I see you stayed clear of J&J Vs Pfizer/Moderna. I am sure that was by design given that the main point you are trying to make is that Vaccines work. However, wouldn’t it be good to map the breakthroughs to vaccines to maybe arrive at a booster decision sooner . I am hoping someone smarter than me already has a plan for the same!
You’ve been critical of early attempts at messaging that were intended to (for lack of a better word) manipulate people (for example, saying masks don’t work in order to preserve supplies for healthcare workers). To me this latest CDC guidance shows they’ve learned that lesson a bit. As it’s become clear how effective the vaccines are, it’s become less and less defensible to mandate masks for the vaccinated, so I think the CDC is building credibility here by saying that openly, instead of yielding to the pressure to maintain mandates that no longer make much epidemiological sense.
That's the part I agree with, but even there they are not saying it outright. The current guidance is that vaccines "reduce" transmission without qualification. That's too vague for people to make sense of. And I would be fine if they did this, but with some warning and better explanation.
I think the CDC has made their messaging problem worse. Unless the feds also were to institute a vaccine passport, the CDC's new guidelines cannot possibly be implemented. Yet, we are, IMO, stubbornly refusing to look to a reliable mechanism to prove vaccination. In contrast, for instance, to the EU.
I think part of why this feels like not a big deal to me is that I don't think enforcement (or it's lack) has been a big part of why some people wear masks and others don't (or why they are more prevalent in some places than others). And what enforcement there has been has come from workers in stores, restaurants, etc., all of which can of course continue to require masks if they want. Enforcement of the _legal_ mask mandate by police has been nonexistent here in New York (maybe it's different elsewhere?). So when people decry the new CDC guidance as relying on the honor system, to me it feels like that's where we've been all along.
But I would love to hear more about the sociology here.
I think you are right that police aren't going around arresting people for not masking. However, people who work at stores don't let people in without a mask. Now that will all change. Interesting Walensky's efforts to put the toothpaste back in the tube today. As we have been told by the CDC (including Walensky) that we mask for others as well as ourselves it is hard to know believe that she thinks that individuals can protect themselves simply by masking themselves. You are under the bus if you haven't yet been able to get a vaccine or have one of the many conditions that Walensky says today should maybe keep you masking (obesity alone, which causes immune issues, is a disease of 40% of the population)
Something the new CDC mask guidelines brought up by way of one of their exceptions, which I have seen relatively little discussion about, is mass transit.
I understand the health-care exceptions, hospitals and care facilities are full of vulnerable people, and presumably also higher densities of infectious people in their COVID wards, in the case of hospitals.
I am less clear on the mass-transit exception. From the beginning of the pandemic, I have occasionally seen articles explaining that subway cars in particular fully exchange their air in relatively short periods of time. I saw one about Boston "T" cars that I think said 90 seconds to fully exchange the air, and I have a bookmarked link to one from the Washington Metropolitan Area Transit Authority explaining that Metro cars fully refresh their air every three minutes.
This makes transit train cars seem to me similar to a well-ventilated indoor space, so the safety angle would then depend on how crowded it is, which for the Washington Metro in particular these days, is "not crowded at all".
There's all kinds of "buts" to this though.
I don't actually know if "fully refreshing air every three minutes" is impressive or not. How often does a well-ventilated building fully refresh its air? Metro cars are currently not crowded at all, but presumably there's some level of crowding that creates an infection danger greater than can be remediated by the ventilation system?
Also, there are secondary effects. While underground, metro cars exchange their air with the air in the tunnel, and the following train exchanges its air with exhaust from the leading train, so maybe air-exchange isn't a good metric at all?
I'm a fan of transit, when full-time on-site work resumes I will want to resume my metro commute, but I'm not finding a lot of hard data on transit safety vs. airborne contagion.
One interesting is the relative paucity of airplane transmission. We've had a few here and there but really few given the denominator. Planes are enclosed spaces but have excellent ventilation, so that's a clue. There are ways to measure the ventilation on mass transit, and we should probably do that. Might help with flu etc. as well.
