COVID Transmissions for 5-14-2021

The CDC has set us free?

May 14, 2021

Greetings from an undisclosed location in my apartment. Welcome to COVID Transmissions.

It has been 543 days since the first documented human case of COVID-19. Unit 543 of the Imperial Japanese Army was part of an inhuman effort to develop biological weapons through human experimentation.

Today we live in a world where the understanding of infectious diseases is instead used to heal and protect.

Speaking of that, today’s issue deals with the new CDC guidance.

One housekeeping note: I will be going on vacation starting next Monday. Monday and Tuesday are part of a Jewish holiday, so there will definitely be no COVID Transmissions on either of those days. I will also be on vacation the rest of the week, but will commit to writing at least one issue of this newsletter. We’ll see if I can make time for more.

Either way, have a great weekend.

Bolded terms are linked to the running newsletter glossary.

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Now, let’s talk COVID.

CDC revises guidance for mask wearing by vaccinated people

Today, the CDC announced that with limited exceptions, vaccinated people do not need to wear masks to prevent COVID-19 in most settings. I watched the press conference live personally, so I am reporting on that rather than linking to a story.

Exceptions noted in the press conference were:

In healthcare settings dependent upon each location’s policies
In transportation venues such as planes, trains, buses, and the accompanying stations and ports for the same
If the person is experiencing symptoms of, or has tested positive for, COVID-19

This is based on reliable information that we now have that vaccination is highly protective against COVID-19 and also appears to strongly limit the ability of vaccinated people to spread COVID-19, to the point where masks do not provide enough added benefit to justify their continued requirement. The other part of the puzzle here is that daily case numbers and deaths in the US have dropped sharply.

However, these daily cases and deaths have dropped to numbers that would have been considered staggering a year ago, so that represents my first point of contention with the CDC on this new statement. I’ll provide more of my opinion in a moment.

Consequently, the new guidance has led to updated graphics and information from the CDC, such as the following:

Image shows a listing of activities, and their risk level if you are vaccinated or unvaccinated (and possibly masked). All activities listed are considered safe when unmasked for the vaccinated. According to the CDC the same content is available in an accessible format at the following link: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/participate-in-activities.html

It is kind of mind-blowing to see this graphic as it currently appears. Just yesterday, the same graphic had a mask on the vaccinated person in all the indoor activities. Now those masks are gone.

One thing I want to point out in all this is that CDC makes recommendations, they do not make laws or policy—in general. When the CDC does make policy, it is generally regarding the conduct of healthcare or laboratory work, and even then that is generally only done in emergencies. What this means is that these recommendations are not the law where you live, particularly if you don’t live in the US. Still, I expect that most US localities will begin to adjust their rules to follow these CDC recommendations. I also expect that process will not happen overnight. So do check local government for current rules regarding masks and other activities to ensure you are following the law where you are.

During the presentation, Dr. Walensky, the CDC director, emphasized that these recommendations are not a policy initiative. She made clear that this is an effort to “follow the science,” and I do agree that these recommendations are supported by our current understanding of the science underlying COVID-19 and vaccination.

The problem is, science doesn’t always tell you about the human value of decisions. Science is also notoriously bad at predicting the unprecedented, and we live in truly unprecedented times. I am afraid that the change in recommendations here may amount to following the science off of a cliff. I agree with the facts on which the recommendations are based, but I think that the recommendation is naive about how people actually will behave. CDC and Health and Human Services officials noted that they believe that this will incentivize vaccination by allowing people to feel more freedom and normalcy once they become vaccinated.

What I believe that the CDC has done is provide a license to anti-vaccine individuals to stop wearing masks. There is no universal vaccine verification system in the US, and so there is no way for businesses and other institutions to check if someone is vaccinated for sure. Vaccine cards are already being forged by people out there. Verification against state databases is far from straightforward. It will be incredibly easy to lie about vaccination status as long as this stays true.

The thing that’s nice about masks is that you can see them. I know if someone is wearing a mask or not. I cannot see your immunoglobulin proteins, and you cannot see mine. You have to trust me to be honest with you. You may trust me, personally, but do you trust everyone you encounter? If the answer is yes, I might suggest revising that position. Not everyone is honest.

I believe that this recommendation will meaningfully increase the odds that everyone will find themselves in indoor settings where there are unmasked and unvaccinated individuals. This means that this recommendation increases the odds that people will get COVID-19, particularly unvaccinated people. The only reasonable way to protect yourself from this situation is to get vaccinated. Even with a mask on your own face, I do not think you are adequately protected from an unmasked, unvaccinated person with reckless attitudes about COVID-19. Such people are not limited to stereotypical areas of the US. In my own neighborhood, the Upper West Side of Manhattan, for months now, someone has been stenciling messages lie “COVID IS STILL A HOAX” onto various surfaces. Somehow I don’t think that person’s vaccinations are up to date.

So at this point, if you know someone who isn’t vaccinated, including yourself, you really need to go get your vaccination. It is no longer something you can afford to delay. The protections that have kept you safe so far are being lifted, and pretty soon, vaccines are going to be the only option you have left for safety. So go and get vaccinated.

The other thing that I wanted to mention about this policy is that I think it’s pretty concerning with regard to children. At this point, vaccination is only available to people over the age of 12 in the US. The recommendations do not consider people under this age, who may now be out in public and potentially could be exposed to unvaccinated, unmasked people. While children will be wearing their own masks, ideally, it is still possible for them to acquire COVID-19 in a setting where there are unmasked people who are not vaccinated. Perhaps the CDC is considering the fact that children are at the lowest risk, but I also think that children have the most to lose. Disabilities created by COVID-19-related injury in children affect more of a child’s life than an older person’s. Each child death robs a person of more potential quality years of living than in an older person. I do not believe that impacts on children should be dismissed in the consideration of COVID-19 protections.

I am hopeful that the risks I envision here will amount to nothing, however. The CDC is right that COVID-19 is on the decline in the US, and perhaps that trend will continue despite this change. Perhaps more people ages 12 and up will get their vaccinations, too. Perhaps we will stop this thing in its tracks. That would be great.

Still, that relies on everyone to step it up. Vaccinations have been slowing, and we need to turn that trend around. The threat is real and it is out there. The best thing you can do for yourself and for everyone, especially now, is to go get vaccinated. Tell your friends.

What am I doing to cope with the pandemic? This:

Preparing for vacation

We’re going to the Berkshires next week. I’m excited! I also have no idea what we’ll be doing there. But I guess with all the changes to CDC recommendations, there might be more options than we expected.

Carl Fink had some thoughts to share on promoting vaccination:

So ... might you want some help on that public education project from a professional instructional designer with bio grad school his past? Who reads your newsletter?
Also, the one thing you didn't include that I might is the topic of variants. Even if a young person was unlikely to get seriously ill from the original Wuhan strain, that is apparently less so for B.1.351, P.1, etc. And even furthermore, suppose someone is magically 100% certain to never get sick from any current variant. If the virus replicates in her body, she is potentially breeding new variants that can endanger everyone (aside from just plain endangering everyone she breathes on, of course).

I think this is a good point, as noted in my response:

Communications is always a work in progress and I welcome your thoughts. Good point regarding the variants; vaccination does appear to offer some degree of "future proofing" since so far the vaccines have remained effective against these variants.

You might have some questions or comments! Send them in. As several folks have figured out, you can also email me if you have a comment that you don’t want to share with the whole group.

Join the conversation, and what you say will impact what I talk about in the next issue.

Also, let me know any other thoughts you might have about the newsletter. I’d like to make sure you’re getting what you want out of this.

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