A man wearing a mask to protect him from the coronavirus rides a bike through Times Square in New York City. New York, NY – April 20, 2020 (Shutterstock)
By David Leonhardt, NY Times
The Centers for Disease Control and Prevention is finally catching up to the science.
For months, research about Covid-19 has pointed to two encouraging patterns. First, the underlying virus that causes Covid rarely spreads outdoors. Second — and even more important — fully vaccinated people are at virtually no risk of serious disease and only a minuscule risk of spreading the virus to others.
But the C.D.C., which has long been a cautious agency, has been unwilling to highlight these facts. It has instead focused on tiny risks — risks that are smaller than those from, say, taking a car trip. The C.D.C.’s intricate list of recommended Covid behavior has baffled many Americans and frightened others, making the guidance less helpful than it might have been.
Yesterday, the agency effectively acknowledged it had fallen behind the scientific evidence: Even though that evidence has not changed in months, the C.D.C. overhauled its guidelines. It said fully vaccinated people could stop wearing masks in most settings, including crowded indoor gatherings.
The change sends a message: Vaccination means the end of the Covid crisis, for individuals and ultimately for society.
If you’re vaccinated, you can safely get together with family and friends, mask-free. You can nuzzle your grandparents or your grandchildren. You can eat in restaurants, go to the movies and attend religious services. You can travel. If you’re vaccinated, Covid joins a long list of small risks that we have long accepted without upending our lives, like riding in a car, taking a swim or exposing ourselves to the common cold.
‘Evidence-based’ and ‘bold’
The announcement also sends a message to the unvaccinated (who, the C.D.C. emphasized, should continue wearing masks in most settings): Life is starting to return to normal, and a vaccine shot is your best protection against a deadly virus. It is also the best way to protect your community and the rest of the world. And the long vaccine waits and difficult sign-up procedures are disappearing in most places.
Some experts praised the announcement. “Good move for the C.D.C. and our country,” Dr. Howard Forman, a Yale School of Medicine professor and former Senate staff member, wrote on Twitter. “They must stop making perfect the enemy of very good. And this is a step in that direction.”
Dr. Uché Blackstock, the C.E.O. of Advancing Health Equity, wrote: “I’m ecstatic about this news! It’s evidence-based and it’s bold. I hope that the updated guidelines incentivize more people to get vaccinated.”
Other experts worried that encouraging vaccinated people not to wear masks might cause unvaccinated people to shed them too — the so-called slippery-slope argument. It is a common concern whenever health authorities lift behavior restrictions. But history suggests it is often overblown. An absolutist message often fails, Julia Marcus of Harvard Medical School has noted, especially when it urges people to take steps that do not actually protect them.
I spoke yesterday afternoon with Senator Susan Collins — the Maine Republican who criticized the C.D.C. during a hearing this week for not hewing to the data — and she argued that the change would lead to safer behavior. “This really matters because if people don’t have confidence in the C.D.C. guidance, if they believe it is driven more by politics than science, then they are likely to disregard the C.D.C. guidelines that we should be following,” Collins said.
Not zero, but normalcy
In the months ahead, the Covid risks will not fall to zero, and it is important to remember that. But zero is not a realistic goal, and the freezing of normal life has brought big costs of its own: children who are not learning; parents who cannot return to the work force; businesses that cannot rehire their workers; and millions of people who miss everyday forms of human companionship.
When Covid was raging out of control, these costs were nonetheless smaller than the alternative. With vaccines widely available, that’s no longer the case.
The C.D.C. has not fully shed its caution. It has not withdrawn its exaggeration of outdoor risks for the unvaccinated. And yesterday’s guidance continues to direct vaccinated people to wear masks and remain physically distant in some circumstances.
Some of those exceptions — like nursing homes, hospitals, homeless shelters and prisons — probably make sense. Many people in these settings are vulnerable, and masks can continue to provide protection, from both small Covid risks and other contagious diseases.
The rationale for other exceptions — like airplanes and public transportation, as well as airports and other travel hubs — is less clear, and the C.D.C. did not offer a public explanation for why vaccinated people need a mask on a bus but not in a bar.
But given the unique role that travel has played in spreading the virus, a little extra caution is not beyond comprehension. It will not last forever, either. Yesterday’s about-face showed that while the C.D.C. may be slow, officials there take their mission seriously and do not enjoy being out of step with science.
“This is a watershed moment in the pandemic,” Dr. Lucy McBride, an internist, wrote on Twitter. “Next up: unmasking kids outdoors. Please, C.D.C.??”