Feeling more and more invisible as an immunocompromised person. I know that most people in this country are unwilling to endure the “terrible sacrifice” of wearing masks to keep us alive. But it gets pretty depressing when public health gives up on us, too.
I hoped the pandemic would make everyone (including employers) take illness a little more seriously and take the precautions they can reasonably take to avoid spreading it. Whenever I read that deaths are not as high as they once were, I can't help but think that's because we've killed off most of the vulnerable people already. The vulnerable who have avoided COVID have to continue to isolate further as the public takes it less and less seriously, or else finally become one of those excess deaths.
I said early on Sweden could have a great economy since they allowed all the weak vulnerable and chronically ill to die from Covid. Joking.. not joking.
Yes, the reason hospitalization/death has “decoupled” from infection is because many of the most vulnerable have already died. This decoupling has little (and maybe nothing) to do with vaccines and boosters.
Is there actually scientific consensus on that statement? Or is it more to do with reaching a certain level of population immunity between vaccines and infections? Or because the later mutations of the virus aren't as deadly as the earlier incarnations? I'd like to see evidence that the decoupling is primarily because of survivorship bias, or whatever the proper term is.
I've been asking this question for a while and hoping an epidemiologist would try to come up with an answer. As I mentioned in another comment, from the rough numbers the potential for survivorship heavily skewing the numbers is high.
Indeed. I was very ill when I got Covid for the first time last August. In bed 3 weeks and almost hospitalized. Every symptom except…fever. Immunocompromised like us can shed active virus for much longer than others, help create variants, etc. So not only are we at higher risk, we could contribute to community risk by not being allowed time to truly recover. I will be making a strong public comment when that opens up, but I feel pretty defeated.
The regional variations are mind-boggling. Here in Boston masks are required for staff in all patient care areas right now, and at Dana Farber Cancer Institute they continue universal masking.
Sadly the radiation/ oncology office I visit with my elderly father almost daily on eastern Long Island has no mask community care. In a cancer center?? I’ll never understand.
there's no evidence that masks reduce transmission of respiratory virus. Masks are also very uncomfortable to wear and impede communication. Now you understand. I was treated for Hodgkin's Lymphoma in the 90s at a top cancer center. I never saw a mask anywhere.
There is evidence that masking reduces transmission of Covid. The only reason more healthcare workers didn’t die in the early days of covid is because we masked.
Definitely not happening in Northeastern Ohio. I don’t care about masking in general, but I do think medical facilities should require them during the winter months.
While the NYC hospitals are requiring it, I was just at a major one in Manhattan on Wednesday and most staff were NOT wearing them. Nor were the visitors.
Depressing is definitely the operative word here. My wife is immunocompromised, but even before that, while in good apparent health, the selfishness and willful ignorance of the masses had been so disheartening.
But…then why aren’t medical establishments requiring them? You would think their goal would be keeping people alive? I went to urgent care last weekend. Only one in a mask. I had an appointment in an oncology clinic. Only one in a mask. Not a medical professional to be seen with a mask on.
Masks cost money. In California there's a huge fight between the nurses union and their employers because the employers don't want to have to pay for PPE.
I’m a nurse, and I always masked after Covid came, even before I was immunocompromised. I had heavy heavy exposure and wasn’t infected until last August when I didn’t even work in the hospital anymore. And I was pcr tested regularly because we had so many outbreaks. I had an unmasked visit with my mom who tested positive the next day. And there it was. I was never lax again with masking and not infected again. Just a coincidence I guess.
I'm sorry to hear your mom got sick. From your story, it's unclear whether you ever had covid, especially during your unmasked visit with your mom.
Were you the only person your mom was exposed to? If she "tested positive the next day," I think it's unlikely you were the one who infected her. Usually it takes at least 2 days or more. Also, if she had never been infected before, she had zero natural immunity and was velcro for the virus meaning unless she was sitting at home alone with zero exposure to the outside world, she could have gotten the virus from anywhere.
But would the CDC ever tell us "oops, masks really don't help much" (even if they knew/suspected it were true) after all the mask and vaccine mandates? Never.