This makes sense that the vaccine is doing precisely what it is supposed to do to protect the vaccinated Yankees, but I'm unclear what the implications are for the unvaccinated (children, hard to reach communities, etc.) and immunocompromised in light of the relaxation on masking. Let's hypothetically say the coach, who is presumed to be the the source, had gone to Costco unmasked (per the new guidelines) either right before he had symptoms or thinking he just had his seasonal allergies. Since he managed to pass on the virus to 7 others (the team members, who stomped it out due to vaccination), should we presume he would have been able to pass it on to more vulnerable citizens at Costco who would not have fared as well? Or is that the wrong way to think about it?
One answer to this could be "well that's why the unvaccinated children/immunocompromised people need to wear masks at Costco." But, we also were told (rightly?) earlier that wearing a mask, perhaps other than a professionally fitted N95 worn by a person with training, doesn't fully protect the wearer and that's why people need to wear masks to protect *others.* So in this hypothetical, if this vaccinated coach went to Costco unmasked and was contagious, are unvaccinated people wearing a not-perfectly-fitting cloth mask purchased at a retailer at risk?
I just don't think it makes sense to try to eliminate every possible risk. Young children are generally at very low risk of serious disease from contracting the virus, plus transmission is vastly reduced from vaccinated people.
The immunocompromised should wear N95s to protect themselves, but we don't need to rely on universal masking for eternity to eliminate a few transmission events from a vaccinated person to an immunocompromised person. If we did, we would never stop masking (there are other viruses out there).
That said, I do think that masking in crowded, unventilated spaces or crowded spaces where you spend a lot of time (e.g. airplane) probably makes sense to reduce spread of all types of pathogens.
I’m with you about not letting very small risks drive our decisions. I guess I’d like more explanation and evidence then that this risk is small now. We have unvaccinated people and until recently we’re hearing that there IS significant danger to them, and so this seems somewhat inconsistent or at least unclear.
I guess I also don’t really understand the urgency many people have shown to ditch masks. Sure, we shouldn’t do them if the science doesn’t support it, but also, this is a very small inconvenience compared to kids not getting to go to school, which was another setting where we had a similar “don’t let small risks drive policy” and I supported having school because it’s important. Or immunocompromised people feeling unable to shop at stores (maybe they wouldn’t have before either). People (not you, just in general) seem very insistent on being able to stop showing concern for others for very little actual benefit.
Unvaccinated adults are indeed at risk. They should get vaccinated.
Immunocompromised people will not be safe, and that sucks. But we can't keep schools & bars & restaurants closed indefinitely to protect a small sliver of the population. Unfortunately immunocompromised people should just avoid those high-risk (to them) activities.
Masks on vaccinated people has very little additional benefit, and I disagree that I should do it out of solidarity or to project my concern for immunocompromised people. I demonstrated my concern by drastically changing my life and my children's lives to avoid infection/transmission for the last 12 months and then by getting vaccinated as soon as I could. Demanding that I wearing a mask just to continue to show that concern is silly.
That said, I continue to wear a mask when indoors at work and when closer than 6 feet from strangers outdoors. I think those of us who have been careful will continue to do so. But the transition back to normal will have to happen at some point, and for vaccinated people, I think that point begins now.
But I think it’s more a matter of, I’d like infectious disease experts to actually answer questions like this to quantify and compare risks here rather than the level of detail we got from the CDC which is almost none. I’m totally open to being convinced the Costco example here isn’t a concern! But I haven’t seen much concrete.
Sorry, I really don’t understand the argument. Immunocompromised people and kids will be at risk (kids less at risk, but we tolerate less for kids - maybe still so much less we shouldn’t worry?) but then we don’t want to inconvenience ourselves a little bit to keep them protected? Just with a mask, until more than 30% or so of people are vaccinated and maybe until the rates are down more (already down a lot, that’s great)! I guess I don’t understand why “I’d rather not wear a mask” beats “immunocompromised people will genuinely be at risk now.”
But immunocompromised people are *not* at more risk now. They are at much *lower* risk, now that people are getting vaccinated. That was my major motivation to get vaccinated as early as possible. So I've taken the most effective step at protecting the vulnerable, but I also need to keep wearing a mask and pretending that I'm not vaccinated?
If experts told us that the vaccine didn't substantially reduce transmission risk and that masks had a large benefit, I'd support continue wearing masks. But the evidence so far is that the vaccine dramatically reduces the chances of infection and transmission (viral load). The evidence is stronger (and the effect size much larger) than that for cloth masks. I remain unconvinced that me wearing a mask is going to make a difference in most scenarios now that I'm vaccinated.
