By Jessie Seigel / Washington, D.C.
In a memorable May 13 address in the Rose Garden, President Biden took off his mask. He proceeded to call it a “great day for America,” and announced the CDC’s new guidelines that people who are fully vaccinated against COVID-19 no longer need to wear masks inside or outside. Then he and Vice President Harris, who had been standing to his right, walked shoulder-to-shoulder, smiling and maskless, back into the White House.
CDC Director Rochelle Walensky amplified that message the same day, saying, “Anyone who is fully vaccinated can participate in indoor and outdoor activities, large or small, without wearing a mask or physical distancing. If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic. We have all longed for this moment when we can get back to some sense of normalcy.”
Three cheers, right? But not so fast. Though the science may be sound, there is a big problem in the information’s delivery and its possible effect on the public’s behavior.
There are many exceptions that President Biden left out of his celebratory announcement, and the media largely left out in their reporting of Walensky’s statement.
The vaccinated still need to wear masks and socially distance when going to doctors, hospitals, nursing homes, homeless shelters, prisons, on buses, trains, planes and other public transit, as well as in airports and bus stations.
Some fully vaccinated people can nevertheless get infected, so if they have symptoms they should put their masks back on and get tested.
And immunocompromised people who have been fully vaccinated should still consult with their doctors before going maskless, because the vaccine may not provide them as thorough protection as it does for others.
In fairness, President Biden’s speech constituted a well-deserved victory lap for what he has accomplished so far on the Covid front, as well as containing strong encouragement to the public to get vaccinated if you have not yet done so.
Likewise, Director Walensky’s announcement at her May 13 White House briefing did enumerate most if not all of these caveats. She justified the new remove-your-mask guidance for vaccinated people by noting three studies—one from Israel and two from the U.S.—demonstrating the Pfizer vaccine’s real-world effectiveness. The Israeli study showed Pfizer to be 97 percent effective against symptomatic Covid and 86 percent effective against asymptomatic Covid. The U.S. studies found vaccines 90 percent effective against infection, and 94 percent effective against hospitalization if infection occurs.
Walensky also said that the vaccines are effective against some variants and that, in the rare cases when a vaccinated person contracts Covid, “it is likely to have a lower viral load, be shorter in duration, and likely less risky of transmission to others.” She stated a final caution that the virus is unpredictable, so the guidance could change again based on future information.
It is doubtful that most people will run to the CDC’s website (www.cdc.gov/vaccines/fully-vaccinated-guidance.html) or hunt up video of Walensky’s May 13 White House briefing (https://www.c-span.org/video/?511739-1/cdc-eases-mask-wearing-restrictions-fully-vaccinated-individuals#) to investigate details. More likely, they will rely on the President’s statement and the media’s truncated quotes of Walensky—which add up to a sunny public relations exercise that does not provide the specific day-to-day guidance people need, and transmits the false impression that the vaccinated can do anything they want without concern. It could also unintentionally result in all Americans abandoning Covid public health measures.
Furthermore, Walensky’s stated basis for the new guidance did not take notice of the differences in virus transmission levels or community spread in different parts of the country and—given that people travel—that our behavior may need to change according to local conditions. In addition, as the Times noted, only about 36 percent of the U.S. is fully vaccinated and there is no way to tell them apart from the 64 percent who are not.
Celine Gounder, who served on Biden’s coronavirus task force during the presidential transition, immediately took issue with the CDC’s guidelines. According to the Washington Post, Gounder suggested that, rather than give blanket guidance, the CDC should connect mask-removal to evidence of low community spread and higher vaccination rates. She also argued that the new guidance should have been issued to state and local health departments, not stated as a wholesale change in health policy. Gounder expressed concern that both the vaccinated and unvaccinated are likely to stop wearing masks as societal pressure to do so lessens.
The reaction of Dr. Leana Wen, former health commissioner for the city of Baltimore, was in line with Gounder’s. Wen told the New York Times that mask recommendations should be lifted locally in regions achieving vaccination rates of 70 percent. Expressing shock at the abrupt turn-about of CDC’s announcement, she said, “We now have a free-for-all. No one is checking who is fully vaccinated. What is to stop people from doing whatever they want to do and making everyone unsafe?”
“Free-for-all” seems the right description. Although the CDC’s most current guidance was issued at the federal level, vaccinated people still must continue to abide by existing state and local regulations. State and local jurisdictions, as well as private businesses, are developing their own varying policies in reaction to the guidelines, creating a confusing mishmash of requirements.
Most Republican governors had already lifted the mask mandates to one degree or another without regard to any of the CDC’s guidelines. Massachusetts Governor Charlie Baker, a Republican exception, said that he was going to review the new guidance before adopting it.
Democratic governors are approaching the new guidelines with caution. Some are keeping portions of their mask mandates in effect, whether for indoors or outdoors. Others are waiting to reach the 70 percent vaccination mark before reopening. And some have said they want to review the guidance before adopting it.
According to WebMD Health News, some large companies like Kroger, Home Depot, Walgreens, and Macy’s are keeping mask requirements in place. Others, like Target, Costco, Starbucks, Walmart, and Trader Joe’s are reportedly easing or dropping mask requirements.