But they should because people are living with all these misconceptions, such as "people who don't wear masks are increasing my risk of hospitalization and death, so now I need to stay home all the time."
300 people dying per day is about the equivalent of three 737 Max aircrafts crashing every two days. As a society, we would never tolerate that. And that doesn't consider Long Covid. The large majority are preventable by vaccination and simple mitigation measures. Except that the politics of division are preempting public health. How many deaths will a politician accept in order to not mask, not isolate, and/or get elected? This is incomprehensible to me. Despicable.
The Centers for Disease CONTROL should stay true to the mission embedded in their name. Bending the knee to politics, and whatever group fictional narrative we’ve arrived at that keeps killing 2,000 Americans a week and giving many more long Covid, is an abdication of duty and moral courage.
At the very least, present honest estimates of the personal, economic, and public health costs of presenteeism when we are sick versus reasonable absenteeism to heal and protect.
The couch, a cozy bathrobe, and Netflix should compassionately await.
I stopped listening to the CDC when they stopped talking about precautions and mitigations. And when 200 members of the CDC Epidemic Intelligence Service got Covid at a CDC conference. The messaging has been abysmal and will remain that way because they don't want Covid to be an issue anymore. Most people have stopped doing anything to mitigate spread. At this point people won't do it if it's the least bit inconvenient to them 'getting back to normal'. No one seems to care that they don't have a right to spread a potentially deadly disease to others. People are still complaining about lockdows that lasted a few months, 4 years ago. When we keep seeing data that shows that 70% of household spread started with a child and then we don't do anything to protect kids in school, we have failed. And we keep failing because of bad public messaging. I never thought I'd view the CDC as illegitimate and useless, but here we are. We have failed at public health and safety. We are failing the younger generations by ensuring they will be generations of brain damaged and permanently disabled people. I'm so tired of being a hostage in my own home. As a caregiver, I didn't have much of a life before Covid, but I have no life now and haven't for years. I no longer see a future where I will ever be comfortable in public spaces again. And PTSD makes masking for more than an hour and a half impossible as it triggers panic attacks, still, after 4 years. What is the point of being alive if you can't live your life. There's no joy in mine anymore. Most of us are not okay and no one cares anymore, not that they ever did. I guess that's the sad truth of the Covid pandemic, very few people actually care about others nor are they willing to do anything they don't want to do to protect others.
"And we keep failing because of bad public messaging..."
I would suggest that we keep failing because it doesn't work. The Chinese tried the most stringent isolation in the world, and it failed utterly. If we could get concrete evidence that masking works *for the individual wearing the mask* when others are not masked, we would have something to work with. But no matter where you look, you get ambiguous results. Accurate messaging is impossible without a believable conclusion. Either we don't have one, or the disinformation has done its job and made people believe that we don't have one.
Theoretically masking helps in places where everyone masks, but that has never been tried. Even in hospitals during the height of the pandemic, 1 in 4 people were masked incorrectly, with their noses showing.
Yes, public health involves a complex array of factors to consider, not just the science of transmission. I strongly believe that public health institutions (CDC in particular) need to provide recommendations that take all these into consideration and do the best job possible at keeping the public healthy. But I also strongly believe that public health institutions (CDC in particular) need to transparently and directly communicate the science, so that individuals who want to be as safe as possible, have that option. And so everyone has access to the information that could allow them to understand that people taking greater care are not being irrational, but are actually making decisions based on science. CDC and other public health agencies have stopped making that information easily accessible. People who used to mask and fight for masking, now look at other people like they are crazy for masking. Similarly people who took all kinds of COVID precautions before, treat people like they are crazy for continuing to take COVID precautions. I had a dangerous and life threatening complication from COVID. At this point, I have to explain to people I barely know (sometimes complete strangers) that that's why I take the precautions I take. Otherwise, they would literally write me off as completely out of touch with reality. Even with that explanation, it's clear that most people think I should get over it, be glad I'm alive and take my chances with getting COVID again.
