations for what would happen throughout the pandemic — such as the summer and winter surges — had largely been accurate. But, he said, for the first time he felt as if he really didn't know what the immediate future would look like regarding the pandemic.
Racing to vaccinate
Cindy Prins, an epidemiologist at the University of Florida, agreed it's too soon to be lifting mask mandates.
"The thing is, we still have COVID circulating and don't have the majority of people vaccinated," she said, adding that while case numbers were lower than they were during the holiday surge, they're still not at ideal levels in most places.
According to data from the Centers for Disease Control and Prevention, more than 80 million doses of COVID-19 vaccines have been administered in the US as of March 3. About 16% of Americans have received their first dose, while about 8% are fully vaccinated.
To reach herd immunity, an estimated 65% to 80% of a population needs to be immune.
The Biden administration is well on its way to achieving its goal of administering 100 million vaccine shots in its first 100 days, and it has plans to further ramp up vaccinations. The president said Tuesday the US will have enough vaccine doses for every US adult by the end of May.
But depending on distribution, it will take months for the doses to be administered.
Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases who is also Biden's chief COVID-19 medical advisor, has said priority groups won't finish getting vaccinated until sometime in April. And it could take until late summer for all eligible adults to receive their shot.
If the more-transmissible B.1.1.7 variant becomes the most common strain, that leaves a lot of time for it to circulate in environments with loosened restrictions.
"It is really a race against time," Prins said.
Before dramatically lifting restrictions, she said, states should have a combination of low transmission as well as a high number of fully vaccinated people to reach a "balance where we feel like we're not going to have widespread transmission."
"We'll get to that point," she said. "But we're not there yet."
'Masks should be among the last to go'
Despite concerns over variants, Noymer of UC Irvine said it's reasonable for states to reevaluate restrictions as case numbers drop.
"People are getting antsy," Noymer told Insider. "What you don't want to have is a situation in which people don't want to follow any restrictions because they feel it's all too strict."
Noymer said loosening restrictions could even have an overall positive effect in some situations. For instance, he mentioned California, where an outdoor-dining ban in the fall sparked outrage and even prompted some restaurants and local jurisdictions to flout the rules.
Noymer considers this a significant problem because it risks some restrictions being viewed as meaningless.
Gov. Gavin Newsom reopened outdoor dining in California in January, prompting some to wonder whether the decision came too soon. But Noymer said it just brought the restrictions closer in line with reality in some places, which can go a long way in maintaining the public's trust.
"I'd like to have these orders still have some meaning when in the fall we might face a new wave with variants," Noymer said.
But as far as what kinds of restrictions can safely be lifted, he said "masks should be among the last to go."
He said relative to other aspects of life that had been disrupted by the pandemic, masks were a minor inconvenience relative to their public-health benefits.
"We know that masking is really important for prevention," Prins said, adding that to keep case numbers from rising again it's crucial for people to continue wearing masks and physical distancing until more Americans can be vaccinated.
Masks could be one of the last parts of the pandemic to go away, as Fauci recently said it's possible Americans will be wearing masks into 2022, even after life begins to look a bit more "normal."
Have a news tip? Contact this reporter at kvlamis@insider.com.
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