For months, I've been criticizing the CDC for being too cautious with what vaccinated people can do.

Now, the CDC has done an about-face that's shockingly abrupt: it's confusing & could actually disincentivize vaccines.

We need an intermediate step: 🧵washingtonpost.com/opinions/2021/…
Don't get me wrong--the vaccinated are very well protected. They are safe to take off masks if they wish.

The problem is: do we trust the honor system for people to now go maskless? What about the danger to people who can't be vaccinated (i.e. kids) or the immunocompromised? /2
The CDC recommendation removes a powerful incentive. Many who were on the fence might have been motivated to get the shot because they could go back to activities they were missing, without a mask.

Now, if no one is checking, and they can do everything anyway, why bother? /3
The CDC should have had 2 intermediate steps.

1) Fully vaccinated people should have no restrictions on public activities if vaccination status can be verified. That means stores & workplaces can be at full capacity, without masks, if they check vaccination status. /4
2) They could set a level of community vaccination, at which point they can do away with verification—for example, if 70% of a community is vaccinated, everyone can take off their masks, vaccinated or not.

We're not yet. This new guidance is premature & should be clarified. /5
We’ve come a long way in #covid19, but not as far as the CDC has suddenly taken us.

The vaccinated may be well-protected, but let’s not forget our obligation to those who do not yet have immunity — & our commitment to end this pandemic once and for all. /END @PostOpinions

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More from @DrLeanaWen

30 Apr
The US is in an "in-between" place. Vaccination substantially reduces #covid19 risk but doesn't eliminate it. There isn't one right answer & people will make different choices from one another.

Here are 3 ways to think about which activities to resume🧵: washingtonpost.com/opinions/2021/…
For vaccinated people, consider three factors when deciding which activities to bring back to your lives:
1) Medical risk of your household
2) Personal risk tolerance (more on this soon)
3) Risk of specific activities
Risk tolerance is a key point. People will have wildly different interpretations of the same statistics. Some want to keep hunkering down. Others will decide that once vaccinated, they can take off their masks and return to pre-pandemic normal. Most are somewhere in between.
Read 4 tweets
29 Apr
Imagine, if at last night's #JointSession, President Biden allowed only vaccinated individuals. They could take off their masks, hug & sit together--just like 2019.

That would be the strongest message that vaccines = return to pre-pandemic normal. /1 washingtonpost.com/opinions/2021/…
Is this scientifically sound?

According to the CDC's own data, there were only 7,157 breakthrough infections among 87 million fully vaccinated people — a rate of 0.008%.

A room of 1,600 is unlikely to have anyone infected. Testing would reduce the likelihood to zero. /2
You wouldn’t know that the vaccines are so effective based on CDC guidelines.

A very damaging narrative is taking hold: If the vaccines are so effective, then why so many precautions for the fully vaccinated? What’s the point of getting inoculated if not much changes? /3
Read 6 tweets
24 Apr
I'm a physician & woman who's in the under 50 age group. I'd chosen to receive the Johnson & Johnson vaccine. If I knew then what I know now about the risk of a rare but serious blood clotting disorder, I would have chosen another vaccine. 🧵@postopinions
washingtonpost.com/opinions/2021/…
The blood clotting disorder associated with J&J, thrombosis with thrombocytopenia syndrome (TTS), is not a run-of-the-mill blood clot. Of the 15 women who had TTS, 3 died. 7 remain hospitalized, 4 in intensive care. Most were previously healthy women, median age of 37. /2
15 cases out of 8 million doses seems like a very low risk. The risk for women in the 18-49 group is higher--1 in 80,000.

This is still low, and benefits of preventing severe illness from #covid19 still far outweigh risks if the J&J is the only vaccine available. /3
Read 6 tweets
13 Apr
As a doctor and volunteer in the J&J clinical trial who received the vaccine <2 weeks ago, here's my take on the recommendation for the FDA & CDC pause for the Johnson & Johnson #covid19 #vaccine: 🧵

nytimes.com/2021/04/13/us/…
(1) This is exactly the right move. All possibly concerning safety signals should be immediately & transparently investigated.

This shows that regulatory entities are doing their job. Even something very rare (6 cases out of 7 million) will be immediately looked into.
(2) The events flagged (blood clots with low platelets) are extremely rare. Causation hasn't been established. The reason this really needs to be alerted now is for doctors who may see patients with this rare condition, to know what to look for and how to treat them.
Read 5 tweets
12 Apr
My latest @PostOpinions column is about the need for urgent attention to an epidemic that is responsible for 300,000 deaths every year: obesity.

As @Dmozaffarian told me, "the slow pandemic of #obesity has intertwined with the fast pandemic of #covid19".🧵washingtonpost.com/opinions/2021/…
Obesity is a major risk factor for diabetes, heart disease, certain cancers & worse outcomes from #covid19. With stress & food insecurity, 42% self-reported gaining weight since the pandemic, with an average addition of 29 pounds. 10% gained 50+ pounds. /2 apa.org/news/press/rel…
The experts I spoke to proposed numerous solutions, including seeing food as medicine so doctors can prescribe healthy produce for patients; changing policies around ultra-processed foods & sugary sodas; and recognizing that systemic racism is built into our food system. /3
Read 6 tweets
7 Apr
There's lots of discussion on the pros/cons of "vaccine passports".

We need to stop using this term. It's inaccurate, inflammatory & divisive.

Instead, let's describe how proof of #covid19 #vaccination can return us to normalcy @postopinions (thread):

washingtonpost.com/opinions/we-ne…
Asking for vaccination status is a kind of health screen to identify those at low risk for infecting others, not unlike symptom questionnaires or #covid19 tests.

If these aren’t seen as constraints on individual liberties, showing vaccine status shouldn't be, either. /2
In addition, individuals are increasingly asking one another whether they’ve gotten their shots. Vaccination enables activities that otherwise couldn’t occur safely.

I think it’s time for us to extend the newfound normalcy from social settings to business operations. /3
Read 9 tweets

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