Optimism at this point is beyond delusional. Basing anything on what Oregon (or the U.K.) has shown is equally ludicrous. When folks adopt a policy of ignoring reality, doubling and tripling down on that policy doesn't make an impact on what they were ignoring in the first place, FFS. Your analogy about seatbelts in this particular context is missing a key point: it became law that seatbelts be worn and there are consequences to breaking that law.
My 10-yo tested positive for COVID last night for the first time (that we know). Currently doing absolutely everything I can to prevent further spread in our household of 6 including high risk members. We sure as heck aren't playing pretend. JFC.
Every erosion of care from the CDC pushes people who are avoiding infection further into isolation.
There's been zero improvement in air cleaning in schools and workplaces. We no longer have access to 8 tests per month per person. There's been an anti-campaign straight from CDC and state PH that de-emphasized, de-normalized mask use. And somehow, healthcare facilities have weaker airborne precautions that they had in 2019. You won't find good-faith reasoning for any of the shrinking caution coming from the CDC. It looks very much like the goal is to promote infection. Sending sick people back to work/school instead of investing in the long term goal of a healthy populace.
PH guidance teaches the public what's what. It should start from a place of higher caution, because it's warranted and because it teaches the public the true range of contagiousness. It should be based on testing; there's no evidence to support a symptom-based system.
A small portion of the public will disregard it. We should never base guidance on their behavior. That's...stupid.
Another portion will need workarounds in order to get by, because they can't afford to isolate for a long period. (That needs to change, but in the meantime...) These folks need our help.
CDC guidance becomes employment policy. Let's not give employers justification to further erode sick leave. But let's offer a side menu of assistance for when people must be in shared spaces: emphasize how a good-fitting mask improves this scenario while underlining that time in public is not ideal and should be limited; make masks free, plentiful, and normalized; make tests free, plentiful, and accessible; and since no is taking responsibility to CLEAN the AIR, teach people how to do it. But be clear that this is making-do. It is *not* the guidance.
The CDC needs to revisit all the ways they've undermined their mission of Control and Prevention. We're experiencing high transmission and high weekly death, and the CDC is having discussions about eliminating iso. There's no way to justify their negligence, but that's very on-brand for them at this point.
I wish I was as optimistic as you that the CDC will clarify.
The public has moved on and most are hostile to people who still care: I watched Celine Gounder on TV tell some morning show hosts who said CDC guidance was as useless as mattress tags that Covid is killing over 2000 people/week--they didn't care.
In an ideal world, there would be free tests that work, paid sick time, free anti-virals--but that's not going to happen in the US.
Other countries are worse: the UK won't vaccinate most people--including kids--and now they're allowing Covid shots to be sold for $57 to over 12 year olds--apparently that's their approach to flu shots too.
As an at risk person, my world has shrunk. I'm so tired of being treated like I'm crazy when I mask and how few opportunities there are to safely engage.
If the guidance is to "let it rip"--with no evidence that fever is meaningful re: transmission--and avoid vulnerable people, it is useless.
I'd obviously vote for a North Star--this is what stops transmission--with very clear guidance for masking. But realistically, North Star isn't going to happen.
This was leaked in late January, but in general not given much publicity by either California nor Oregon that they had updated their guidelines online to leave it up to the infected to decide for themselves when they felt well enough (asymptomatic) to resume going out and back to work or school. Rather outrageous that it seems the CDC will go along with the general public having decided that precautions are no longer necessary. Extremely frustrating.
As a high risk older person who, along with my even more high risk husband, has been masking and taking precautions against COVID infection for almost 4 years, my stomach reeled when I read the news about this in the Washington Post the other day.
Honestly, I should have seen it coming; Dr. Michael Osterholm, in his recent “Osterholm Update” podcast said, “We have to get the most out of what people are willing to do.”
I appreciate your review of the push and pull of public health challenges. But let’s be real about WHY the challenges exist in the first place. Those responsible for communicating facts throughout the pandemic (CDC, especially) have spectacularly failed in their mission of disease control and prevention.
With the exception of the herculean efforts of a few notable science communicators (yourself, Osterholm, Dr. Emily Smith, Nerdy Girls, etc.) the communication from government health officials was noisy and convoluted, often backtracking, resulting in a loss of public attention, and ultimately, public trust. I don’t know how that gets reversed; as the damage has been so great.