How do you think about the risk of a vaccinated individual with covid eventually experiencing long haul covid symptoms like persistent fatigue or brain fog? I've heard this can follow even asymptomatic infections. Is this simply very unlikely, such that it isn't worth worrying about for most vaccinated people?
We will need to wait and see, of course, and nobody can guarantee what the clinical results will be. However, a mild or even asymptomatic infection pre-vaccine is not really the same as one post-vaccine. Before, we are hit with a novel pathogen, even if we manage to keep it mild it is still something novel. After vaccination, we are hit with a pathogen that managed to replicate just a bit before getting shut down by an immune system that was familiar with it. I wouldn't be surprised if we got little to no such sequelae from post-vaccination breakthroughs that were mild or asymptomatic. As usual, one must keep epistemic humility when reasoning from principles, so we will see for sure once some more time passes. What I wrote above is what I'd personally feel if I got hit with a breakthrough case after vaccination.
I logged in to ask the same question. On the news a few nights ago I heard that the CDC either hasn't been collecting data regarding this question or hasn't publicly stated that they are. Zeynep, do you know if that is true? If so, shouldn't they be trying to find the answer to Alex's question?
The CDC has been totally non-transparent about all their advice and decisions. I can imagine a good explanation: it now estimates that the difference between the likelihood of a masked vaccinated person transmitting the disease compared to the likelihood of an unmasked person transmitting the disease is so miniscule, that the benefits do not outweigh the also miniscule costs of wearing a mask. [I assume a mask protects the mask wearer far less (essentially zero) than it protect other FROM the wearer.]
Instead, we are left wondering what kind of cost benefit analysis they did to come up with this decision like so many other questionable decisions: not promoting screening of asymptomatic people, not delaying the second shot, the J&J "pause," not approving the Astra Zeneca vaccine on the basis of UK tests and experience.
So I feel torn about masking up. I advocated masks before the CDC recommended them. I urged my friends to follow the science, mask up, and practice social distancing. I offended some family members because I refused to attend an indoor gathering while COVID was raging. Now the CDC tells me to unmask. On the one hand, I believe I should to keep my messaging consistent. On the other hand, I live in an area where vaccination resistance is really high. I am fine with unmasking outdoors. I feel uncomfortable unmasking indoors. I also do not feel like going to a large family gathering indoors where most of the people are not vaccinated. I want to demonstrate that I trust the vaccine, and I want to follow the science. What is the science here?
Seems reasonable to continue to avoid the unvaccinated, especially when that is fairly easy to do (it's not easy when they're family). The vaccine is effective, but that doesn't mean we should push the limit. Seatbelts and airbags are effective, but we shouldn't knowingly swerve into oncoming traffic.
I am concerned that this sudden change of CDC policy 1- is unenforceable as we have no vaccine passports ; 2- occurred w/o much apparent consultation/notification of states, unions, industry, etc; 3- was done in such a sudden manner that states, businesses, etc had no time to prepare 4- could well end up backfiring in that people who never really wanted to get the vaccines but were thinking about it will now feel it unnecessary; 5- could result in our downward curve to start going up again.
In such an incautious sudden policy change, if it turns out to have been a mistake, how can the CDC recover from it? In terms of both its credibility and also in terms of new, more cautious guidance?
This is a great vaccine but I fear that this new policy will backfire- on the CDC and all of us.
Wait, I missed the basic argument for the CDC to continue recommending masking? That there are some demographics that somehow can't find a vaccine despite doses being free and easily available at several locations in most towns? Doesn't seem like reason enough to ask everyone to perform the charade of wearing a mask when the chance they will contract and/or transmit the virus is very small.
Or is it that anti-vaxxers will also feel more free to remove their masks? I honestly don't know how many anti-vaxxers were masking to begin with, and I have no idea what messaging is best to reach them. I don't think the CDC knows, either. I think they've chosen the reasonable path of just telling the truth and offering reasonable guidance. If unvaccinated people chose not to follow the guidance and also unmask, is that a problem with the guidance or a problem with those people?
I think the reason the announcement was abrupt is that the CDC messed up the first announcement. They shouldn't have made it so complicated and made vaccination seem useless. They realized they were overly conservative and reversed course.
