The CDC's new guidance has devolved into a giant mess. It was a major blunder to cede responsibility: Effectively ending mask mandates is not just about science--it's a major policy decision that should have been made by President Biden himself.🧵
To be clear, it was appropriate for the CDC, as a scientific agency, to review the data & come out with a statement that vaccinated people are at little risk for contracting #covid19 & spreading it to others.
But they went way beyond this to basically end all indoor masking. /2
Arguably, this was the single biggest decision that the Biden team has made on #covid19, yet the president himself didn't find out about it until the morning of the announcement.
Some actions:
* Clarify that if vaccine status can't be verified, indoor mask mandates must still remain in place.
* Define region-by-region criteria for when such mandates can be lifted - i.e. when 70% of a community is vaccinated. /4
* Stop its queasiness over vaccine verification. Businesses, employers & schools are looking for leadership on how they can ensure a safe environment. The White House has already been working on minimum requirements for such credentialing; this is the time to release them. /5
* Critically, President Biden needs to own that CDC's guidance was released prematurely & without considering many consequences.
The White House must engage local/state officials, union reps, business leaders, and offer a big mea culpa for not having done so before. /6
A decision on something as overarching & consequential as ending mask mandates should have been directed from the very top. If Pres Biden does not course-correct, the existing confusion could harm Americans' health & prolong the pandemic. /END @aslavitt46@WHCOVIDResponse@WHCOS
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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 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.
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.
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.
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
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
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: 🧵
(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.
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