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Mask Whiplash, Anyone?

Masks are coming off by the millions even though only 37% of eligible people in the U.S. are fully vaccinated. If you think the “honor system” will work in terms of the unvaccinated wearing masks as requested by the Center for Disease Control and Prevention (CDC), you win the Optimism Award!

There are positive responses to the CDC’s recent guidance – relief that our long siege is abating and welcome freedom for the fully vaccinated. There’s also concern that the recent guidance was premature and puts large groups of people at risk: those having trouble accessing vaccines, the immunocompromised, those needing more time to make up their minds, children, and vaccinated people who don’t want to be around unmasked unvaccinated people, period. Scientists and journalists have been complaining. The public is scratching its collective head: how safe is it to do … what?

We need to look at the past in order to understand the present unease with our esteemed federal public health agencies. Very early in 2020, the CDC and the Food & Drug Administration (FDA) made a couple of horrendous mistakes. There were the contaminated Covid-19 test kits that the CDC distributed to labs around the country AFTER labs were forbidden from making their own tests (which they could have done easily and well) and after a good test from Europe was refused. An FDA official called the CDC lab “filthy”, but the FDA bore responsibility for some of the troubles as well. In addition, the CDC and the World Health Organization (WHO) both initially discouraged mask-wearing in ways that had devastating consequences.

Testing for Covid-19 was limited to almost nobody. Early on, you had to have been in certain parts of China recently and have certain symptoms. And guess what this led to? Doctors not testing their sick patients and misdiagnosing them. It happened in my family. A relative had these symptoms in late March: chest pressure with respiratory difficulty, cough, sore throat, dizziness, body aches, loss of smell and taste. Her physician decided she had a “cold”.

As late as August, the CDC’s guidelines stated that asymptomatic people, even in close contact with a person ill with Covid, “do not necessarily need a test.” It turns out many people with Covid do not show symptoms. In September, the CDC briefly posted guidance about airborne transmission – catching up to the science at last! – and then abruptly removed it, falling back on its inadequate guidance about droplet transmission, the 6-foot rule, etc. A federal official commented on the guidance that disappeared: “It was posted by mistake…. Somebody hit the button and shouldn’t have.” Two months earlier, 239 scientists had published a letter urging public health organizations to tell the world the truth about aerosol transmission. If the science had been acted upon back then, schools and businesses would have been working hard on improving ventilation systems. Lives would have been saved and we would have many fewer people suffering the agonies of long-haul Covid.

The CDC and the WHO collaborated in perpetuating the myth that fomite transmission – touching contaminated surfaces or objects and then touching our eyes, noses, or mouths – was a significant source of transmission long after the data showed otherwise. How sad that a zillion gallons of disinfectant are now polluting the world’s waterways and potentially adversely affecting the microbiomes of our and our children’s bodies. We can also worry a lot less about outdoor exposure unless we are unmasked, in close proximity, and for quite a while. There are almost no documented cases of outdoor transmission, but the CDC website says the rate is “under 10%” [of cases] when in fact the science suggests it’s perhaps .1%. It’s one thing to not know what’s what and be careful while science is sorting things out; it’s another to perpetuate an untruth when the truth is known.

Which brings me to my biggest concern about poor guidance from the CDC, which is – sad to say – unending! This month – May of 2021 – the CDC finally acknowledged that the virus is aerosolized (meaning airborne and inhalable). It can also circulate around a not well-ventilated room for a long time (so forget about the 6-foot rule and the notion of 15 minutes exposure being a meaningful threshold). That is great news, except … the CDC guidance on their website says this mode of transmission is “uncommon”. Scientific studies indicate that this kind of transmission is not only common, it’s almost certainly the most common means of transmission. Linsey Marr, an aerosol expert at Virginia Tech, says the CDC’s updated guidance is “misleading,” adding, “If you’re in a poorly ventilated environment, virus is going to build up in the air, and everyone who’s in the room is going to be exposed.”

The CDC had its back against the wall during the Trump administration, as there was tension between the guidance it wanted to give the public and what the White House wanted. The agency has I hope regained its autonomy in recent months. Politics aside, the stakes are very high. Last week it was reported that the U.S. has suffered not over 580,000 deaths, as our official count would have it, but over 900,000 deaths, given the striking load of “excess mortality” since the pandemic began.

Bad public health guidance has consequences. I am a huge admirer of the CDC and the wonderful work it has done since its creation after World War II, when its mission was to prevent malaria from spreading across our country. The agency has enormous power over what the American public does and what the states tell us and our schools and businesses to do. We need the CDC. We also need it to do better as we move into what we all hope is a freer and healthier future. Onward!

Johannes Plenio / Unsplash


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