Meanwhile, the United Food and Commercial Workers, the labor union that represents more than 800,000 grocery store workers in the U.S, and Canada, criticized the CDC for failing to consider how this new policy will affect workers, who must deal with unvaccinated customers. Marc Perrone, the union’s president, said in a statement: “Millions of Americans are doing the right thing and getting vaccinated, but essential workers are still forced to play mask police for shoppers who are unvaccinated and refuse to follow local Covid safety measures. Are they now supposed to become the vaccination police?”
In addition, WebMD Health News reported the concern expressed by Lisa Labruno, Senior Executive Vice President for the Retail Industry Leaders Association. Labruno said that the CDC’s announcement “creates ambiguity for retailers because it fails to fully align with state and local orders.” She urged coordination between the CDC, state, and local governments to provide business retailers with some consistency.
Defending the CDC, a senior HHS official told Politico that the agency “just can’t win. First, they are told that they are being too careful, too cautious with masks and travel. Then, they go forward with recommending getting rid of masks for vaccinated people and they are targeted for doing too much too soon. I mean, which is it?”
This complaint inadvertently touches upon the crux of the problem. The CDC should not be framing its public pronouncements based upon either pressure to be more cautious or to be less so. Its messaging, like its work, should be based on the science.
But the Biden-CDC messaging appears to be based instead on principles found in social science—in particular, an attempt to use public relations to sell people on vaccination. The promotion of the freedom to socialize that only vaccinated people can enjoy is meant to entice others to get vaccinated. But this won’t work on anti-vaxxers and anti-maskers who already refuse to don masks and openly socialize at spreader events anyway. (The old capitalist enticements of free tickets to music festivals offered by New York City’s Mayor Bill de Blasio or the free hamburgers and French fries offered by the Shake Shack chain seem more likely to succeed.) The so-called hesitant, who may be reachable, need to be convinced by thorough information, not enticed.
The Biden Administration also appears to be trying to quiet the Trump-created partisan political divide over mask wearing by speaking oh-so-softly and carrying no stick. In heralding the CDC’s removal of the mask mandate, Biden said, “Some people may want to continue to wear a mask even if they are fully vaccinated. Let’s all be kind and respectful to one another as we come out of this pandemic and respect those who want to continue to wear a mask even if they’ve been vaccinated.” He also said, “Please treat them with kindness and respect. We’ve had too much conflict, too much bitterness, too much anger, too much politicization of this issue about wearing masks. Let’s put it to rest.”
Though President Biden had the best of intentions in making that statement, pleading in that supplicating fashion with those who oppose masks is insulting to those of us who are vaccinated—treating us as if we are nervous Nellies who should be humored and shown patience by the unvaccinated or unmasked until we get comfortable with this alleged return to normalcy. But treating our behavior as neurotic normalizes theirs. And our behavior is anything but irrational.
The CDC’s changes, updates, and sometime backtracking of guidelines does not inspire confidence. For example, a May 17 Politico article reported that CDC guidelines issued on March 8 said vaccinated people could gather indoors, maskless, with unvaccinated people from one other household. But how was that determined? Why was it limited to one other household and not two? Or none?
Three weeks later, the guidelines were revised to say that vaccinated people don’t need to wear masks indoors or out when in small groups with other vaccinated people and, in some circumstances, with unvaccinated people as well. But it does not appear that “small groups” was defined. Would this be five people? Ten? Fifteen? We are left to figure out the full meaning of CDC guidance on our own. Under these circumstances, it is not absurd for us to take mask removal slowly.
In addition, though infection of the vaccinated may be rare, and the CDC claims such cases would be mild, it does not specify what is meant by “mild.” Would it be like a cold with a bit of fever and a slight cough? Or would CDC define it as anything short of being put on a respirator? If the latter, one might still be well advised to do their utmost to avoid catching the virus, including wearing a mask around unknown people who may go about unvaccinated and unmasked.
Furthermore, since there is no established process for determining who has been vaccinated and who hasn’t, how can we be expected to trust that anyone without a mask is vaccinated? One must wonder whether the Biden Administration is shying away from instituting some form of certification for fear that the Republicans will use it to further inflame their right-wing followers, as they have already done by labeling even the idea of vaccination certificates “vaccine passports.”
In the meantime, we are left with the practical everyday quandaries of how and to what degree we still need to protect ourselves. The May 13 guidelines depend, in essence, on the honor system, on—as Walensky put it—people being honest and doing the right thing. We’ve already seen that this has not worked with anti-maskers.
In the early 1900s, Mary Mallon, an asymptomatic carrier of typhoid (yes, she is the infamous Typhoid Mary) insisted on continuing her trade as a cook, by which she was spreading the disease. New York City’s Department of Health did not rely on the honor system; they stopped her by holding her in isolation–in Mary's case, for years.
In a health emergency, depending on everyone in a large population to do the right thing on their own is a rose-colored recipe for disaster. That approach does not belong in a public health policy. Nor do public relations considerations or political pressures. The Biden Administration and the CDC need to work with states and localities to correct this serious misstep before it undermines the nation’s fragile Covid recovery.
Jessie Seigel is a fiction writer, an associate editor at the Potomac Review, a reviewer for The Washington Independent Review of Books, and a dabbler in political cartoons at Daily Kos. She has twice received an Artist’s Fellowship from the DC Commission on the Arts and Humanities for her work. But, Seigel also had a long career as a government attorney, in which she honed her analytic skills. Of this double career, Seigel would say, “I guess my right and left brains are well balanced.” More on and from Seigel can be found at The Adventurous Writer, https://www.jessieseigel.com.