Your comments on the confusing pictures reminds me of the way I always have to look up the laundry symbols on my clothes. I've also had to contact support for my washer and dryer (is "delicate" slower agitation or shorter agitation? Is "heavy" for heavy clothing or heavy soil? Is "easy care" hotter than "delicates"? What temp is "timed dry?") I don't want to know what some engineer guy thinks is good for my clothes, I want to know what's physically happening inside those barrels.
The other problem with the CDC graphical messaging is that it doesn't really include distancing. For the entire Covid period people losing friends and neighbors over vehement "mask AND distance" vs. "mask OR distance" arguments. (Maybe we've at least arrived at a kind of scolding fatigue and will just give it up for awhile.)
Finally, thanks for the realistic listing/prioritizing of our reasons for wearing masks. For me, protecting myself has always been #1. Since I've been so, so careful (easy when you're retired), the probability of me making someone else sick has always seemed pretty low. Now that I'll be traveling fully vaccinated, visiting kids, that probability will rise a bit. But now that I've finally got genuine, U.S. manufactured, comfortable N-95s, tightened glasses and shorter hair, mask-wearing is ironically a lot easier now.
Yes, outdoors, even when unvaccinated, Linsey Marr (really a brilliant scientist on all this) says that for her, masks OR distancing was enough. That had been my rule of thumb as well, mostly, throughout the last year. (Except of course as courtesy! I masked up when passing people). That's partly why I think this was too timid: we already were okay without masks for the most part outdoors.
Thanks for the post, Zeynep, and for the Atlantic piece which I read and enjoyed. I take your points about the communication blunders. How many categories should that CDC chart have though? Would a fair representation of your positions be:
1) vaccinated - don't worry about masks unless you want
2) unvaccinated, outdoors and distanced - don't worry about masks unless you want
3) unvaccinated, outdoors and talking closely - put a mask on
Thanks for fighting the good fight on outdoor masking!
Have you thought about when you'll start writing about goal posts for ending indoor mask mandates? This whole year, you've played such an essential role in getting conversations started before public opinion shifts in the directions needed. I'm seeing a bit more openness to recognizing that vaccines do, actually, give us our lives back amongst the left-liberals who've been most resistant to that messaging, but the ethical/democratic/social value of stranger intimacy still plays no role in these conversations.
For those of us who live in and love New York, how do we make that part of our lives again? Proof of vaccination? % vaccinated? I'll likely have to get revaccinated as the Excelsior Pass doesn't recognize my first vaccination and there's no way to correct the record, but if that's what it takes...
Hey Zeynep! Love your work and Insight! Anyway, curious if you have thoughts on how this whole outdoors mask debate might relate to those of us with small kids. I've had a couple of outdoor playdates in the past couple of days since the new guidance has been released, and everyone stayed masked up, I think in large part due to habit, but also because the guidance just doesn't seem to address *children*.
They're obviously not vaccinated, though all the adults are either fully vaxxed or nearing the 2-week-post-2nd-shot date. And my (only mildly well-informed) take on things leans towards the idea that kids aren't great social distancers, and that they'll be fairly close to each other for fairly long stretches of time during a play date, so... keep masks on?
On the other side of the coin, if even that is perhaps too cautious--if there is decent evidence to support the idea that being unmasked, outside, in close proximity but not in a 'crowd' is minimally risky--my kids and I would be delighted to have the ability to see friends' faces!
I guess I'm just frustrated along with you that the CDC guidelines are... just ok, and not as clear or forthright as they could be. And I personally think having some guidance aimed directly at families, many of whom are wondering exactly what I am, would be good!
Yeah, tough. Obviously, I really cannot give advice but part of the reason I write is this is exactly the kind of thing that public health agencies should be providing guidance on! I can only say how I think about it in terms of making my own personal decisions, which may not apply to others and other situations. I think the risk to kids is really low outdoors especially when the adults around them are vaccinated and there is little community spread. (Which is my area right now). Lots of kids seem fine with masks, so when that's the case, it's the easy way out. I see mixes of kids with masks and masks off all the time. Obviously, it is harder for younger kids. WHO does not recommend masks for kids under five. I think this is so personal, too. Before adult vaccination, the concern was about them transmitting to more vulnerable adults. Now, it's a question of the risk to the kids themselves which was already on the very low side, but of course, it's not zero. On the other hand, it's rarely zero for anything: some parents don't feel comfortable letting their kids play on monkey bars if they are too high--and sometimes kids do get hurt on these! In the end, though, the combination of outdoors plus vaccinated adults plus low community risk really is fairly close to baseline risk, so it's hard to say if there is a right or wrong answer beyond... personal comfort level.