What I do believe is that capitulating to the scientific ignorance of a public who, by and large, have moved on from any sort of COVID precautions, will not result in greater adherence to whatever new lower guidelines the CDC sets. My guess is that they will be ignored altogether.
Some history informs my pessimism:
Masking dropped after Dr. Rochelle Walensky said the vaccinated couldn’t get COVID and could unmask. That announcement resulted in everyone, vaccinated or not, taking off their masks.
After the CDC reduced the isolation days from 10 to 5 (at the behest of Delta airlines), the CDC said those infected with Covid should mask for the subsequent 5 days until day 10. Most people, even public school nurses I know, seemed unaware of that part of the guidance. It just never happened. And nobody knows that they should mask for 10 days if they’ve had a known COVID exposure.
Even HCW don’t seem to understand the facts around COVID. My grandkids’ different pediatricians have told my kids that rapid tests stay positive as long as PCRs, and that masks don’t really work. Many high risk friends over 60 have not been able to get a Paxlovid prescription because their doctors think they are unnecessary.
I was in the hospital recently for an emergency, and while the hospital had a mandatory mask policy for staff and visitors, most staff were unmasked or wearing them under their noses or as chin straps. Most patients were unmasked. The only N-95s in sight were the ones worn by my husband and me.
I had high hopes for the Biden administration to do what was necessary to reduce Covid infections. After all, he made promises during his campaign “to shut down the virus,”
He even held a memorial at the start of his presidency to honor all those who had died. The deaths have continued, with more dying under this administration than the previous. Are we really okay with the current number of 2000 weekly deaths? As Mike Osterholm says, “These are our mothers and fathers, our sisters and brothers, our neighbors and friends.” And some are our children.
The politicization of the pandemic response has been heartbreaking. Biden’s PR firm told him in February of 2022 that he and others in his party need to move on from COVID: https://punchbowl.news/wp-content/uploads/IMPACT-COVID-positioning-strategy-memo.pdf It’s obvious that the party has taken the hint. COVID prevention is a non-starter. The recent Senate committee hearing on Long Covid is one dim light of hope, but it mostly focused on the after-effects of infection, rather than prevention.
For heaven’s sake, even Trump’s surgeon general Jerome Adams is speaking out against lowering the isolation days for Covid. It’s upside down world time!
I’m disillusioned with public health. And mad as hell.
the virus is not controllable. Nothing we have done in 4 years has controlled the virus. It's like trying to control the wind. Biden saying he was going to "shut down the virus" was stupidity.
Yes, I really want that, too. My husband and I are elderly and have various comorbidities (I spent much of yesterday in a nearby ER). We want to boost as often as science says (real science, not "science" undermined by right-wing politics).
There is a theoretical limit where getting the same shot over and over at a high enough frequency stops working -- Dr. Jetelina has written about this. Every six months, with the vaccine updated at least once a year, is pretty far away from that. That's already been recommended for some groups and if it had an adverse effect we'd know by now.
I'm still hoping for better vaccines. For now, from the science we have, it looks like we need regularly update vaccines and boosters at least every 6 months.
I'm not going to play the game of you asking me to disprove your claim., especially when it's so vague. Please define what you mean by "too many boosters" (I don't know of anyone recommending "every 3-4 months" for example; my PC doc certainly doesn't) and "not good".
Otherwise, it's just dueling opinions, and I don't have time for that.
The original poster said they “want to boost as often as science says.” My point is that science may not say boosting in small intervals is the best course. Once a year? Fine. Multiple times a year? We don’t know. And that is the truth. We don’t know.
Dear Katelyn and the CDC, we urge you to provide a clear direction for public health. It is concerning to see public health officials distancing themselves from science, as this only further undermines trust in science and public health. How can the CDC create credibility if it succumbs to the limited understanding of science in a population with low scientific literacy? Our leaders need to convey the standard and indisputable facts and hold their ground, so that society can make necessary adjustments. The pandemic demonstrated that society will adapt, even if political and public health officials are dismissive. Any message that contradicts sound scientific guidance erodes confidence in the CDC. Let's take a cue from Pfizer's Superbowl ad and celebrate science and facts. The world would be a better place with more science and facts.
