Post #1188: The CDC finally awakens

Posted on July 27, 2021


Refer to Post #1175, from two weeks ago, for the background.

Today, easily two weeks after risk levels clearly and obviously exceeded those on May 13, 2021, the CDC has finally awakened to the current danger.  Sort of.  It is now being reported that the CDC will modify (not withdraw) its May 13, 2021 guidance stating that vaccinated people don’t need masks or social distancing.

The changed recommendation has been phrased in terms of “high transmission” areas.  So the CDC seems to be saying that everyone should mask up in “high transmission areas”.  Only.

Assuming the CDC is using this term as it has in the past, “high transmission” areas means geographic areas that are in the middle of an outbreak.  Geographic areas that currently have high rates of new COVID-19 cases per day.

Now go back, and take a look at the charts of the states in my last post.  There’s a high rate of growth in new cases in virtually every state.  The U.S. divides rather neatly into two areas:

  • states that are currently “high transmission” areas, and
  • states that will soon be “high transmission” areas.

But the CDC guidance only applies to the states that are currently “high transmission” areas.  The guidance does not recognize that the rapid growth in new cases will soon turn the entire U.S. into a “high transmission” area.

Taken literally, as I understand it from the reporting, the revised CDC guidance has two parts:

  1.  If you’re well on your way to becoming a “high transmission” area — which I argue is true for literally the entire U.S. that isn’t already there  — then do nothing.  Just let the pandemic proceed.
  2. If you’ve already reached the “high transmission” status, then wear masks indoors.

It’s as if the CDC has absolutely nobody on staff who actually understands public health policy.  Or compound growth rates.  Or something.

Perhaps they are simply too stubborn flatly to rescind their guidance.  As they were in admitting that airborne transmission of COVID-19 is a significant vector of infection.  As they were in finally rescinding their original guidance that social distancing was adequate, and masks were unnecessary.

Within that context, this partial backtracking on their May 13 guidance is consistent with those multiple prior examples of foot-dragging.  Even though withdrawing it entirely would have made far more sense.

I don’t say that for the pleasure of shaking my finger at the CDC.  I say that to get across the message that you ought to ignore that “high transmission areas” part of the current CDC guidance.  Ignore it because it makes no sense from a public health perspective given the current rapid new-case growth rate across the U.S..  And ignore it because there’s just too high a chance that it’s there primarily for CYA, from a bureaucracy that famously has a hard time saying that its prior guidance was wrong.

One more try at that last point:  In the past, the CDC said “don’t wear masks”, and the outbreak grew, and they had to recant that.  That left them open to considerable criticism.  Recently, the CDC said “drop your masks”, and the outbreak grew even faster, and they had to recant that.  And that is surely going to open them up to more criticism.  Limiting the recommendation to “high transmission” areas makes no scientific sense, given the rapid new-case growth rate.  So please consider the possibility that, in good bureaucratic form, they have weasel-worded the recommendation to blunt criticism, and not because that’s what good public health policy would suggest.

This revised CDC guidance is somewhat helpful.  But it would have been vastly more helpful if they’d just said that everybody needs to wear masks in indoor public spaces.  And if they’d said that two weeks ago.

I’ll remind you that the case counts we see today were locked in more than two weeks ago, owing to the all the lags between infection and the final reported data.  Even if the U.S. could turn on a dime and mandate a return to masks (and maybe other COVID hygiene) today, we’d begin to see the results of that show up some time in the second week of August.  But only in the states that currently have high new-case counts, because those will be the only areas counted as “high transmission” areas.

Finally, I’m seeing a lot of talk in the news by experts who say, not to worry, hospitalization rates and mortality rates won’t be so bad because we’ve vaccinated a large share of the high-risk population.  I wish those experts would bother actually to look at the data (Post #1178) before opening their mouths.  Or bother to look at the study out of Scotland showing that the Delta variant is more virulent than the prior variants.  Near as I can tell, the hospitalization and mortality rates for this round are going to be just like the last round.  That’s what the data show so far, that’s what the Scottish study should imply.  By vaccinating a larger share of the highest-risk, we’ve merely fought the virus to a standstill regarding hospitalization and mortality rates.

And I now return to trying to get the straight facts regarding the risks faced by the fully vaccinated under the Delta variant.