Thanks so much for the reply! And I know you can’t offer *real* guidance but I do appreciate how you’ve been thinking about all this for the last year, so I’m glad to have your thoughts here. The final rub, for me, is the ‘low community risk’. When you say your area, is that CH? I’m over in Cary, and the NYT tracker is still screaming VERY HIGH RISK here in Wake. Which also seems kind of nuts because it’s so much lower than it was at the peak, but idk how they’re deciding what counts as high levels of community spread.
So if I can be so forward as to ask another question, where would you draw the line between low community spread and… not low? Are you looking at cases per 100k? Test positivity? Something else? Thank you so much!!!
As someone who hasn't flown in over a year, I've been hoping that by the time I'm in the airport the shoes-and-liquid security theater will have been replaced with hygiene theater. But I worry we'll just have both. (The security theater does seem to have been gradually dying down over the past decade, but the fact that it was increasing for nearly 6 years post 9/11, and didn't just instantly jump to the high point and start fading, does worry me.)
It was doubled up, both security and hygiene theater. But the airport was fairly empty so it was speedy. Who knows what it will look like after travel starts up again! Hand sanitize! Take shoes off! Put shoes back on! Hand sanitize again!
I almost got run over by a dude on a Vespa this morning. He blew through a stop sign, not paying attention at all, because he was buckling his helmet with one hand while steering with the other. But at least he had a blue surgical mask properly affixed over his nose and mouth. 🙄
Yep, definitely watch the Trevor Noah rant, but read the articles for such as "...this part of the empirical record is still evolving.." and other great takes on life as it is currently lived.
I found the Atlantic article confusing because, while it was clear that you didn't like the CDC recommendations, after reading it, I wasn't sure which recommendations you thought were wrong and what better recommendations would look like.
In particular, I thought the complaint from Linsey Marr about being unable to memorize the CDC charts to be a bit unfair. The idea isn't to memorize everything, it's to read the chart, think about which recommendations are personally relevant to you, and adjust your habits if it makes sense. This seems true of pretty much all COVID advice? How often are we memorizing things? Public health campaigns seem similar to other ad campaigns in that they depend on repetition for ideas to sink in?
Also, making things less binary would probably make them still more complex and harder to remember, if that's the goal.
I hear you, but let me offer this as response. The guidelines were also internally inconsistent. The fact-checkers at the Atlantic had so much trouble figuring out what they said (to confirm my interpretation). Why not just say: masks aren't necessary outside unless you are unvaccinated and going to be talking or yelling at close distance for a long time, but some people have personal or medical reasons to keep wearing them, so let's be respectful all around. The CDC at the same time told vaccinated people they can avoid masks indoors but they should wear masks outside in crowds. We don't even have examples of transmission outside really in crowds before the vaccines, so why now? Maybe they have a reason like the sociology of it? They think crowds are where people talk at each other at length? I'm not sure. I think giving explanations (aerosols/disperse outside/vaccines are super protective) can help get past the binary...
I see "fully vaccinated" is getting a good run. The trope will be binned, quietly, in less than 12 months when it becomes difficult to explain why it did not mean "fully protected" (in the sense of, say, measles vaccination). Who generated "fully vaccinated", anyway?
Might depends on what we'll use for " ... also got the booster " in twelve months. Currently some countries' vaccination requirements stipulate that it be within the last six months. Stay tuned.
I have found listening to comments by Rochelle Walensky extremely frustrating. We seem to have little understanding of risk in the USA and her presentations do not help. When you compare various CDC warnings re risks- for example- J and J and being vaccinated yet being told to mask indoors- I think about how much more risk we face every time we get into an automobile or someone purchases a gun.. Is this lack of understanding of risk/benefit a particularly American phenomena or is it pretty universal?
I have a lot of sympathy for her, essentially having to hit the ground running in the middle of all this after a year of mismanagement and meddling. And yes, risk misinterpretation is super common around the world. We aren't set up for this! That said, I still think we can expect them to do better, not because we don't understand how tough it is, but because the need is there and the crisis is still here. But it really is tough to communicate risk to a scared world in the middle of a pandemic.
I wonder if you have ever read "The Great Barrington Declaration," which, it seems to me, proposed sensible approaches to a nuanced (as opposed to an authoritarian sledge-hammer) to the pandemic, which wasn't, in the end, very "pan."
