Another interesting flashpoint of disagreement between a prominent, camera-friendly medical authority and Joe Biden’s new and improved CDC. Former FDA chief Scott Gottlieb made a splash last week when he warned the CDC not to be too cautious with their guidance for vaccinated people. Those who have been immunized *are* going to go out and do things, he reminded them, starting with seeing their grandkids. The CDC’s better off recognizing that and advising them how to do the things they want to do more safely than advising them not to do those things at all, which is an invitation to having the public ignore the guidance altogether.

The CDC appeared to take Gottlieb’s advice to heart with today’s new recommendations — somewhat. It’s okay to meet with unvaccinated low-risk people, like grandchildren, so long as you limit the gathering to just one household, the agency proclaimed. But public spaces like restaurants? And traveling after a year of being cooped up? Still thumbs down on that for now.

Dr. Leana Wen, one of CNN’s better-known medical analysts, can’t help but sigh.

My takeaway from new @CDCgov guidance: It's good that CDC provided clarity on small-group visits. However, it's far too cautious & is missing a major opportunity to tie vaccination status with reopening policies. (This is what I'd said should be there, with @PamelaBrownCNN) pic.twitter.com/nYtL5Z6NEd

— Leana Wen, M.D. (@DrLeanaWen) March 8, 2021

Joining @BrookeBaldwin @CNNnewsroom: While some guidance is better than no guidance, I’m disappointed by the overly timid approach of @CDCgov. Public health depends on public trust, and when the advice does not make common sense & meet people where they are, we lose that trust.

— Leana Wen, M.D. (@DrLeanaWen) March 8, 2021

TV medical experts don’t like having daylight between their recommendations and the CDC’s during a pandemic, knowing that consistent messaging is important to convincing the public to adopt certain behavior. That’s doubly true with a left-wing administration that’s promised to “restore science” to the White House and not let politics shape its public-health message — except when the teachers unions require it, of course. For Gottlieb and now Wen to undercut the CDC this way, they must feel strongly that the agency is being too restrained in incentivizing people to get vaccinated. “The CDC is missing a major opportunity to tie vaccination status with reopening guidance. By coming out with such limited guidance, they are missing the window to influence state and national policy,” Wen elaborated in an email to the AP today. She wants more access to public spaces for the vaccinated, it seems. “Vaccine hesitancy will be the major barrier to herd immunity. We need to address this by being clear of the freedoms people will gain after vaccination,” she tweeted yesterday.

Gottlieb made a similar point during his appearance on “Face the Nation” on Sunday morning:

“We can’t be so far behind the aspirations of the public that the guidance itself gets ignored,” he said. “I think people are rightly sensing that vulnerability overall is declining right now as you see more and more people get vaccinated, as we have more population-wide immunity from this virus from prior infection as well. So people are going to want to start to do things. They’re going to want to start to go out more. And we need to take that into consideration in terms of how we’re putting out guidance.”

A thought I had yesterday: Since we know the percentages of each state’s population that have received their first and second doses, why not tie restrictions like capacity levels for businesses and the status of the mask mandate to vaccination benchmarks? For instance, once 25 percent have gotten both shots, businesses statewide are authorized to open at 50 percent capacity no matter what their local authorities say. At 40 percent vaccinated, businesses move to 75 percent capacity. At 60 percent, all capacity limits lift and the mask mandate is canceled. It’s unclear to me if Wen has something similar in mind or if she simply wants the CDC to encourage individual vaccinated people to resume public activities like indoor dining and theater-going. It’d be easy enough for the agency to issue guidance recommending that those who’ve been immunized should feel free to return to public spaces while those still waiting their turn should avoid them. That would strongly incentivize vaccination among holdouts. But some people who are unvaccinated and extremely risk-neutral would exploit the new rule to return to public spaces as well, falsely claiming that they’ve had their shots, and some infections would happen that way. There needs to be some way to limit public spaces to the vaccinated, even if it’s just asking for their (easily forged) card showing that they’ve received both doses.

It does look like we’re headed to a “benchmark” system sometime soon, per this segment from CNN that aired this afternoon. Watch Sanjay Gupta at 2:15 here reporting that new guidance is expected to come from the CDC periodically as vaccination rates increase. For example, once every state has hit, say, 20 percent of the population receiving its second dose, the agency may endorse travel for vaccinated people again. They *are* going to give people behavioral reasons to get their shots, in other words, which is good. They’re just going to do it on a sliding scale pegged to the total number of vaccinations knowing that the more people there are who are immunized, the less risk increased social activity poses to everyone.

Today @CDCgov said fully vaccinated people can gather with others who’ve been vaccinated w/o a mask or distancing. Sr WH #covid19 adviser @Aslavitt tells me it’s just a first step in recommendations of how we will return to normal. (1/2) pic.twitter.com/AiEvpc50oL

— Dr. Sanjay Gupta (@drsanjaygupta) March 8, 2021