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The summer spike in COVID-19 cases comes as an unfortunate surprise to health officials and experts who for a brief period believed the United States was largely in control of the pandemic.
“It’s low season. It shouldn’t spread that fast during the summer,” says Ali Mokdad, who tracks coronavirus trends at the Institute for Health Metrics and Evaluation at the University of Washington. Respiratory illnesses such as influenza and COVID-19 typically increase in winter, when people spend much of their time sequestered indoors.
But here in the scorching summer heat, hospitals in parts of the country are once again being taken over by COVID patients. The July 4 holiday rallies – which President Biden once hoped to mark the country’s independence from the virus – may have fueled new epidemics. Cases, hospitalizations and deaths increase after a long decline.
In mid-May, with more than a million new people getting vaccinated every day, the Centers for Disease Control and Prevention released guidelines stating that it was safe – for fully vaccinated people – to get rid of. their masks in most contexts. “You can do things that you stopped doing because of the pandemic,” CDC director Rochelle Walensky said at the time.
Now, with immunization progress stalled, a growing number of doctors and experts say the CDC ditched masking too soon. They want the national public health agency to call for masking and mitigation measures in areas that are suffering, to stop the spread of the virus.
“We need to reduce the circulation of the virus right now, so when we start the push in the winter we will be in a better position,” Mokdad said.
Healthy on science, poor on politics
The CDC’s guidelines in May were based on solid science, but led to bad policies, says Dr. Ali Khan, former head of the CDC, now at the College of Public Health at the University of Nebraska Medical Center. Vaccines protect people from serious illnesses caused by COVID-19, so it made sense to let vaccinees stop wearing masks.
“The science was strong back then,” says Khan. The CDC had expected the ad to encourage people to get vaccinated. This is the case for some, says Khan – but it also led to the de facto lifting of mask policies for unvaccinated people – just before the more transmissible delta variant began to take hold.
The summer wave, he says, is the result: “Those who didn’t want to wear a mask and didn’t want to be vaccinated are now spreading the disease to others who are not vaccinated. “
The timing of the orientation was wrong, says Jessica malaty rivera, an infectious disease epidemiologist who worked with The COVID Tracking Project.
“When the Biden administration and the CDC [said] if you are vaccinated you can take your mask off, i screamed, ”she said. “Because for so long we’ve been talking about getting to a place where transmission is low and vaccination is high. Transmission was inferior [at the time]. Vaccination was not high. So it seemed really premature. ”
The tone of the message also signaled to those vaccinated that they could exercise caution, Rivera says. “It gave people, in their minds, immunity passports,” she said, “It told them, ‘I’m vaccinated, I can go to Miami. I’m vaccinated, I can go to this basement party. ”
The message around using the lifting mask should have been more gradual, Rivera said: “You can change some of your behaviors, but don’t just be pissed off like the pandemic isn’t happening. instead of eliminating [all caution], was where we needed to go. “
Requires more masking, especially indoors
It’s not too late for the CDC to change its tone now, especially with a more transmissible virus that spreads quickly, says Dr Carlos del Rio, epidemiologist at Emory University: “In my mind it would be advisable the CDC say, given the spread of the delta variant in our country, we would recommend people to start using masks indoors again, ”especially in areas with huge spikes in cases.
“It would help if the CDC said, if your numbers hit a certain level, you should recommend masking,” he says.
Implementing indoor mask mandates for everyone, regardless of vaccination status, is “the right and scientific thing to do,” says Mokdad of the IHME. “This is the only way to send a signal to the public in the United States that we are not out of danger [while] we encourage [more] people go to get vaccinated.
Several health care organizations have recently called for universal masking, for both vaccinated and unvaccinated people, including National Nurses United, a large nursing union, and the American Academy of Pediatrics, which recently recommended it in schools. . Rivera says this policy would be safer and easier to implement than the CDC guidelines, which offer different options for people who have been vaccinated and who are not.
“Who will monitor who is vaccinated and who is not? Teachers, administrators, parents?” Rivera adds that having different rules for vaccinated and unvaccinated people “creates all kinds of issues of fairness, judgment and access.”
So far, the CDC maintains its statement that people who are vaccinated generally do not need to wear masks. “At this time, we have no plans to change our masking guidelines,” CDC spokesman Jason McDonald wrote in bold in an email to NPR.
During a White House press briefing on July 22, CDC director Rochelle Walensky described wearing a mask for vaccinated people as “a very individual choice.”
“You get exceptional levels of protection against this vaccine and you can choose to add an extra layer of protection by putting on a mask,” she said, while suggesting that local authorities in places with vaccination coverage large gaps and rising case rates are considering “additional measures.”
The public is rocked by the fact that the summer wave is largely hitting unvaccinated youth, who are more likely to survive COVID-19, Khan says. But there is a risk that the upsurge in cases will spill over to more vulnerable groups, such as the elderly and the immunocompromised.
“There are still a lot of people in these high risk groups who have not yet received the vaccine, and it is not 100% effective,” he notes; Meanwhile, cases are increasing rapidly from week to week.
Vaccinated people are always protected. But the more the virus circulates in the community, the more likely it is that people – both unvaccinated and vaccinated – will catch it.
“What you don’t want is for the disease to spread from young people to people at high risk, which would be a disaster,” Khan said.
NPR’s Allison Aubrey, Selena Simmons-Duffin and Rob Stein contributed to this report.