“There really are very few ways to interpret this newfound attitude that aren’t ‘welp, now that we’re all getting covid, suddenly these measures we’ve had in place all this time are looking awfully restrictive,” tweeted Noam Blum about the class subtext underlying the CDC’s new policy. Now that the work-from-home professional class is suddenly in the virus’s crosshairs, our public-health bureaucracy has had a eureka moment that COVID rules don’t need to be as rigid as they’ve been in the past.
Fauci and CDC chief Rochelle Walensky did the rounds on cable news last night and this morning to defend the new guidance, which calls for people to isolate for five days instead of 10 after testing positive so long as their symptoms seems to be “resolving” by day six. After that, they can get back to work provided that they wear a mask on days six to 10. And any ol’ mask will do, it seems, even though hardly anyone believes a cloth mask provides meaningful protection from a virus as contagious as Omicron. Notably, and to the shock of many infectious disease experts outside the government, there’s no requirement in the new guidance that someone with COVID test negative on day six before leaving isolation. They can just assume they’re no longer contagious and get back at it.
Fauci told one clear lie during his appearances last night and one … “debatable truth,” let’s call it. Here he is with a skeptical Chris Hayes, who wanted to know if the new guidance is based on anything scientific or if it’s just the CDC’s way of acknowledging that tens of millions are going to catch Omicron in the next month and we can’t have all of them isolating for 10 days. Especially essential service providers like cops, firefighters, and health-care workers.
.@chrislhayes pressed Fauci tonight on new CDC guidance.
HAYES: Is there any science backing up the idea that after 5 days… you’re not still shedding virus?
FAUCI: This is one of those situations… that we often say, you don't want the perfect to be the enemy of the good. pic.twitter.com/NVSqfZ8yUk
— Dan Diamond (@ddiamond) December 29, 2021
There is science here, Fauci insists. The average person is most likely to be highly contagious on days one through five after testing positive. After that, their contagiousness typically falls off to the point where a mask should be able to protect those around them. Ideally we’d have everyone isolate for the full 10 days but a trade-off had to be made given the insane amount of spread that the U.S. is about to see.
Will Saletan of Slate summarized that logic this way: “Health officials are openly compromising the strictness of their guidance to accommodate public resistance. Exactly what COVID liberals (mostly political conservatives) have called for. … and what COVID hawks (mostly medical experts and political liberals) are now criticizing.” Walensky was even blunter than Fauci about that in an interview this morning. The public won’t “tolerate” 10 days of isolation at this point, she noted, so science had to bend to economic and psychological reality.
CNN's @kaitlancollins: "It sounds like this decision had just as much to do with business as it did the science."@CDCDirector Dr. Rochelle Walensky: "It really had a lot to do with what we thought people would be able to tolerate." pic.twitter.com/Ek3X3S7Q9S
— The Recount (@therecount) December 29, 2021
Why wasn’t that the standard from the start? Is Blum’s cynical explanation the correct one?
There is some scientific logic behind the CDC’s decision but Fauci and Walensky have conspicuously skirted around it in interviews, probably because they fear what would happen if they acknowledged it frankly. With each passing day it’s clearer that Omicron is much more transmissible and much less dangerous than Delta. The truth that they dare not utter is that they expect everyone will catch it in short order but that few will suffer greatly, which puts it more in the category of a flu than COVID. It may have been worth shutting down society to protect people from a virus that’s killed 800,000 Americans, especially before vaccines were available, but the cost/benefit has now shifted drastically with the new variant.
If they admit that, however, many people will decide not to bother quarantining for even five days. If it’s no worse than a flu then you follow flu protocols about isolating, right?
Fauci and Walensky probably still aren’t 100 percent sure that Omicron won’t ultimately overwhelm hospitals even though their confidence about that must be growing. So they’re playing it safe — within reason — by asking people to quarantine for five days instead of 10, knowing that everyone will be infected eventually but that the new rules might at least slow down transmission a bit. But they can’t admit that that’s what they’re doing. A frank assessment of lower risk from Omicron would lead to some people abandoning all precautions.
The “debatable truth” I mentioned is the claim that most people won’t be infectious after day six. Is that true? Scientists and health-care pros aren’t convinced:
“To me, this feels honestly more about economics than about the science,” said Yonatan Grad, an associate professor of immunology and infectious diseases at the Harvard T.H. Chan School of Public Health, who has tracked coronavirus infections in the National Basketball Association.