And then, what the heck does someone do about Florida the maverick?
I think your comparison of risk messaging between the J&J vaccine and masking is relevant. In the J&J instance, the message is "the risk is minimal, it is safe to use, just be aware". With masking, the message is a mess. We have much more experience with messaging pharmaceutical risk than what is appropriate behavior in a pandemic so maybe there is a learning curve here.
I find her presentation at least as frustrating as her statements. I'm not a "zoomer," so I have not closely studied the information on doing this right, but in a Gotomeeting hearing on a proposal before our (small) city, I saw better backgrounds, better lighting, and much better audio quality from regular citizens than I have ever seen from Walensky. (My husband and I looked pretty good ourselves, and sounded pretty good too, using the mic and camera on an aging laptop, Nobody echoed.).
Walensky looks uneasy. Yes., I grant that unease is a reasonable feeling. But is she just a nervous person or is she telling us something she doesn't believe? I can have sympathy for her too, but she needs some help with her presentation. Or she needs to be able to accept the help that she has available.
I also second Anne's observation of the understanding of risk. I liked one of the early types of pandemic recommendations, charts that showed risks in increasing order. There were probably 20 actions on the list, but it was easy to follow.That let me rank going to the grocery store, dining, haircut, etc. and decide where personal risk tolerance combinded with "Do I need this?" puts me. Now if there would just be another chart for vaccinated people, taking in to account that the pandemic is receding and not surging, that would be what I need now. You could even make two lists, one labeled masked and one labeled unmasked. That just tells me whether to take the mask when I go out because I may need it, You could convey a lot more information that way with less confusion. Instead I hear that flying is safer because the air is filtered and I hear (from some other source) that flying is not safe. That is not helpful.
I love your chart idea. I agree, the charts from early on where so much clearer than the graphic used by Walensky. Like you, I also don't zoom much but I do make the effort to have decent lighting and sound. A little effort on Walensky's part could go a long way to making her easier to watch and understand.
Your comments on the confusing pictures reminds me of the way I always have to look up the laundry symbols on my clothes. I've also had to contact support for my washer and dryer (is "delicate" slower agitation or shorter agitation? Is "heavy" for heavy clothing or heavy soil? Is "easy care" hotter than "delicates"? What temp is "timed dry?") I don't want to know what some engineer guy thinks is good for my clothes, I want to know what's physically happening inside those barrels.
The other problem with the CDC graphical messaging is that it doesn't really include distancing. For the entire Covid period people losing friends and neighbors over vehement "mask AND distance" vs. "mask OR distance" arguments. (Maybe we've at least arrived at a kind of scolding fatigue and will just give it up for awhile.)
Finally, thanks for the realistic listing/prioritizing of our reasons for wearing masks. For me, protecting myself has always been #1. Since I've been so, so careful (easy when you're retired), the probability of me making someone else sick has always seemed pretty low. Now that I'll be traveling fully vaccinated, visiting kids, that probability will rise a bit. But now that I've finally got genuine, U.S. manufactured, comfortable N-95s, tightened glasses and shorter hair, mask-wearing is ironically a lot easier now.
Yes, outdoors, even when unvaccinated, Linsey Marr (really a brilliant scientist on all this) says that for her, masks OR distancing was enough. That had been my rule of thumb as well, mostly, throughout the last year. (Except of course as courtesy! I masked up when passing people). That's partly why I think this was too timid: we already were okay without masks for the most part outdoors.
Thanks for the post, Zeynep, and for the Atlantic piece which I read and enjoyed. I take your points about the communication blunders. How many categories should that CDC chart have though? Would a fair representation of your positions be:
1) vaccinated - don't worry about masks unless you want
2) unvaccinated, outdoors and distanced - don't worry about masks unless you want
3) unvaccinated, outdoors and talking closely - put a mask on
4) unvaccinated, indoors - put a mask on
How about
4) unvaccinated, indoors - try to find an alternative, but if you must, then mask on.
Woah I just saw you on Slow Boring!
Thanks for fighting the good fight on outdoor masking!
Have you thought about when you'll start writing about goal posts for ending indoor mask mandates? This whole year, you've played such an essential role in getting conversations started before public opinion shifts in the directions needed. I'm seeing a bit more openness to recognizing that vaccines do, actually, give us our lives back amongst the left-liberals who've been most resistant to that messaging, but the ethical/democratic/social value of stranger intimacy still plays no role in these conversations.
