They were supposed to be issue this days ago but evidently had a rethink before putting it out. The CDC has taken heat lately even from respected members of their own field for being too cautious in incentivizing vaccines. Vaccinated people are going to want to do stuff now that they’re immunized, Scott Gottlieb recently reminded them. Tell them that they can’t do much of anything and you’re inviting the public to ignore the guidance.
But tell them that they can do anything they want, i.e. an immediate return to full normalcy, and there may be unintended consequences.
In the end the agency chose the Goldilocks option, or what passes for one in a hyper-cautious public-health bureaucracy.
CDC Director Dr. Rochelle Walensky announces fully vaccinated people can gather indoors without masks in small, private settings. pic.twitter.com/Jyxg9J62L3
— The Recount (@therecount) March 8, 2021
To sum up:
Those who are vaccinated are allowed to:
Visit with other fully vaccinated people indoors without wearing masks or physical distancing.
Visit with unvaccinated people from a single household who are at low risk for severe disease indoors without wearing masks or physical distancing.
Refrain from quarantine and testing following a known exposure to COVID-19, if asymptomatic.
The “full normalcy” option would have encouraged vaccinated people to do anything they want to do. Go to restaurants and theaters! Travel extensively! It’s 2019 again! The CDC didn’t want to do that because the available data suggests that vaccinated people *can* transmit the virus to those who are unvaccinated, although at lower rates than an infected person who hasn’t had their shots can. Encourage vaccinated people to mix freely with the unvaccinated in public settings and you may seed an outbreak. Beyond that, the public-health brain trust is forever worried about the risk-management signals it sends to the general public, knowing how eager Americans are to socialize again. If the advice to vaccinated people was to return to full normalcy, some unvaccinated people would revert to full normalcy too. That’s not what the feds want to see when we’re still several months from herd immunity.
The ultra-cautious approach would have advised vaccinated people to socialize with each other and only with each other. No exceptions. You can have your vaccinated friends over for dinner but the risk of transmitting the virus to an unvaccinated person is too great to allow the immunized and unimmunized to mix. There was a big, obvious problem with that approach, though: It would mean vaccinated grandparents still couldn’t hug their unvaccinated grandkids, exactly the sort of thing Gottlieb was worried about. Tell Americans that they can’t do that and they’ll never listen to you again. The hugs are gonna happen. Make peace with it and adjust your guidance accordingly.
Which is what the CDC did. The second rule in the excerpt above, endorsing vax and un-vax mixing when limited to a single household where transmission is low-risk, as it is with children, is obviously aimed at encouraging grandparent/grandchild reunions. Go ahead and hug ’em, says the CDC. That’s the Goldilocks option.
The takeaway is: Think “small” and think “safe.” Larger gatherings in public, where the risk of transmission is less certain, are still verboten.
CDC still recommending masks for vaccinated Americans and other steps, like avoiding crowds, that Walensky says remain important to curbing covid spread. pic.twitter.com/NuUfFMMGLk
— Dan Diamond (@ddiamond) March 8, 2021
There aren’t many average joes who were waiting on the CDC to make up its mind before deciding what it’s safe for them to do, but the guidance might still be useful by encouraging vaccine acceptance among holdouts thanks to the headlines it’ll generate about experts believing it’s safe for vaccinated people to socialize again. And it may rein in some riskier behavior by people who’ve been vaccinated and have been operating on the assumption that that meant “full normalcy.” Now that the agency has said otherwise, some who’ve had their shots may begin to manage their risk to others more scrupulously.
Politico reports that the guidance initially considered endorsing travel by vaccinated people, a much stronger signal towards full normalcy. But the new variants got in the way:
An earlier draft of the guidelines included a travel section but senior health officials decided not to release that portion of the recommendations at this time, one senior administration official told POLITICO. Advice on whether vaccinated people need to quarantine after exposure to someone with Covid-19 also sparked debate at a White House meeting Friday, one day after the guidelines were originally set for release…
Officials previewed the guidance during a White House meeting on Friday, according to two people with knowledge of the discussions. But at the time, there remained lingering concerns about whether the document was clear enough. One sticking point in particular had been the CDC’s recommendations for whether vaccinated Americans should quarantine after Covid-19 exposure, those sources said, especially as more cases of reinfections are confirmed globally.
Brazil is one of the few countries in the world where the pandemic is getting worse right now, due in part to the emergence of a variant that’s capable of reinfecting people who’ve already had common COVID. Hopefully the current vaccines provide enough immunity to defeat that variant but no one wants to bet too heavily on it without further study. A more feasible Goldilocks approach to vaccinated people traveling, then, would have been to encourage it within the U.S. but not abroad, as those who’ve been immunized are going to insist on some degree of movement after a year of being frozen in place. Once again Gottlieb is the realist here, understanding that those who’ve had their shots will want some degree of normalcy in exchange for not embracing full normalcy. And since the share of the population that’s been vaccinated is the same share that tends to have poor outcomes from COVID, we can give them some normalcy without crippling hospitals if there’s a surge in cases:
We'll cross 60% of those over age 65 vaccinated and 70% of those over 75. The overall vulnerability of the population to Covid is declining, giving more chance to re-engage in things we value. We need to look at vulnerability of population in measuring risk, not only prevalence pic.twitter.com/nLNVtUVm5d
— Scott Gottlieb, MD (@ScottGottliebMD) March 7, 2021
Even in deep blue Chicago, the powers that be are looking for ways to give people a taste of normalcy as cases fall:
Folks, we've significantly slowed the spread of COVID, getting our positivity rate down to 2.8%. And now, we can begin to safely welcome fans back to our baseball stands on opening day. Although we’re reopening, masking is still of utmost importance. 😷⚾ pic.twitter.com/pkGnMDkSUc
— Mayor Lori Lightfoot (@chicagosmayor) March 8, 2021
Vaccinated people are going to travel. Let’s focus on getting them to travel to Chicago for Cubs games instead of to Rio de Janeiro. Exit quotation from Benjy Sarlin, putting today’s guidance into temporal context: “Everything in between was a horror filled with preventable deaths, but it’s incredible we’re hitting the one-year anniversary of Tom Hanks Day with a vaccine rollout in full spin and CDC announcing major moves toward normalcy.” It’s been the longest year ever in so many ways, but in another it’s been a very short one.