“I suspect what it will do is result in at least some people emerging from isolation more quickly, and so there’ll be more opportunities for transmission and that of course will accelerate the spread of Covid-19,” he added, noting that people were unlikely to adhere strictly to masking advice after leaving isolation…
“I don’t think reducing the time for isolation overall is a bad idea,” said Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada. “But saying, ‘Five days is probably OK, based on Delta, so let’s give it a shot and see,’ is really not what you should be doing.”
“It’s only going to lead to more illness, more cases,” said the head of one national nurses union to WaPo. “No worker should be forced to come to work when they’re still sick.” That’s the point of the guidance, though — to give businesses cover to tell workers, particularly essential workers, to get back on the job on day six so long as their symptoms are in the process of “resolving.” Whether they’re sick or not.
The outright lie Fauci told last night came in an interview on CNN, when he insisted adamantly that the new guidance wasn’t influenced by the shortage of rapid tests. But experts can’t come up with an explanation besides that one for why the CDC wouldn’t ask people to at least test negative before leaving quarantine. (In the UK, you’re asked to test negative twice.) Multiple news outlets have sources from inside the government whispering to them today that of course the guidance is a function of the lack of available tests. Ideally everyone who tests positive would isolate until they have proof that they’re no longer contagious, but the White House disgracefully never made producing rapid tests a priority. So the CDC has no choice but to let people who are in the process of recovering leave quarantine before they know they’re no longer a danger to others. From CNN:
Television footage of long lines at testing centers grabbed Biden’s attention over the Christmas weekend. And the shortage of tests factored into the administration’s decision Monday not to recommend tests for individuals exposed to the virus to emerge from a shortened five-day quarantine, according to an official familiar with the discussions.
“If we require a test, people are going to say, ‘What if we can’t get a test?'” the senior administration official said, recounting internal deliberations on condition of anonymity. “Rather than letting the perfect be the enemy of the good,” the official said, the US Centers for Disease Control and Prevention opted for less stringent language, noting that “best practice would also include a test for SARS-CoV-2 at day 5 after exposure.”
The NYT heard the same thing: “A scientist who has discussed isolation policy with the C.D.C. in recent months said that officials said the agency could not recommend rapid tests while supplies were so scarce. The scientist spoke on the condition of anonymity to describe confidential discussions.” We’re going to have still-infectious people mingling with the uninfected in the middle of a giant wave because the Biden White House couldn’t get its act together on rapid tests over the course of 11 months. And the country’s top science bureaucrat, Anthony Fauci, is lying to the public about the impact of that reality on the new guidance presumably to provide political cover to his boss, the president.
The scientific cover story being offered by Fauci and Walensky for not insisting that people test negative before leaving quarantine is that rapid tests supposedly aren’t very predictive after day five of illness. That’s news to Michael Mina, an epidemiologist:
No I don't agree at all. Zero data to support that.
Until recently MOST ppl were not testing until already at peak infectivity or closer to the day 5 that is now being discussed
They worked then
What changed? Nothing
They detect antigen of active replicating virus.
— Michael Mina (@michaelmina_lab) December 29, 2021
People are testing themselves sooner in the course of their illness lately because they’re experiencing symptoms sooner thanks to the priority immunity they’ve gained. That means that the old rule of thumb for how long someone might remain contagious after testing no longer applies. Maybe it used to be that people wouldn’t have symptoms until five days after infection, would test themselves on day six, and would stop being contagious on day 11. Lately it may be that they’re having symptoms on the day after they were infected and are testing themselves that same day. They might still be contagious on day 11 — but the new CDC guidance would send them back to work on day seven. Not great.
Maybe it’s time to shift to a new cover story, then: Since people can test positive looooong after they were infected, tests no longer make sense.
LATEST: The newly updated CDC guidelines don't require testing at the end of isolation because PCR tests can stay positive for up to 12 weeks, CDC Director Dr. Rochelle Walensky tells @GMA. https://t.co/p6HUxeD4Go pic.twitter.com/TmVaF0eRcG
— ABC News (@ABC) December 29, 2021
So testing is useless as a gauge of when people are no longer infectious? That’s news to the UK and the rest of the world.
Still, it’s nice to have confirmation even at this late stage of the pandemic that “science” is just a talisman that public-health bureaucrats use to defend their policy trade-offs, which are based on a lot more than actual science. Maybe someday Fauci and Walensky will get around to explaining why the current trade-off calculus differs from the one at the start of the pandemic. It wouldn’t be hard, but as I explained above, they’re reluctant to say anything too encouraging about Omicron’s mildness. Exit question: If they’re going to encourage contagious people get back to being around others, shouldn’t they at least insist that those people wear N95 masks? Or is that another thing the feds can’t recommend in good conscience because, somehow, we don’t have enough supply of those either?