What You Need to Know About King County’s Mask Directive for Indoor Spaces

Last week the CDC updated its mask guidance for fully vaccinated people, this week King County's Public Health Official issued an updated mask directive for the county. Here's what you need to know.

From King County’s Public Health Insider Blog:

With local COVID-19 case and hospitalization rates decreasing but still at elevated levels, King County Health Officer Dr. Jeff Duchin has issued an updated Directive strongly urging all residents, fully vaccinated or not, to continue wearing face masks in public indoor settings.

Last week, on May 13, the U.S. Centers for Disease Control and Prevention (CDC) announced new guidance that people who are fully vaccinated no longer need to wear masks for most activities.

While the Washington State Department of Health (DOH) announced state guidelines consistent with the CDC, both CDC and DOH highlight that mask policies should take into account local COVID-19 circumstances and requirements. Today’s Directive that applies to King County takes into account these local conditions.

Summary of the indoor mask directive available in 35 languages

Frequently Asked Questions on masks page updated to include information on the indoor mask directive

We asked Dr. Duchin to weigh-in on some key questions about the Directive.

Can you tell us more about the Directive: Why are you issuing it now?

Public Health—Seattle & King County is issuing this Directive to help us all stay safer until our community is more protected from the virus.

Our community has made great progress with our vaccination rates, particularly for older adults, but rates are lower in many others and vary by age, neighborhood, race and ethnicity. We want to avoid an increase in people who are unvaccinated without masks in indoor settings at a time when we have substantial COVID-19 activity in the community.

We know the strategy of masking by everyone in indoor public spaces has been working well and can help us stay protected until disease rates are lower and more people are vaccinated.

Why should I be wearing a mask in indoor public spaces if I’m fully vaccinated?

We agree that COVID-19 vaccines give high protection against infection and spreading the virus to others, and unvaccinated people are the ones at risk to acquire and spread COVID-19.

In stores and other public spaces, if we say only unvaccinated people need to wear a mask, we have no way to know who is vaccinated and who isn’t, and it’s impractical for businesses to determine that.

If unvaccinated people do not wear masks, the risk for COVID-19 spread increases. So, from a practical and community health perspective, the most reliable way to ensure everyone is safe is for everyone to wear a face mask for a few more weeks, until we get vaccination rates higher and disease rates lower.

What does it mean for a King County resident?

The CDC and DOH guidance require unvaccinated people to wear masks when in indoor public spaces. This Directive, in addition, strongly urges everyone – vaccinated and unvaccinated – who is five years and older to continue wearing face coverings in indoor public spaces. This means that whenever someone enters a public building – including retail, grocery stores, restaurants, government buildings – they should wear a mask to protect themselves and others.

In addition to the local Directive, Washington state continues to require everyone age five and older in schools, child care settings, public transportation, correctional facilities, homeless shelters, and health care settings such as doctor’s offices, long-term care, and hospitals to also wear well-fitted masks.

For anyone who is not fully vaccinated, the State Department of Health Order also remains in effect: People who are not fully vaccinated are required “to wear a face covering in any indoor public setting, or when outdoors and unable to maintain six feet of physical distance from others.”

For many of us who’ve been wearing masks in public, this King County Directive should not change our behavior. It continues the guidance and policies that were working well for our community from before the CDC’s update last week.

The Directive will remain in effect until 70% or more of King County residents 16 years of age and older are fully vaccinated. Someone is considered fully vaccinated two weeks after their second shot (or in the case of the Johnson & Johnson vaccine, their first shot). We’re hopeful that we’ll achieve this goal in late June.

Why are we not immediately adopting CDC guidance?

There are a few important factors.

Rates of COVID-19 cases and hospitalizations are falling but remain elevated in King County. When COVID-19 rates are high, it’s more likely that people will come in contact with someone who is infected who is not wearing a mask. If rates continue to go down, lower levels of COVID-19 will make it safer for everyone.

Also, large segments of our population are not yet fully vaccinated.

