Nervous experts counter relaxed new CDC rules: Maybe this isn't such a hot idea

The best summary of where we’re at with the CDC after yesterday’s shocking mister-gorbachev-tear-off-those-masks news comes from Lawrence Gostin, a professor of public-health law. “I feel badly for the CDC because they’re trying to do the right thing,” he told the Daily Beast. “But no matter what they do, they’re being criticized, and as a result they’re going from the sublime to the ridiculous or the ridiculous to the sublime—I don’t know. Yesterday, there were all kinds of restrictions on vaccinated people, and today it’s a green light to go back to normal, and there’s no change in the epidemiology.”

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On Tuesday Rochelle Walensky told Susan Collins that national case counts were still too high to make her feel comfortable sending her 16-year-old to camp, never mind that kids rarely suffer from the disease and most adults who might catch the virus from her son have been vaccinated. Two days later she was telling the country that it’s time for vaccinated people to get (almost) completely back to normal, even indoors.

From the sublime to the ridiculous or the ridiculous to the sublime.

Some members of her own profession think the new masks-off guidance is ridiculous, including at least one who’s spent months urging the CDC to lighten up on restrictions for vaccinated people. Leana Wen believes that easing certain precautions for those who’ve been immunized can incentivize vaccination. But easing them completely (or almost completely) may have the opposite effect:

She expanded on that in an op-ed today. What she wants are vaccine passports in wide use to ensure that certain public spaces are reserved for people at low risk. Only then will the immunocompromised and young kids, people who can’t yet be protected by vaccination, feel safe to be out in public again. Instead, the CDC is inviting a free-for-all in which the vaccinated and unvaccinated can freely mingle, raising the risk of infection to those who are unprotected. What incentive do the unvaxxed have now to get their shots, asks Wen, if they’re free to whip off their masks and lie about their status in order to access the same public spaces that the vaccinated are?

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But look: Vaccine passports just ain’t happening. There isn’t enough public support for them except in venues where people are traveling, like airplanes. Vaccine passports would also — hopefully — be a solution to a very temporary problem, which is how to keep the vaccinated and unvaccinated segregated until the country reaches herd immunity, at which point they can mingle safely. By the time the tech for passports was up and running and had been widely adopted, we’d probably either have reached herd immunity or have given up on ever reaching it. Either way, if we’re not doing vaccine passports indefinitely, why start?

As for incentivizing the unvaccinated to get vaxxed, I don’t see how the previous status quo was incentivizing them. Righties have critiqued the Biden White House and experts like Fauci relentlessly over the past few months for “underselling the vaccine” by continuing to recommend that vaccinated people take precautions. If you want people to get their shots, we said, tell them that they can get back to normal safely once they do. Well, the CDC finally did that yesterday. Now Wen’s unhappy that the unvaccinated can do all the stuff they’ve been wanting to do without taking precautions simply by lying about whether they’ve had their shots or not.

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I have news for her, though. The unvaccinated have been doing all the stuff they’ve been wanting to do without taking precautions for awhile now. Maybe the CDC’s strong sign of confidence in the efficacy of the vaccines yesterday will convince a few of them to get jabbed at long last.

Wen’s not alone in believing that the CDC went too far in relaxing the rules, though. In fact, for all the grief we’ve given the agency for being too cautious with its guidance, by the standards of its industry it may be downright reckless.

A survey of hundreds of epidemiologists by the Times found that a majority believed we’d still be masking for a year or more. Eighty-eight percent believed that even fully vaccinated people should continue to mask up outdoors when in a large crowd. Why are epidemiologists being so cautious? Because: We haven’t reached herd immunity yet, which means the new maskless back-to-normal America is destined to see a rash of new infections:

Yet most said mask-wearing continued to be necessary for now, because the number of vaccinated Americans had not yet reached a level that scientists consider necessary to significantly slow the spread of the virus. Until then, there are too many chances for vaccines, which are not 100 percent effective, to fail, they said.

“Crowded circumstances, indoors or outdoors, necessitate a mask until community levels of Covid are much lower,” said Luther-King Fasehun, a doctor and an epidemiology Ph.D. student at Temple University…

Respondents also said that as long as the virus was still spreading, masks were important to protect high-risk people and those who cannot be vaccinated, like children or people who have underlying health conditions.

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Gostin also believes that the new guidance is too relaxed. Sure, vaccinated people can ditch their masks outdoors, he told the Daily Beast, but attending a crowded indoor event like a fitness class could be asking for trouble because “there’s no way to know who is vaccinated and who isn’t.” That’s been a common critique of the new CDC rules since yesterday afternoon and features in Wen’s commentary too: Dropping most precautions before we’ve reached herd immunity even in indoor spaces is extremely risky because there could be unvaxxed people in that crowd who are at risk.

To which I’ll say the same thing I said yesterday: And? The unvaccinated know the risks. If they want to foolishly assume that risk by crowding into indoor spaces with strangers (again, as many of them have been doing for months), that’s their problem. Charles Cooke:

The answer to this, of course, is that you can’t know [who’s vaccinated and who isn’t], but, that if you’re vaccinated, it doesn’t matter whether you know, because unvaccinated people can’t hurt you. Or, at least, that’s the answer if one assumes that the fear is medical in nature. But, of course, it’s not. It’s social. What Phang, Osterholm, and their many fellow travelers are really asking is, “Without masks, how will I know who to disrespect?” Evidently, the final transmutation of the virus has been from epidemiological marker to political totem.

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By all means, we should keep pushing towards herd immunity and continue to look for creative ways to incentivize vaccination in order to make it safer for kids and people who are immunocompromised to socialize. (Although kids are at extremely low risk of severe illness, a fact which critics of the new CDC policy like Wen have glossed over in the past 24 hours.) But there’s no reason to stick to May 2020 rules in light of May 2021 realities, when nearly 60 percent of adults have had at least one shot and vaccines are now being made available to kids aged 12-15.

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David Strom 6:40 PM | April 18, 2024
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