We are now getting more information on what new data was behind the CDC’s revised guidance on masking the COVID era. In internal power point presentation what shared with The Washington Post and the CDC is apparently making a public presentation today. A key data point appears to be an apparent super spread event on July 4 in Provincetown, Massachusetts, suggesting a very efficient spread of COVID among vaccinated people. As you know, I have followed the emerging data very closely. There is so much conflicting data on transmissibility and even on what constitutes transmission and infection (more on this later) that it is really very difficult to know what is going on. I’d say the more you dig into the data, more confusing it gets, no less. With all that said, it is clear that Delta COVID is much more transmissible than previous versions and that the vaccines available, while still very effective, are not as effective as they seemed and probably were even a couple of months ago.
That sucks. But here we are.
But I wanted to mark another Article in the post for your attention. It’s an op-ed by Leana S. Wen, a physician and former Baltimore City Public Health Commission, who has been a prominent public voice during COVID. Wen’s argument is essentially this. Yes, there seems to be new data that vaccinated people can transmit the virus. But the vast majority of transmission is still carried out by unvaccinated people. So why are vaccinated people being asked to re-mask when they are clear that it is not the main problem?
Let me quote who …
The CDC is also trying to urge localities and businesses to reimplement indoor mask requirements due to the rise in coronavirus infections. That is the correct policy, but it uses the wrong explanation. The vaccinated are not a major source of spread. Even if every vaccinated person wears a mask, that is not going to solve things when the vast majority of transmission is from unvaccinated people.
And that’s the real problem the CDC is trying to solve: it wants the unvaccinated to wear masks indoors. Without proof of vaccination, the only way to do it reliably is to ask those vaccinated to wear our masks as well. Relying on the honor system was a huge failure, and the best way to slow down the current surge is to have everyone go back to masking.
That’s what the CDC should have announced: We need a return to indoor mask mandates not because the vaccinated are suddenly a problem, but because we don’t trust the unvaccinated to voluntarily do the right thing. This is not a comment on the effectiveness of the vaccine, or even on the cunning of the delta variant, but rather on the failure of unvaccinated Americans to fulfill their social obligation to act in the interests of everyone’s health.
I don’t know what the CDC people “want” or “want.” And I think she may be underestimating at least a little bit how much Delta is a genuinely new factor. But Wen is certainly right about what is happening here. We continue to trust those responsible to pick up the pieces of the irresponsible. We have not been able to count on those who are not vaccinated voluntarily getting vaccinated. And we cannot rely on them wearing masks to limit the impact of their irresponsibility on others. We can’t even trust them to be honest enough to adhere to a policy of masking only the unvaccinated. So we are left with a possibly too broad orientation and a continuing lack of clarity as to why all this is happening.
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As I have said for some time, the problem with our policy is that we are not doing enough to place the burden of non-vaccination directly on those who have not been voluntarily vaccinated. That is the most equitable and effective approach. However, here we can see that the effort of public authorities to solve the problem of the irresponsibility of the unvaccinated actually manages to lead them to a kind of public contempt. The science has clearly changed with the Delta variant. It is much more transmittable. But the problem remains that Delta is spreading like wildfire among the unvaccinated and is reaching the shores of the United States vaccinated.
So just as we have managed to unbalance by making the vaccinated carry the burden created by the unvaccinated, we now have public health authorities disregarding their own authority due to overly aggressive pampering of the unvaccinated. So now they are also shouldering the burden of the unvaccinated, not at the cost of daily inconvenience, but at the cost of their public authority. We all suffer from it.
We need to place the burden of non-vaccination on the unvaccinated. And we have to make it clear to the public that the problem is not related to vaccines. They are to blame. They are to blame. And even more, the influencers, celebrities and political actors who have driven resistance to vaccination are to blame.