But why do the vaxed need a mask? Even if they are around the unvaxed, what risk do they face? Maybe they shouldn't be in a mixed choir, but otherwise?
And about vaxing kids: the way I read it, the mortality risk to an unvaxed healthy child is less than that of a vaxed senior. Shouldn't we be sending those doses to places with lots of unvaxed seniors?
Just out of curiosity. Are the drug companies still following the original participants of the drug trials? I hope so as one of the unknowns is how long the vaccine will remain effective. At what point might it be determined that an additional booster is needed? What recommendations does the CDC have for fully vaccinated people who get COVID? Get a booster? Do nothing? Go hang gliding? We still have a little over 40,000 new cases each day. What do we know about those new cases? What are the demographics? If you have been vaccinated but are living in a hot spot, do the new recommendations still apply?
This morning, as I go about normal errands, I see that there remains a lot of confusion about what’s acceptable and what’s not. Many people, inside and out, continue masking. Not sure what’s peer pressure or force of habit, and what’s inability to tell if “this is an OK place.”
I’m going masked if for no other reason than not to stand out. State-level guidance is definitely well behind the CDC.
Yeah. We probably should not test vaccinated people this aggressively, because it will definitely lead to a selection bias as well—we will find more positives among them.
Worth noting as of May 2021 the CDC has changed how it counts breakthrough cases.
"At the start of May, the CDC shifted from monitoring all reported breakthroughs to only those that result in hospitalization or death, Tom Clark, head of the vaccine evaluation unit for the CDC’s vaccine task force, said in an interview. The goal of the new strategy, according to the agency: maximize the quality of data collected on cases."
This Bloomberg article highlights the debate around this:
Hmm maybe the CDC will still tally breakthrough cases that aren't severe, just not "monitor" them?
I remember reading the CDC would change the way it counts and reports breakthrough cases but this Bloomberg article doesn't make it clear if only severe breakthrough cases will be counted or all breakthrough cases will be.
I see you stayed clear of J&J Vs Pfizer/Moderna. I am sure that was by design given that the main point you are trying to make is that Vaccines work. However, wouldn’t it be good to map the breakthroughs to vaccines to maybe arrive at a booster decision sooner . I am hoping someone smarter than me already has a plan for the same!
You’ve been critical of early attempts at messaging that were intended to (for lack of a better word) manipulate people (for example, saying masks don’t work in order to preserve supplies for healthcare workers). To me this latest CDC guidance shows they’ve learned that lesson a bit. As it’s become clear how effective the vaccines are, it’s become less and less defensible to mandate masks for the vaccinated, so I think the CDC is building credibility here by saying that openly, instead of yielding to the pressure to maintain mandates that no longer make much epidemiological sense.
That's the part I agree with, but even there they are not saying it outright. The current guidance is that vaccines "reduce" transmission without qualification. That's too vague for people to make sense of. And I would be fine if they did this, but with some warning and better explanation.
I think the CDC has made their messaging problem worse. Unless the feds also were to institute a vaccine passport, the CDC's new guidelines cannot possibly be implemented. Yet, we are, IMO, stubbornly refusing to look to a reliable mechanism to prove vaccination. In contrast, for instance, to the EU.
I think part of why this feels like not a big deal to me is that I don't think enforcement (or it's lack) has been a big part of why some people wear masks and others don't (or why they are more prevalent in some places than others). And what enforcement there has been has come from workers in stores, restaurants, etc., all of which can of course continue to require masks if they want. Enforcement of the _legal_ mask mandate by police has been nonexistent here in New York (maybe it's different elsewhere?). So when people decry the new CDC guidance as relying on the honor system, to me it feels like that's where we've been all along.
But I would love to hear more about the sociology here.
I think you are right that police aren't going around arresting people for not masking. However, people who work at stores don't let people in without a mask. Now that will all change. Interesting Walensky's efforts to put the toothpaste back in the tube today. As we have been told by the CDC (including Walensky) that we mask for others as well as ourselves it is hard to know believe that she thinks that individuals can protect themselves simply by masking themselves. You are under the bus if you haven't yet been able to get a vaccine or have one of the many conditions that Walensky says today should maybe keep you masking (obesity alone, which causes immune issues, is a disease of 40% of the population)
Something the new CDC mask guidelines brought up by way of one of their exceptions, which I have seen relatively little discussion about, is mass transit.
