Last month, Long Beach said its indoor masking requirements would be lifted once the city reached a seven-day cumulative rate of less than 50 cases per 100,000 residents.

But this week, Long Beach lifted its mask mandates though the case rate remains double that number, as the city follows new federal guidelines.

City officials have said all along that data will drive decisions, but for Long Beach City Health Officer Dr. Anissa Davis, revising COVID-19 health orders can be a tough balance as federal, state and county rules are frequently changing.

Last week, Davis issued an updated health order allowing vaccinated people to forgo face masks in most indoor settings. But days later, the city switched gears and issued an updated order allowing everyone to forgo masks indoors regardless of vaccination status.

Davis said she issued the change on Monday following new guidelines by the U.S. Centers for Disease Control and Prevention that officially moved Long Beach into the “low level” risk for virus activity.

Davis, in an interview this week, admits the shifting changes can confuse residents, but she said she’s working to keep up with the ever-changing data and research in the pandemic. Long Beach is one of just a handful of California cities with its own health department and can issue its own health orders independent of the county.

“I think it’s always a balancing act in making sure you’re taking in people’s concerns and on the other hand, trying to reduce the risk of transmission as much as possible,” she said.

As the winter surge in cases subsided this year, Los Angeles County and Long Beach were among the last large municipalities in the country to keep strict mask mandates.

But with cases now at lower levels, Davis said she feels more comfortable loosening mask mandates, though face coverings are still strongly encouraged.

“We’ve had really strict requirements around masking when our goal was to completely eradicate the virus, but now we understand the fact that we are going to be living with COVID,” she said. “We’re not going to get rid of this virus, but we can continue to protect ourselves.”

Previously, guidelines were based largely on case rates, but the CDC’s new designations for risk categories released this week are based mostly on virus-related hospital admissions and the percentage of hospital beds occupied by COVID-19 patients.

To be in the low risk category, the new guidelines require municipalities first to have a seven-day average case rate under 200 people per 100,000 residents. Long Beach’s seven-day average was 100 as of Wednesday.

Davis said the city is also in the low risk category for under indicators, such as the number of new COVID-19 hospital admissions per 100,000 population. The city is now averaging under 10 new admissions per 100,000 residents.

In one of the last holdouts, Los Angeles County has also moved to loosen its mask mandates. As of Friday, indoor mask-wearing is no longer mandatory in accordance with the new CDC guidelines.

Masking in Long Beach and the county is still required in higher-risk settings, including health care facilities, public transit and long-term care facilities.

While case rates have drastically decreased and masking rules have changed, Davis said life is far from normal.

“Right now things look promising and we’re cautiously optimistic,” she said. “But with COVID, you can never be sure. We’re still waiting to see what happens.”