Susan Collins to CDC chief: I used to think your agency was the gold standard but not anymore

A lot of people agree, and not just average joes like me and you or politicians like Collins. There’s an unusual number of stories on the wires today quoting fellow scientists grumbling about the CDC’s self-defeating hypercaution in issuing COVID guidance. Ed already wrote about the most widely circulated one, in which the NYT challenged the CDC’s assessment that less than 10 percent of COVID transmission happens outdoors. That’s technically true, wrote David Leonhardt, but misleading in the same way that it’d be misleading that less than 10 percent of Americans win the lottery. Outdoor transmission accounts for more like one percent — or possibly one-tenth of one percent — of COVID infections. By being so conservative in its estimate, the agency is misleading people into believing they’re at greater risk outdoors than they are.

Other experts are exasperated that the CDC still hasn’t meaningfully relaxed its guidance for vaccinated people. Under the latest rules, fully vaxxed people are still advised to mask up outdoors in crowds despite the extremely low risk from outdoor transmission involving the vaccinated.

Most experts interviewed for this story say the agency has struggled to take advantage of the latest scientific findings to communicate as rapidly as possible with the American public. And when the guidance is issued, it tends to be overly cautious…

“There’s still a lot of abstinence-only in their Covid guidances,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “People somehow kind of walled off what they know about HIV, opioid use, and hep C … and we are the worse for it.”…

[Rich] Besser, the former acting CDC director, also acknowledged that certain CDC guidelines, including advice on what vaccinated people can safely do, were released later than he would have liked. He attributed the CDC’s slowness to a culture in which it “gets challenged in settings where the science is incomplete, or settings where the science may not exist at all.”…

“If their advice is too disconnected from reality, and if they are too slow, then they make themselves irrelevant,” [Leana] Wen, the George Washington professor said. “I understand that they’re in a difficult position. However caution and indecision also comes at a price.”

A Vox reporter contacted experts who’ve been vaccinated and asked them if they still deem themselves to be at risk from indoor transmission. Nope, not really, they said. Some are still wearing masks but only to protect others from being inadvertently infected by them just in case they happen to be carrying the virus. Others shrugged at the possibility of being infected, noting that “breakthrough infections” tend to be mild or asymptomatic. “I am fully vaccinated and have resumed normal activities,” said one infectious disease specialist in California. “I have gone indoor dining, went to my first movie theater, and would go to a bar if there was an opportunity!”

Collins and other Republicans pressed Walensky on two areas of guidance. One was outdoor transmission, suddenly a hot topic thanks to the NYT story, and the other was the agency’s already notorious rules for summer camp, which calls for masking even young children outdoors in the heat. Watch, then read on:

Don’t blame us for the “less than 10 percent” estimate on outdoor transmission, says Walensky. That came from an analysis in the Journal of Infectious Diseases last November. (“Five identified studies found a low proportion of reported global SARS-CoV-2 infections occurred outdoors ([less than] 10%) and the odds of indoor transmission was very high compared to outdoors (18.7 times; 95% confidence interval, 6.0–57.9).”) But Leonhardt challenged some of the data in that study in his piece this morning, noting that some cases of outdoor transmission in Singapore that influenced the conclusion most likely happened indoors. When he dialed around to epidemiologists, more than one told him they estimated that less than one percent of transmissions happen outdoors.

Why didn’t the CDC prefer that expert estimate to the number in the Journal analysis?

As for camp, Walensky says that her own 16-year-old son is being kept home this year for the simple reason that cases in the U.S. are higher now than they were at this same point last year. Right, but … most of the vulnerable adults in the population have been immunized now, including more than 70 percent of senior citizens. There’s much less risk of infected camp kids starting chains of transmission that’ll end up killing grandma. And it’s probably *not* true that there were fewer infections last year at this time than there are now; we had less testing capacity at the time, remember. Also, 16-year-olds have been eligible for the Pfizer vaccine in some states for more than a month. Did her son just turn 16 and hasn’t had a chance to be vaccinated yet? If he missed the start of the camp he usually attends, can’t he just get vaxxed now and attend one that starts next month? Her own agency is about to approve vaccination for ages 12-15. We’re running out of excuses why kids can’t camp safely in June or July.