Ya’ll ready for this?
On Thursday, the Centers for Disease Control and Prevention (CDC) website had a new statement: “If you are fully vaccinated, you can resume activities that you did prior to the pandemic.” So assuming that you are not Deadpool or the Lone Ranger, “fully vaccinated people can resume activities without wearing a mask or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.” So starting now, get ready to see more people without face masks on and moving within six feet or one Denzel (because Denzel Washington is about six feet tall) of each other.
While some are celebrating this change, others are wondering whether the new guidelines are too unlimited, so to speak, too soon. In other words, is this a case premature relaxation?
After all, according to the New York Times, the U.S. still had over 35,000 new reported Covid-19 cases on Wednesday. Over 35,000 is nowhere close to zero unless you happen to be living in “negative 35,000” land. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is still spreading and so are more contagious variants of the virus.
Nonetheless, the CDC seems to be changing its stance for three main reasons. The first is the Covid-19 vaccine. In a White House Press Briefing, CDC Director Rochelle Walensky, MD, cited “numerous reports in the literature that demonstrate the safety and real-world effectiveness of the authorized vaccines.” After a rocky start in late 2020, as in a hit-your-head-repeatedly-with-a-rock start, the Covid-19 vaccination program has really picked up since late January with 35.8% of the total U.S. population now fully vaccinated and 46.6% having received at least one dose, according to the CDC Covid-19 Vaccine Tracker. That’s not the 75% or so needed to reach herd immunity thresholds yet. But it may already be slowing the virus.
After a surge in cases during the Winter, the number of new Covid-19 cases and resulting hospitalizations and deaths has been trending downwards. Scientists have credited the vaccination program for bringing down these numbers at least in part, although rising temperatures and humidity could be helping to some degree as well.
The second reason is the unvaccinated. Early on, Covid-19 vaccines seemed as difficult to get as toilet paper was last year. However, now the roll-out seems to have reached an inflection point with vaccination rates slowing significantly. Those not yet vaccinated include people who may not have ready access to current vaccination sites due to distance, schedule issues, and other barriers. But they also include people who are considered “vaccine hesitant,” who may be reluctant to get the vaccine for a range of reasons.
Of course, some of these folks are in the “never ever gonna get it” crowd. But some may just need a little more incentive. Telling people that once they are fully vaccinated they can continue to wear face masks and social distance may not tip the scales for these latter folks. Some people may view this like being told to eat kale so that can eat kale. Therefore, policy makers have been looking for more ways to incentivize more people to get vaccinated. After all, over 200 free Krispy Kreme doughnuts may not be incentive enough since sometimes over 300 Krispy Kreme doughnuts to change one’s mind. So perhaps the ability to drop other precautions could provide more incentive.
A third reason is people complaining about having to wear face masks and maintain social distancing. While you may not find many people saying, “face masks are so wonderful to wear, they make me feel sexy,” some people have acted as if face masks were like chastity belts on their faces, protesting and clamoring to make it stop. Plus, face masks can be a reminder that things aren’t normal.
Nevertheless, not everyone is so ready to jump back in precaution free. For example, Jenn Chávez, a radio host at Oregon Public Broadcasting tweeted the following:
And Leana Wen, MD, former Baltimore Health Commissioner, used the word “stunned” when describing the change in CDC guidance:
Note that “stunned” is not necessarily a good thing, unless you are talking about chocolate cake. Others have said that they will continue to wear face masks and practice social distancing despite the change:
All in all, “I have so many questions” seems to be the response of many after Thursday’s switch. This isn’t surprising since the change in CDC guidance does raise the following five concerns:
1. How can you tell who has really been vaccinated?
News flash: people may lie. This ain’t the United States of Truth Serum. For example, according the Greg Hodge writing for the HuffPost, 53% of people in the U.S. lie on their dating profiles. Apparently,“working in the film industry” or “working in entertainment” are among the top 10 fibs told. So for anyone who learned the hard way that “worked on the set of the movie Titanic” on a dating profile may have really meant “turned many dates into the Titanic,” it shouldn’t be too surprising that some people have actually been creating fake Covid-19 Vaccination Record Cards, as I recently covered for Forbes. Why? To lie.