I understand the health-care exceptions, hospitals and care facilities are full of vulnerable people, and presumably also higher densities of infectious people in their COVID wards, in the case of hospitals.
I am less clear on the mass-transit exception. From the beginning of the pandemic, I have occasionally seen articles explaining that subway cars in particular fully exchange their air in relatively short periods of time. I saw one about Boston "T" cars that I think said 90 seconds to fully exchange the air, and I have a bookmarked link to one from the Washington Metropolitan Area Transit Authority explaining that Metro cars fully refresh their air every three minutes.
(Link:https://twitter.com/wmata/status/1393291680896458757)
This makes transit train cars seem to me similar to a well-ventilated indoor space, so the safety angle would then depend on how crowded it is, which for the Washington Metro in particular these days, is "not crowded at all".
There's all kinds of "buts" to this though.
I don't actually know if "fully refreshing air every three minutes" is impressive or not. How often does a well-ventilated building fully refresh its air? Metro cars are currently not crowded at all, but presumably there's some level of crowding that creates an infection danger greater than can be remediated by the ventilation system?
Also, there are secondary effects. While underground, metro cars exchange their air with the air in the tunnel, and the following train exchanges its air with exhaust from the leading train, so maybe air-exchange isn't a good metric at all?
I'm a fan of transit, when full-time on-site work resumes I will want to resume my metro commute, but I'm not finding a lot of hard data on transit safety vs. airborne contagion.
One interesting is the relative paucity of airplane transmission. We've had a few here and there but really few given the denominator. Planes are enclosed spaces but have excellent ventilation, so that's a clue. There are ways to measure the ventilation on mass transit, and we should probably do that. Might help with flu etc. as well.
This makes sense that the vaccine is doing precisely what it is supposed to do to protect the vaccinated Yankees, but I'm unclear what the implications are for the unvaccinated (children, hard to reach communities, etc.) and immunocompromised in light of the relaxation on masking. Let's hypothetically say the coach, who is presumed to be the the source, had gone to Costco unmasked (per the new guidelines) either right before he had symptoms or thinking he just had his seasonal allergies. Since he managed to pass on the virus to 7 others (the team members, who stomped it out due to vaccination), should we presume he would have been able to pass it on to more vulnerable citizens at Costco who would not have fared as well? Or is that the wrong way to think about it?
One answer to this could be "well that's why the unvaccinated children/immunocompromised people need to wear masks at Costco." But, we also were told (rightly?) earlier that wearing a mask, perhaps other than a professionally fitted N95 worn by a person with training, doesn't fully protect the wearer and that's why people need to wear masks to protect *others.* So in this hypothetical, if this vaccinated coach went to Costco unmasked and was contagious, are unvaccinated people wearing a not-perfectly-fitting cloth mask purchased at a retailer at risk?
I just don't think it makes sense to try to eliminate every possible risk. Young children are generally at very low risk of serious disease from contracting the virus, plus transmission is vastly reduced from vaccinated people.
The immunocompromised should wear N95s to protect themselves, but we don't need to rely on universal masking for eternity to eliminate a few transmission events from a vaccinated person to an immunocompromised person. If we did, we would never stop masking (there are other viruses out there).
That said, I do think that masking in crowded, unventilated spaces or crowded spaces where you spend a lot of time (e.g. airplane) probably makes sense to reduce spread of all types of pathogens.
I’m with you about not letting very small risks drive our decisions. I guess I’d like more explanation and evidence then that this risk is small now. We have unvaccinated people and until recently we’re hearing that there IS significant danger to them, and so this seems somewhat inconsistent or at least unclear.
I guess I also don’t really understand the urgency many people have shown to ditch masks. Sure, we shouldn’t do them if the science doesn’t support it, but also, this is a very small inconvenience compared to kids not getting to go to school, which was another setting where we had a similar “don’t let small risks drive policy” and I supported having school because it’s important. Or immunocompromised people feeling unable to shop at stores (maybe they wouldn’t have before either). People (not you, just in general) seem very insistent on being able to stop showing concern for others for very little actual benefit.
Unvaccinated adults are indeed at risk. They should get vaccinated.
Immunocompromised people will not be safe, and that sucks. But we can't keep schools & bars & restaurants closed indefinitely to protect a small sliver of the population. Unfortunately immunocompromised people should just avoid those high-risk (to them) activities.