The CDC has lost all credibility. That happens when you lie to the public repeatedly. Things like "stand 6 feet part" weren't "science"....it was based on nothing. When you rip apart society over a virus and lie over and over, it's a long road back.
Reality has finally set it and exposed all the propaganda. These viruses are not controllable in any way.
I think each individual has to make their own decisions based on the information provided and their personal health status. For me, Long Covid has been a life changer, I will continue to isolate and keep myself as healthy as possible until we know more through research.
As a regular person, I don't think I had much direct awareness of CDC recommendations prior to the pandemic. Sure, I was raised to always wear a seat belt, but the messaging from the CDC was being delivered through local governments, agencies, and other types of messaging (I was pretty young in the 80s, so I don't know for sure).
Today, the CDC recommendations are intended to inform state health departments (which, in turn, establish guidelines for school districts), employers' policies, and physicians' guidance for patients. But when they are recommendations and not laws, there's not much behind the guidance UNLESS these health agencies choose to promote them.
And I think Dr. Jetelina is correct that we need to look at the reality and logistics of 5 days of isolation; even salaried employers in high-paying jobs are unlikely to have more than 6 days of allotted sick time a year. So, if you have two kids and each gets covid, it's infeasible to take 10 days of sick time... not to mention that leaves none for yourself if you also get sick. So then we have parents going to work sick because they don't want to "waste" sick days on themselves, and kids in school with covid, flu, RSV, strep, etc. because the parent simply can't take enough time off to be home with the child, at the risk of losing their own job.
Not to mention that most schools figured out in 2020 how to turn on a dime and shift to remote learning, almost instantly. In 2020-21, and even 2021-22, most schools that were in person had a remote option where students could watch live-streamed classes remotely if they were sick, so that they could still participate in class and wouldn't be behind if they had to miss a few days of school. I can't speak for every district, but where I live in the Northeast, there is no longer any option for remote learning. An older student (middle school or high school) who misses more than one or two days of school at a stretch is (for lack of more eloquent language) screwed. It's very difficult to make up work, and it causes a ton of stress for kids. So they refuse to stay home, because the consequences of missing school and the stress of the makeup work is too much -- and that's why kids are going to school sick.
So, this is less about how the public hears the CDC, in my opinion. It's about whether employers, state governments, and school districts are hearing what the agency is saying, and whether they are going to comply. It has to come from the top, which is the employers and school districts. If they make it feasible for someone to take five days off for covid (or for a child with covid), and if the schools make it reasonable for a child to be out for five days without consequences, maybe over time this will become normal. But until then, it's not going to matter what the CDC advises, because people still need to go to work and school, as the personal consequences of taking that much time off are too great. I am not saying I agree with this; but I think it's the reality for most Americans.
I think what CDC does matters. But I do agree that there is a much bigger issue. We need to build a society that cares about people and people's health, survival and flourishing more than profits. Otherwise, we won't ever effectively address public health, the climate crisis or a million other things. And people will be stuck making ridiculous decisions that no one should have to make.
I can tell you once mandates were lifted. My school district had no isolation guidelines, didn't know what the rules were for what constituted an outbreak, or gave ANY notices regarding potential exposure to COVID for 2 years. Nothing was recommended- no masking, testing, telling anyone anything about COVID. You could do what you want. Our school district is 30-40 percent chronically absent for the last 2 years. The kids are sick all the time, the parents are sick and what it looks like from hospitalizations and death is that the infants and grandparents then get hospitalized and some die. So my school district has done the experiment already and this is what we get. I think all school districts have been doing that because those turning in data on average nation wide is 30% chronically absent (18 days out of the school year).
My son missed six days with Covid last year- the most days he has ever missed previously. It was insanely stressful. That wouldn’t be allowed this year. Guidance from our district last month said it is ok to come to school if you don’t feel well. And if you Covid, as there is no longer a required isolation period by our local health department, so they won’t require it either. Schools want bodies to have good attendance, good report cards, and keep funding.