The CDC’s guidance is based on the fact that COVID-19 vaccines work incredibly well, and the science absolutely shows that vaccines provide strong protection. In fact, COVID-19 vaccines not only protect the person vaccinated, but because they decrease the risk of spreading the infection as well, they protect the community.

However, there is no easy way to know who has been vaccinated in public spaces. This means that both unvaccinated and vaccinated people would likely have close contact, without masks, in indoor settings. With current rates of COVID-19 circulating and because large numbers of people are not vaccinated yet, including many frontline workers, the risk of COVID-19 spread in indoor settings could increase.

This problem is made worse when considering people who are still vulnerable to getting COVID-19. This includes unvaccinated children younger than 12, many 12-15-year-olds and younger to middle-aged adults who have not had as much time to be vaccinated, and the tens of thousands of people in King County who are immuno-compromised and may not be fully protected through vaccination.

For these reasons, I believe it is clearly in our community’s best interest to temporarily continue doing what has been working well for us, until we have higher vaccine coverage and less COVID-19 spread.

The CDC clarified that ending indoor mask mandates should be linked to local circumstances and requirements. What do our disease and vaccination rates tell you?

In King County, we have just recently had a fourth wave of infections and hospitalizations. Currently, we have substantial or high levels of COVID-19 transmission among many of our communities.

While our vaccination rates are very encouraging with 70% of eligible people having received one or more doses and more than 50% being fully vaccinated, our COVID-19 vaccination rates and risks vary by age, race, ethnicity, and geography. This raises equity concerns. Because of living and working conditions, not everyone has had the same access to the vaccines. By allowing a bit more time for everyone to get vaccinated, we will have greater community protection for everyone.

Since Washington state and King County have different mask guidance, what should I follow?

All local jurisdictions have the authority and responsibility to implement stronger guidance based on that county’s needs. In King County, we’ve determined that ending the indoor mask mandate would likely lead to preventable COVID-19 spread primarily among the unvaccinated.

Residents of King County and King County businesses should follow our King County guidance and comply with this directive.

Other counties in Washington also have local mask guidance.

Are there spaces where the Directive does not apply?

This Directive applies only to indoor spaces that are open to the public. It does not apply to indoor spaces that are generally closed to the public, including private businesses, offices, and other places of employment.

Employers should continue to follow current guidance and requirements from the Washington State Department of Labor and Industries on worker safety.

This Directive also does not apply to outdoor places. When outdoors, masks are not required as long as a distance of six feet is maintained from people who are not from the same household. Please follow current Washington state guidance on the use of masks outdoors.

What should businesses and employees know about this directive?

I strongly encourage all businesses that are open to the public, including grocery stores and other retail settings, to continue implementing policies and practices to ensure that their customers and employees wear face coverings. Businesses have the authority to continue to require people to wear masks in their establishments. If you need signage, you can find some on our King County webpages, along with tips for getting a snug fit.

It is also a good idea to take steps to improve indoor ventilation & air quality to reduce the risk of spreading COVID-19 in indoor settings.

Washington state issues guidance that governs how employers are required to protect employees’ health. Employees with disabilities or other underlying medical conditions that make masks necessary for their health can request accommodations.

What is the difference between a Directive and an Order?

A Directive calls for voluntary compliance, which has been our main strategy to contain COVID-19. An Order would require enforcement or penalties. This Directive is consistent with the education-based approach we’ve taken throughout the pandemic and which has worked well thanks to the support of our residents and businesses.

In addition to complying with the Directive, how can individuals help slow the spread of COVID-19?

It is critical we recognize that the pandemic is not over. There is a real possibility that we could see increases in COVID-19 activity in the coming months, particularly in areas where fewer people have been vaccinated.

So now, the most important thing you can do for yourself and for your community is to get vaccinated and continue wearing a mask in public spaces for just a while longer. I know it’s tough and we all desperately want to return to something resembling normal. Let’s not give up yet!

Originally published May 20, 2021