For those of us who live in and love New York, how do we make that part of our lives again? Proof of vaccination? % vaccinated? I'll likely have to get revaccinated as the Excelsior Pass doesn't recognize my first vaccination and there's no way to correct the record, but if that's what it takes...
Thank you. Definitely on my mind, but not yet.
Hey Zeynep! Love your work and Insight! Anyway, curious if you have thoughts on how this whole outdoors mask debate might relate to those of us with small kids. I've had a couple of outdoor playdates in the past couple of days since the new guidance has been released, and everyone stayed masked up, I think in large part due to habit, but also because the guidance just doesn't seem to address *children*.
They're obviously not vaccinated, though all the adults are either fully vaxxed or nearing the 2-week-post-2nd-shot date. And my (only mildly well-informed) take on things leans towards the idea that kids aren't great social distancers, and that they'll be fairly close to each other for fairly long stretches of time during a play date, so... keep masks on?
On the other side of the coin, if even that is perhaps too cautious--if there is decent evidence to support the idea that being unmasked, outside, in close proximity but not in a 'crowd' is minimally risky--my kids and I would be delighted to have the ability to see friends' faces!
I guess I'm just frustrated along with you that the CDC guidelines are... just ok, and not as clear or forthright as they could be. And I personally think having some guidance aimed directly at families, many of whom are wondering exactly what I am, would be good!
Thanks!
Yeah, tough. Obviously, I really cannot give advice but part of the reason I write is this is exactly the kind of thing that public health agencies should be providing guidance on! I can only say how I think about it in terms of making my own personal decisions, which may not apply to others and other situations. I think the risk to kids is really low outdoors especially when the adults around them are vaccinated and there is little community spread. (Which is my area right now). Lots of kids seem fine with masks, so when that's the case, it's the easy way out. I see mixes of kids with masks and masks off all the time. Obviously, it is harder for younger kids. WHO does not recommend masks for kids under five. I think this is so personal, too. Before adult vaccination, the concern was about them transmitting to more vulnerable adults. Now, it's a question of the risk to the kids themselves which was already on the very low side, but of course, it's not zero. On the other hand, it's rarely zero for anything: some parents don't feel comfortable letting their kids play on monkey bars if they are too high--and sometimes kids do get hurt on these! In the end, though, the combination of outdoors plus vaccinated adults plus low community risk really is fairly close to baseline risk, so it's hard to say if there is a right or wrong answer beyond... personal comfort level.
Thanks so much for the reply! And I know you can’t offer *real* guidance but I do appreciate how you’ve been thinking about all this for the last year, so I’m glad to have your thoughts here. The final rub, for me, is the ‘low community risk’. When you say your area, is that CH? I’m over in Cary, and the NYT tracker is still screaming VERY HIGH RISK here in Wake. Which also seems kind of nuts because it’s so much lower than it was at the peak, but idk how they’re deciding what counts as high levels of community spread.
So if I can be so forward as to ask another question, where would you draw the line between low community spread and… not low? Are you looking at cases per 100k? Test positivity? Something else? Thank you so much!!!
I’m delighted you’re experiencing security theater at the same time as hygiene theater. Equally effective. Equally comforting to the bewildered.
As someone who hasn't flown in over a year, I've been hoping that by the time I'm in the airport the shoes-and-liquid security theater will have been replaced with hygiene theater. But I worry we'll just have both. (The security theater does seem to have been gradually dying down over the past decade, but the fact that it was increasing for nearly 6 years post 9/11, and didn't just instantly jump to the high point and start fading, does worry me.)
It was doubled up, both security and hygiene theater. But the airport was fairly empty so it was speedy. Who knows what it will look like after travel starts up again! Hand sanitize! Take shoes off! Put shoes back on! Hand sanitize again!
I almost got run over by a dude on a Vespa this morning. He blew through a stop sign, not paying attention at all, because he was buckling his helmet with one hand while steering with the other. But at least he had a blue surgical mask properly affixed over his nose and mouth. 🙄
Yep, definitely watch the Trevor Noah rant, but read the articles for such as "...this part of the empirical record is still evolving.." and other great takes on life as it is currently lived.
I found the Atlantic article confusing because, while it was clear that you didn't like the CDC recommendations, after reading it, I wasn't sure which recommendations you thought were wrong and what better recommendations would look like.
In particular, I thought the complaint from Linsey Marr about being unable to memorize the CDC charts to be a bit unfair. The idea isn't to memorize everything, it's to read the chart, think about which recommendations are personally relevant to you, and adjust your habits if it makes sense. This seems true of pretty much all COVID advice? How often are we memorizing things? Public health campaigns seem similar to other ad campaigns in that they depend on repetition for ideas to sink in?