Is it feasible to develop a tablet to drop a toilet to test for Covid 19? Can sewer analysis be adapted for use by an individual or household? If not, why?
Feeling more and more invisible as an immunocompromised person. I know that most people in this country are unwilling to endure the “terrible sacrifice” of wearing masks to keep us alive. But it gets pretty depressing when public health gives up on us, too.
I hoped the pandemic would make everyone (including employers) take illness a little more seriously and take the precautions they can reasonably take to avoid spreading it. Whenever I read that deaths are not as high as they once were, I can't help but think that's because we've killed off most of the vulnerable people already. The vulnerable who have avoided COVID have to continue to isolate further as the public takes it less and less seriously, or else finally become one of those excess deaths.
LOL, yes. This. Culling the herd…
I said early on Sweden could have a great economy since they allowed all the weak vulnerable and chronically ill to die from Covid. Joking.. not joking.
Yes, the reason hospitalization/death has “decoupled” from infection is because many of the most vulnerable have already died. This decoupling has little (and maybe nothing) to do with vaccines and boosters.
What doesn’t kill you makes you stronger.
Is there actually scientific consensus on that statement? Or is it more to do with reaching a certain level of population immunity between vaccines and infections? Or because the later mutations of the virus aren't as deadly as the earlier incarnations? I'd like to see evidence that the decoupling is primarily because of survivorship bias, or whatever the proper term is.
I've been asking this question for a while and hoping an epidemiologist would try to come up with an answer. As I mentioned in another comment, from the rough numbers the potential for survivorship heavily skewing the numbers is high.
Car accidents kill pretty indiscriminately. Hope you're strong enough!
Indeed. I was very ill when I got Covid for the first time last August. In bed 3 weeks and almost hospitalized. Every symptom except…fever. Immunocompromised like us can shed active virus for much longer than others, help create variants, etc. So not only are we at higher risk, we could contribute to community risk by not being allowed time to truly recover. I will be making a strong public comment when that opens up, but I feel pretty defeated.
Doctors and nurses are not even wearing masks, so I feel like they have given up too.
The regional variations are mind-boggling. Here in Boston masks are required for staff in all patient care areas right now, and at Dana Farber Cancer Institute they continue universal masking.
Masks in medical settings are required in Marin County California too, but less than half the medical staff comply.
That depends where you live. In NY state (NYC and Westchester) most hospitals and doctors offices are back to masking for the winter.
Sadly the radiation/ oncology office I visit with my elderly father almost daily on eastern Long Island has no mask community care. In a cancer center?? I’ll never understand.
there's no evidence that masks reduce transmission of respiratory virus. Masks are also very uncomfortable to wear and impede communication. Now you understand. I was treated for Hodgkin's Lymphoma in the 90s at a top cancer center. I never saw a mask anywhere.
There is evidence that masking reduces transmission of Covid. The only reason more healthcare workers didn’t die in the early days of covid is because we masked.
The highest quality evidence (real-world data and RCTs) does not show that masks reduce the transmission of covid.
That is disgusting.
Definitely not happening in Northeastern Ohio. I don’t care about masking in general, but I do think medical facilities should require them during the winter months.
While the NYC hospitals are requiring it, I was just at a major one in Manhattan on Wednesday and most staff were NOT wearing them. Nor were the visitors.
Same. As a high risk person I feel like I'm supposed to just go away.
Depressing is definitely the operative word here. My wife is immunocompromised, but even before that, while in good apparent health, the selfishness and willful ignorance of the masses had been so disheartening.
where's the evidence that wearing masks keeps people alive?
"YAWN" same old trope..
What happened to the evidence we gave you? Not going through this again.
But…then why aren’t medical establishments requiring them? You would think their goal would be keeping people alive? I went to urgent care last weekend. Only one in a mask. I had an appointment in an oncology clinic. Only one in a mask. Not a medical professional to be seen with a mask on.
Masks cost money. In California there's a huge fight between the nurses union and their employers because the employers don't want to have to pay for PPE.
I have spent thousands on masks. Believe me, I know.
