Masks. Again.

On July 27th the CDC issued new mask-wearing guidelines for fully vaccinated people, suggesting that even those who have received their full vaccination go back to wearing masks indoors in areas of substantial or high transmission. If you’re curious to know if you are in one of these areas, never fear, the CDC has a color-coded chart for you. In addition, the CDC is now recommending that fully vaccinated people be tested for COVID if they have been exposed to the virus and to wear a mask indoors for 14 days post-exposure. The sudden change of heart from the CDC is ostensibly in response to the rise of the Delta variant in the US and concerns that the current vaccines on the market may not offer as much protection against infection and transmission of the virus.

To be precise, the CDC’s rationale is

“Infections happen in only a small proportion of people who are fully vaccinated, even with the Delta variant. However, preliminary evidence suggests that fully vaccinated people who do become infected with the Delta variant can spread the virus to others.”

That would certainly be big, and quite troubling, news if true. The Delta variant is currently the most dominant variant in the US, and it is more contagious than Original COVID (aka the Alpha variant). There have also been cases of breakthrough infections with the Delta variant among fully vaccinated people although the symptoms seem to be mild to moderate, not remotely rising to the level unvaccinated people experience from the Alpha or Delta variants. 

Let’s circle back to that preliminary evidence — while it’s hard to pin down when the Delta variant first showed up in the US the UK has pegged it to mid-April so it’s a safe assumption it appeared in the US at the same time or very shortly thereafter. And while the Delta variant is ripping through communities at a much faster rate than the Alpha variant did, the spread is predominantly in areas where vaccinations rates are low. If we assume a mid-April introduction date in the US, that would be a three month period of both hard and empirical data to look over to see if there has been a spike in infections / hospitalizations / deaths from the Delta variant in fully vaccinated people. So far, both sets of data do not show any cause for massive alarm that vaccinated people are at risk from the Delta variant. 

What about transmission you ask? Since that seems to be the CDC’s main concern, let’s look at what it is giving us in the way of preliminary data to assess risk factors. So far, it is…less than stellar. The updated guidance seems to rely on a study based on a model based on vaccines approved for use in India that do not meet US standards (no shade, just stating facts). Add to that an anonymous administration official — take this as you will — told STAT News

“An administration official, speaking on the condition of anonymity, told STAT that health experts do not have studies proving that fully vaccinated people are transmitting the virus. Rather, the official said, the updated guidance is based on studies showing that vaccinated people who contract the Delta variant have similarly high levels of virus in their airways, which suggested that they may be infectious to others. With other variants, vaccinated people had substantially lower levels of virus in their noses and throats compared to unvaccinated people.”

Anon official included, I’ve yet to see any hard data that suggests that vaccinated people are transmitters of the Delta variant. Worse yet, I’ve not seen the CDC make any sort of rigorous case that vaccinated people should go back to using the sorts of precautions they used pre-vaccination. If data comes out that suggests otherwise I will gladly change my mind — as someone who has been living with someone who contracted COVID (no, we don’t know which variant) I can say I have no time nor inclination to deal with that bullshit. 

So what’s the real play here? I think it’s twofold — the need for the CDC to look like it’s Doing Something about the rise of the Delta variant and to also look like it’s Doing Something about unvaccinated people going around maskless. Justin Amash hit on that last issue in a pointed tweet

“The White House and CDC should be honest with us: What they really want is for unvaccinated people to mask up, but since they don’t trust them to act voluntarily, they’re demanding that everyone mask up so it’s easy to enforce. This approach is untenable.”

The fallout from this approach has already been seismic in Extremely Online-Land — vaccinated people are royally pissed that they are now being asked to mask up without any hard evidence that they should, and I agree. All COVID vaccines are approved for everyone aged 16 and up, and the FDC has updated their EUA for the Pfizer vaccine to anyone aged 12 and up. I fully understand that there are people who can’t get vaccinated right now due to underlying health issues and there are parents who aren’t comfortable with their tender age children getting vaccinated, I feel sympathy for the former and understand the latter. 

But mark my words — this about face on mask wearing by the CDC will do much more harm than good. It will harden the anger of vaccinated people toward non vaccinated people, and it has already re-introduced the conversation around vaccine passports. Not to mention it absolutely will not convince anyone to get vaccinated.

As always, our government’s messaging on vaccination completely misses the mark.