I can’t shake the feeling that this advice will … not be heeded.
“People cannot feel safe just because they had the two doses. They still need to protect themselves,” Dr. Mariangela Simao, WHO assistant director-general for access to medicines and health products, said during a news briefing from the agency’s Geneva headquarters.
“Vaccine alone won’t stop community transmission,” Simao added. “People need to continue to use masks consistently, be in ventilated spaces, hand hygiene … the physical distance, avoid crowding. This still continues to be extremely important, even if you’re vaccinated when you have a community transmission ongoing.”
You can’t have a hot vax summer with a face diaper on. But with the super-contagious B.1.617 Indian or “Delta” variant now spreading aggressively in the U.S., go figure that public-health experts are nudging people back towards maximum precautions. (In the UK, where Delta is now ubiquitous, they’re back up to the U.S. per-capita equivalent of 70-80,000 cases per day despite having all but crushed COVID a month ago.) I think that also explains the curious episode from a few days ago of Anthony Fauci recommending in a White House video that vaccinated people avoid crowds if possible, especially if they live in an area with a low rate of vaccination. The administration ended up deleting that footage because it contradicts the official CDC guidance — for now — but Fauci’s clearly worried about Delta too.
Which makes me wonder: Is there any evidence that vaccinated people infected by Delta are more likely to pass it on to others than they are with less contagious variants? Rochelle Walensky famously said a few months ago that the data shows that vaccinated people “don’t carry the virus,” which was an exaggeration but only a slight one. Immunized people apparently rarely transmit the more common varieties of SARS-CoV-2, which is why the CDC is comfortable with them unmasking around unvaccinated people.
But maybe Delta has changed that calculus. That would explain the WHO wanting the vaxxed to mask up and Fauci wanting them to avoid crowds. If they have some information suggesting that B.1.617 is transmitting even among those who are inoculated — which would be a big problem — it’d be nice if they shared it.
If the data doesn’t suggest that vaccinated people are infecting others with Delta, though, then why do we need to take to precautions? Like Patrick Ruffini says:
This is a statistical parlor game at this point. The reality is that we are down to lethality that is much lower than the flu. And that was the point of all our efforts all along. Mission accomplished. Go home.
— Patrick Ruffini (@PatrickRuffini) June 26, 2021
I’m sympathetic to that. But I wonder if Ruffini’s right that vaccinated people can’t have “serious complications” from infection. We know that the vaxxed are very, very, very unlikely to end up in the hospital or in the morgue from the virus, but how often after being infected do they end up with “long COVID,” which is more common than you might think among the population? How often do they end up losing brain tissue after recovering, another frightening and frequent complication?
Politico is reporting today that the White House is so worried about Delta rampaging through parts of the country with low vaccination rates that they considered asking local officials to reinstate restrictions — before giving up on the idea because they realized people wouldn’t follow the rules at this stage of the pandemic:
The Centers for Disease Control and Prevention, the Department of Health and Human Services and the White House Covid-19 Task Force have discussed whether to press mayors and governors in the Midwest and South, where the highly transmissible Delta variant is spreading quickly, to once again require mask mandates, according to three senior Biden health officials. But the administration ultimately concluded that many people who are not vaccinated are also those who have resisted wearing masks.
That would be foolish, as it would ignite a public uproar and end up achieving nothing. Multiple studies have shown that, although masks work to limit transmission in certain circumstances, mask mandates do not. People are going to take precautions or not based on their personal level of risk tolerance, not because the governor’s handing down orders. If you want people in red states wearing masks again, the best thing to do is just tell them the ugly truth about how fearsome B.1.617 is and hope that they manage their risk accordingly.
…although the feds may have a little something else in mind to nudge them:
The CDC is now considering whether to update guidelines for schools and for domestic and international travel. Federal and state health officials are debating how and whether to recommend proof of vaccination for everything from restaurants to movie theaters to office buildings. The fear, Fauci recently told POLITICO, is that recommending proof of vaccination could cause an uproar among unvaccinated people. While federal health officials have pledged so-called vaccine passports will not be implemented at the national level, some states and private businesses have explored using vaccine passes to support safe reopening.
Team Biden has said repeatedly that they won’t issue any federal rules requiring vaccine passports. But the White House and the CDC could influence state policy by formally recommending them. Is that coming? The only thing that truly works to protect people from Delta is getting vaccinated, not a three-dollar cloth mask you might buy at CVS. The feds may be desperate enough now to convince holdouts to get the jab as B.1.617 circulates that they’re willing to shift from a purely “carrot” approach and start wielding a stick. Endorse vaccine passports to exclude the unvaccinated from certain public spaces and maybe some unvaxxed people will go get immunized.
Or maybe they won’t. Once the White House recommends vaccine passports it’ll touch off another nasty partisan culture war in which blue states that already have high vaccination rates move to mandate them while red states with low vaccination rates rage against them. The “stick” approach won’t work on the places that most desperately need an uptick in people getting vaxxed. What then?
I think it’s a matter of time before the CDC readjusts its guidance to recommend masks for vaccinated people, at least in crowded indoor spaces, in the belief that that might help limit transmission of Delta. Whether anyone heeds that guidance is a separate question, but the agency will want to do something to communicate to Americans that B.1.617 is no joke and they should do what they can to avoid infection by it.