If doctors and nurses believed wearing a mask kept them and their patients safer from covid, logic holds they would mask.
I’m a nurse, and I always masked after Covid came, even before I was immunocompromised. I had heavy heavy exposure and wasn’t infected until last August when I didn’t even work in the hospital anymore. And I was pcr tested regularly because we had so many outbreaks. I had an unmasked visit with my mom who tested positive the next day. And there it was. I was never lax again with masking and not infected again. Just a coincidence I guess.
I'm sorry to hear your mom got sick. From your story, it's unclear whether you ever had covid, especially during your unmasked visit with your mom.
Were you the only person your mom was exposed to? If she "tested positive the next day," I think it's unlikely you were the one who infected her. Usually it takes at least 2 days or more. Also, if she had never been infected before, she had zero natural immunity and was velcro for the virus meaning unless she was sitting at home alone with zero exposure to the outside world, she could have gotten the virus from anywhere.
I agree. So I am left to think they probably don’t work as much as some might think.
But would the CDC ever tell us "oops, masks really don't help much" (even if they knew/suspected it were true) after all the mask and vaccine mandates? Never.
But they should because people are living with all these misconceptions, such as "people who don't wear masks are increasing my risk of hospitalization and death, so now I need to stay home all the time."
Some are and some not and for various reasons.
300 people dying per day is about the equivalent of three 737 Max aircrafts crashing every two days. As a society, we would never tolerate that. And that doesn't consider Long Covid. The large majority are preventable by vaccination and simple mitigation measures. Except that the politics of division are preempting public health. How many deaths will a politician accept in order to not mask, not isolate, and/or get elected? This is incomprehensible to me. Despicable.
The Centers for Disease CONTROL should stay true to the mission embedded in their name. Bending the knee to politics, and whatever group fictional narrative we’ve arrived at that keeps killing 2,000 Americans a week and giving many more long Covid, is an abdication of duty and moral courage.
At the very least, present honest estimates of the personal, economic, and public health costs of presenteeism when we are sick versus reasonable absenteeism to heal and protect.
The couch, a cozy bathrobe, and Netflix should compassionately await.
I stopped listening to the CDC when they stopped talking about precautions and mitigations. And when 200 members of the CDC Epidemic Intelligence Service got Covid at a CDC conference. The messaging has been abysmal and will remain that way because they don't want Covid to be an issue anymore. Most people have stopped doing anything to mitigate spread. At this point people won't do it if it's the least bit inconvenient to them 'getting back to normal'. No one seems to care that they don't have a right to spread a potentially deadly disease to others. People are still complaining about lockdows that lasted a few months, 4 years ago. When we keep seeing data that shows that 70% of household spread started with a child and then we don't do anything to protect kids in school, we have failed. And we keep failing because of bad public messaging. I never thought I'd view the CDC as illegitimate and useless, but here we are. We have failed at public health and safety. We are failing the younger generations by ensuring they will be generations of brain damaged and permanently disabled people. I'm so tired of being a hostage in my own home. As a caregiver, I didn't have much of a life before Covid, but I have no life now and haven't for years. I no longer see a future where I will ever be comfortable in public spaces again. And PTSD makes masking for more than an hour and a half impossible as it triggers panic attacks, still, after 4 years. What is the point of being alive if you can't live your life. There's no joy in mine anymore. Most of us are not okay and no one cares anymore, not that they ever did. I guess that's the sad truth of the Covid pandemic, very few people actually care about others nor are they willing to do anything they don't want to do to protect others.
"And we keep failing because of bad public messaging..."
I would suggest that we keep failing because it doesn't work. The Chinese tried the most stringent isolation in the world, and it failed utterly. If we could get concrete evidence that masking works *for the individual wearing the mask* when others are not masked, we would have something to work with. But no matter where you look, you get ambiguous results. Accurate messaging is impossible without a believable conclusion. Either we don't have one, or the disinformation has done its job and made people believe that we don't have one.
Theoretically masking helps in places where everyone masks, but that has never been tried. Even in hospitals during the height of the pandemic, 1 in 4 people were masked incorrectly, with their noses showing.