Also, making things less binary would probably make them still more complex and harder to remember, if that's the goal.
I hear you, but let me offer this as response. The guidelines were also internally inconsistent. The fact-checkers at the Atlantic had so much trouble figuring out what they said (to confirm my interpretation). Why not just say: masks aren't necessary outside unless you are unvaccinated and going to be talking or yelling at close distance for a long time, but some people have personal or medical reasons to keep wearing them, so let's be respectful all around. The CDC at the same time told vaccinated people they can avoid masks indoors but they should wear masks outside in crowds. We don't even have examples of transmission outside really in crowds before the vaccines, so why now? Maybe they have a reason like the sociology of it? They think crowds are where people talk at each other at length? I'm not sure. I think giving explanations (aerosols/disperse outside/vaccines are super protective) can help get past the binary...
I see "fully vaccinated" is getting a good run. The trope will be binned, quietly, in less than 12 months when it becomes difficult to explain why it did not mean "fully protected" (in the sense of, say, measles vaccination). Who generated "fully vaccinated", anyway?
Might depends on what we'll use for " ... also got the booster " in twelve months. Currently some countries' vaccination requirements stipulate that it be within the last six months. Stay tuned.
What's a good alternative?
"fully vaccinated" seems as good as any succinct way to say it to me.
"good-as-yer-gonna-get"
"1dose after ≥14 days & 2dose,dose 2 after ≥14 days"
I have found listening to comments by Rochelle Walensky extremely frustrating. We seem to have little understanding of risk in the USA and her presentations do not help. When you compare various CDC warnings re risks- for example- J and J and being vaccinated yet being told to mask indoors- I think about how much more risk we face every time we get into an automobile or someone purchases a gun.. Is this lack of understanding of risk/benefit a particularly American phenomena or is it pretty universal?
I have a lot of sympathy for her, essentially having to hit the ground running in the middle of all this after a year of mismanagement and meddling. And yes, risk misinterpretation is super common around the world. We aren't set up for this! That said, I still think we can expect them to do better, not because we don't understand how tough it is, but because the need is there and the crisis is still here. But it really is tough to communicate risk to a scared world in the middle of a pandemic.
I wonder if you have ever read "The Great Barrington Declaration," which, it seems to me, proposed sensible approaches to a nuanced (as opposed to an authoritarian sledge-hammer) to the pandemic, which wasn't, in the end, very "pan."
And then, what the heck does someone do about Florida the maverick?
I think your comparison of risk messaging between the J&J vaccine and masking is relevant. In the J&J instance, the message is "the risk is minimal, it is safe to use, just be aware". With masking, the message is a mess. We have much more experience with messaging pharmaceutical risk than what is appropriate behavior in a pandemic so maybe there is a learning curve here.
I find her presentation at least as frustrating as her statements. I'm not a "zoomer," so I have not closely studied the information on doing this right, but in a Gotomeeting hearing on a proposal before our (small) city, I saw better backgrounds, better lighting, and much better audio quality from regular citizens than I have ever seen from Walensky. (My husband and I looked pretty good ourselves, and sounded pretty good too, using the mic and camera on an aging laptop, Nobody echoed.).
Walensky looks uneasy. Yes., I grant that unease is a reasonable feeling. But is she just a nervous person or is she telling us something she doesn't believe? I can have sympathy for her too, but she needs some help with her presentation. Or she needs to be able to accept the help that she has available.
I also second Anne's observation of the understanding of risk. I liked one of the early types of pandemic recommendations, charts that showed risks in increasing order. There were probably 20 actions on the list, but it was easy to follow.That let me rank going to the grocery store, dining, haircut, etc. and decide where personal risk tolerance combinded with "Do I need this?" puts me. Now if there would just be another chart for vaccinated people, taking in to account that the pandemic is receding and not surging, that would be what I need now. You could even make two lists, one labeled masked and one labeled unmasked. That just tells me whether to take the mask when I go out because I may need it, You could convey a lot more information that way with less confusion. Instead I hear that flying is safer because the air is filtered and I hear (from some other source) that flying is not safe. That is not helpful.
I love your chart idea. I agree, the charts from early on where so much clearer than the graphic used by Walensky. Like you, I also don't zoom much but I do make the effort to have decent lighting and sound. A little effort on Walensky's part could go a long way to making her easier to watch and understand.