Masks on vaccinated people has very little additional benefit, and I disagree that I should do it out of solidarity or to project my concern for immunocompromised people. I demonstrated my concern by drastically changing my life and my children's lives to avoid infection/transmission for the last 12 months and then by getting vaccinated as soon as I could. Demanding that I wearing a mask just to continue to show that concern is silly.
That said, I continue to wear a mask when indoors at work and when closer than 6 feet from strangers outdoors. I think those of us who have been careful will continue to do so. But the transition back to normal will have to happen at some point, and for vaccinated people, I think that point begins now.
But I think it’s more a matter of, I’d like infectious disease experts to actually answer questions like this to quantify and compare risks here rather than the level of detail we got from the CDC which is almost none. I’m totally open to being convinced the Costco example here isn’t a concern! But I haven’t seen much concrete.
Sorry, I really don’t understand the argument. Immunocompromised people and kids will be at risk (kids less at risk, but we tolerate less for kids - maybe still so much less we shouldn’t worry?) but then we don’t want to inconvenience ourselves a little bit to keep them protected? Just with a mask, until more than 30% or so of people are vaccinated and maybe until the rates are down more (already down a lot, that’s great)! I guess I don’t understand why “I’d rather not wear a mask” beats “immunocompromised people will genuinely be at risk now.”
But immunocompromised people are *not* at more risk now. They are at much *lower* risk, now that people are getting vaccinated. That was my major motivation to get vaccinated as early as possible. So I've taken the most effective step at protecting the vulnerable, but I also need to keep wearing a mask and pretending that I'm not vaccinated?
If experts told us that the vaccine didn't substantially reduce transmission risk and that masks had a large benefit, I'd support continue wearing masks. But the evidence so far is that the vaccine dramatically reduces the chances of infection and transmission (viral load). The evidence is stronger (and the effect size much larger) than that for cloth masks. I remain unconvinced that me wearing a mask is going to make a difference in most scenarios now that I'm vaccinated.
But I take your point, and will not flaunt my unmasked face in other people's personal space just for the sake of it.
Hi Zeynep, thanks as always for a great article.
How do you think about the risk of a vaccinated individual with covid eventually experiencing long haul covid symptoms like persistent fatigue or brain fog? I've heard this can follow even asymptomatic infections. Is this simply very unlikely, such that it isn't worth worrying about for most vaccinated people?
We will need to wait and see, of course, and nobody can guarantee what the clinical results will be. However, a mild or even asymptomatic infection pre-vaccine is not really the same as one post-vaccine. Before, we are hit with a novel pathogen, even if we manage to keep it mild it is still something novel. After vaccination, we are hit with a pathogen that managed to replicate just a bit before getting shut down by an immune system that was familiar with it. I wouldn't be surprised if we got little to no such sequelae from post-vaccination breakthroughs that were mild or asymptomatic. As usual, one must keep epistemic humility when reasoning from principles, so we will see for sure once some more time passes. What I wrote above is what I'd personally feel if I got hit with a breakthrough case after vaccination.
I logged in to ask the same question. On the news a few nights ago I heard that the CDC either hasn't been collecting data regarding this question or hasn't publicly stated that they are. Zeynep, do you know if that is true? If so, shouldn't they be trying to find the answer to Alex's question?
The CDC has been totally non-transparent about all their advice and decisions. I can imagine a good explanation: it now estimates that the difference between the likelihood of a masked vaccinated person transmitting the disease compared to the likelihood of an unmasked person transmitting the disease is so miniscule, that the benefits do not outweigh the also miniscule costs of wearing a mask. [I assume a mask protects the mask wearer far less (essentially zero) than it protect other FROM the wearer.]
Instead, we are left wondering what kind of cost benefit analysis they did to come up with this decision like so many other questionable decisions: not promoting screening of asymptomatic people, not delaying the second shot, the J&J "pause," not approving the Astra Zeneca vaccine on the basis of UK tests and experience.