Without an official Vaccine Passport system, it may be tough to distinguish the truly vaccinated from the only telling you that they’ve been vaccinated. So what’s to prevent a person who hasn’t been vaccinated acting as if he or she were vaccinated and not wearing face masks or social distancing? Relying on an Honor System requires one thing: honor. And that may not be the first word that you think of when you think about our society right now.
2. The Covid-19 vaccines do not offer perfect protection. Breakthrough infections can occur.
The Covid-19 vaccines can offer substantial protection but are not gigantic concrete full-body condoms. Such condoms don’t exist and wouldn’t be great to wear during sex. A vaccine effectiveness of 70% to 95% in protecting against more severe Covid-19 is pretty high but not 100%. Plus, it’s still not completely clear what the effectiveness may be in preventing you from being infected and spreading the virus. Breakthrough infections, which are Covid-19 coronavirus infections in those fully vaccinated, can still occur. Just look at what happened to the New York Yankees, with eight fully vaccinated players getting infected with the Covid-19 coronavirus, as described by Joshua Cohen for Forbes. This doesn’t mean that you should hide under your bed muttering, “breakthrough infections, breakthrough infections,” since they seem to be relatively rare.
3. What about Covid-19 coronavirus variants?
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has a high underlying mutation rate. If the SARS-CoV2 were running a FedEx (formerly known as Kinko’s) store, it would be a terrible place to go for a number of reasons. One is that the viruses tend to make errors when making copies. In this case, the copies are of themselves, with the mutation rate being the probability of errors in replicating their genetic material whenever copies are made. While some of these errors (otherwise known as mutations) may lead to weaker viruses, other may lead to even stronger versions or variants. Just because the Covid-19 vaccines appear to be highly effective against the versions of the virus that happen to be circulating now doesn’t mean that they will protect as well against future versions. And future variants may spread for a while before being detected.
4. All outdoors and indoors locations and activities are not the same.
“Resume activities that you did prior to the pandemic” can mean different things for different people. For some, it could be just returning to indoor sit-down restaurants with friends. For others, it may be squeezing into a packed Happy Hour with strangers, treating personal space like a toilet seat, and yelling “woooo” or “YOLO” while launching spit from their mouths like geysers. So depending on the person, “resume activities” could be like “release the hounds.”
At the same time, the configuration and ventilation of indoors locations and even some outdoor locations can vary quite substantially too. Some may have good air circulation and filtration, whereas others may be more like “you can tell that someone farted here three days ago.” Many existing studies have lumped together different locations to determine the risk of Covid-19 coronavirus transmission when in fact the risk many differ quite substantially from place to place. Would it not make sense to maintain social distancing and face mask use at least in locations that are higher risk?
5. It’s still not clear how long the Covid-19 vaccines will offer protection.
This is still an open question. It seems like the available Covid-19 vaccines can protect you for at least six months. However, since the Phase 3 clinical trials for the Pfizer/BioNTech and Moderna Covid-19 vaccines didn’t start until last July 2020, people have not been vaccinated long enough to tell whether vaccine protection may last much longer than six to eight months right now.
So is the latest CDC change early relaxation? While many are understandably eager to “return to normal” whatever that really means in the middle of a pandemic, the question is whether more gradual and more progressive relaxation of precautions would have been better. After all, Israel didn’t relax outdoor face mask mandates until over 50% of their total population was vaccinated and case rates dropped much lower. Of course, the CDC did include the caveat, “except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance,” which means that not all states and municipalities may follow the CDC’s lead.
So what should you do? Of course, every person has a different tolerance for risk. But remember it isn’t just about you. Keep in mind the above five concerns. You may want to continue social distancing and wearing face masks especially when around people whom you cannot verify are fully vaccinated. Even when among those fully vaccinated, maintain reasonable precautions. Remember that the Covid-19 coronavirus pandemic is still a public health emergency even though fewer face masks and lack of social distancing may lull you into a false sense of security. You may long for a return to normal. But that can’t truly happen until the Covid-19 coronavirus is more under control.