So I feel torn about masking up. I advocated masks before the CDC recommended them. I urged my friends to follow the science, mask up, and practice social distancing. I offended some family members because I refused to attend an indoor gathering while COVID was raging. Now the CDC tells me to unmask. On the one hand, I believe I should to keep my messaging consistent. On the other hand, I live in an area where vaccination resistance is really high. I am fine with unmasking outdoors. I feel uncomfortable unmasking indoors. I also do not feel like going to a large family gathering indoors where most of the people are not vaccinated. I want to demonstrate that I trust the vaccine, and I want to follow the science. What is the science here?
Seems reasonable to continue to avoid the unvaccinated, especially when that is fairly easy to do (it's not easy when they're family). The vaccine is effective, but that doesn't mean we should push the limit. Seatbelts and airbags are effective, but we shouldn't knowingly swerve into oncoming traffic.
I am concerned that this sudden change of CDC policy 1- is unenforceable as we have no vaccine passports ; 2- occurred w/o much apparent consultation/notification of states, unions, industry, etc; 3- was done in such a sudden manner that states, businesses, etc had no time to prepare 4- could well end up backfiring in that people who never really wanted to get the vaccines but were thinking about it will now feel it unnecessary; 5- could result in our downward curve to start going up again.
In such an incautious sudden policy change, if it turns out to have been a mistake, how can the CDC recover from it? In terms of both its credibility and also in terms of new, more cautious guidance?
This is a great vaccine but I fear that this new policy will backfire- on the CDC and all of us.
Wait, I missed the basic argument for the CDC to continue recommending masking? That there are some demographics that somehow can't find a vaccine despite doses being free and easily available at several locations in most towns? Doesn't seem like reason enough to ask everyone to perform the charade of wearing a mask when the chance they will contract and/or transmit the virus is very small.
Or is it that anti-vaxxers will also feel more free to remove their masks? I honestly don't know how many anti-vaxxers were masking to begin with, and I have no idea what messaging is best to reach them. I don't think the CDC knows, either. I think they've chosen the reasonable path of just telling the truth and offering reasonable guidance. If unvaccinated people chose not to follow the guidance and also unmask, is that a problem with the guidance or a problem with those people?
I think the reason the announcement was abrupt is that the CDC messed up the first announcement. They shouldn't have made it so complicated and made vaccination seem useless. They realized they were overly conservative and reversed course.
But why do the vaxed need a mask? Even if they are around the unvaxed, what risk do they face? Maybe they shouldn't be in a mixed choir, but otherwise?
And about vaxing kids: the way I read it, the mortality risk to an unvaxed healthy child is less than that of a vaxed senior. Shouldn't we be sending those doses to places with lots of unvaxed seniors?
Just out of curiosity. Are the drug companies still following the original participants of the drug trials? I hope so as one of the unknowns is how long the vaccine will remain effective. At what point might it be determined that an additional booster is needed? What recommendations does the CDC have for fully vaccinated people who get COVID? Get a booster? Do nothing? Go hang gliding? We still have a little over 40,000 new cases each day. What do we know about those new cases? What are the demographics? If you have been vaccinated but are living in a hot spot, do the new recommendations still apply?
This morning, as I go about normal errands, I see that there remains a lot of confusion about what’s acceptable and what’s not. Many people, inside and out, continue masking. Not sure what’s peer pressure or force of habit, and what’s inability to tell if “this is an OK place.”
I’m going masked if for no other reason than not to stand out. State-level guidance is definitely well behind the CDC.
The Yankees also got the J and J vaccine, and predictably many see this as “evidence” the shot is less effective.
Yeah. We probably should not test vaccinated people this aggressively, because it will definitely lead to a selection bias as well—we will find more positives among them.
Worth noting as of May 2021 the CDC has changed how it counts breakthrough cases.
"At the start of May, the CDC shifted from monitoring all reported breakthroughs to only those that result in hospitalization or death, Tom Clark, head of the vaccine evaluation unit for the CDC’s vaccine task force, said in an interview. The goal of the new strategy, according to the agency: maximize the quality of data collected on cases."
This Bloomberg article highlights the debate around this:
https://www.bloomberg.com/news/articles/2021-05-09/cdc-limits-reviews-of-vaccinated-but-infected-spurring-concerns
Hmm maybe the CDC will still tally breakthrough cases that aren't severe, just not "monitor" them?
I remember reading the CDC would change the way it counts and reports breakthrough cases but this Bloomberg article doesn't make it clear if only severe breakthrough cases will be counted or all breakthrough cases will be.