Yes, public health involves a complex array of factors to consider, not just the science of transmission. I strongly believe that public health institutions (CDC in particular) need to provide recommendations that take all these into consideration and do the best job possible at keeping the public healthy. But I also strongly believe that public health institutions (CDC in particular) need to transparently and directly communicate the science, so that individuals who want to be as safe as possible, have that option. And so everyone has access to the information that could allow them to understand that people taking greater care are not being irrational, but are actually making decisions based on science. CDC and other public health agencies have stopped making that information easily accessible. People who used to mask and fight for masking, now look at other people like they are crazy for masking. Similarly people who took all kinds of COVID precautions before, treat people like they are crazy for continuing to take COVID precautions. I had a dangerous and life threatening complication from COVID. At this point, I have to explain to people I barely know (sometimes complete strangers) that that's why I take the precautions I take. Otherwise, they would literally write me off as completely out of touch with reality. Even with that explanation, it's clear that most people think I should get over it, be glad I'm alive and take my chances with getting COVID again.
Optimism at this point is beyond delusional. Basing anything on what Oregon (or the U.K.) has shown is equally ludicrous. When folks adopt a policy of ignoring reality, doubling and tripling down on that policy doesn't make an impact on what they were ignoring in the first place, FFS. Your analogy about seatbelts in this particular context is missing a key point: it became law that seatbelts be worn and there are consequences to breaking that law.
My 10-yo tested positive for COVID last night for the first time (that we know). Currently doing absolutely everything I can to prevent further spread in our household of 6 including high risk members. We sure as heck aren't playing pretend. JFC.
Let's talk about isolation.
Every erosion of care from the CDC pushes people who are avoiding infection further into isolation.
There's been zero improvement in air cleaning in schools and workplaces. We no longer have access to 8 tests per month per person. There's been an anti-campaign straight from CDC and state PH that de-emphasized, de-normalized mask use. And somehow, healthcare facilities have weaker airborne precautions that they had in 2019. You won't find good-faith reasoning for any of the shrinking caution coming from the CDC. It looks very much like the goal is to promote infection. Sending sick people back to work/school instead of investing in the long term goal of a healthy populace.
PH guidance teaches the public what's what. It should start from a place of higher caution, because it's warranted and because it teaches the public the true range of contagiousness. It should be based on testing; there's no evidence to support a symptom-based system.
A small portion of the public will disregard it. We should never base guidance on their behavior. That's...stupid.
Another portion will need workarounds in order to get by, because they can't afford to isolate for a long period. (That needs to change, but in the meantime...) These folks need our help.
CDC guidance becomes employment policy. Let's not give employers justification to further erode sick leave. But let's offer a side menu of assistance for when people must be in shared spaces: emphasize how a good-fitting mask improves this scenario while underlining that time in public is not ideal and should be limited; make masks free, plentiful, and normalized; make tests free, plentiful, and accessible; and since no is taking responsibility to CLEAN the AIR, teach people how to do it. But be clear that this is making-do. It is *not* the guidance.
The CDC needs to revisit all the ways they've undermined their mission of Control and Prevention. We're experiencing high transmission and high weekly death, and the CDC is having discussions about eliminating iso. There's no way to justify their negligence, but that's very on-brand for them at this point.
I wish I was as optimistic as you that the CDC will clarify.
The public has moved on and most are hostile to people who still care: I watched Celine Gounder on TV tell some morning show hosts who said CDC guidance was as useless as mattress tags that Covid is killing over 2000 people/week--they didn't care.
In an ideal world, there would be free tests that work, paid sick time, free anti-virals--but that's not going to happen in the US.
Other countries are worse: the UK won't vaccinate most people--including kids--and now they're allowing Covid shots to be sold for $57 to over 12 year olds--apparently that's their approach to flu shots too.
As an at risk person, my world has shrunk. I'm so tired of being treated like I'm crazy when I mask and how few opportunities there are to safely engage.
If the guidance is to "let it rip"--with no evidence that fever is meaningful re: transmission--and avoid vulnerable people, it is useless.
I'd obviously vote for a North Star--this is what stops transmission--with very clear guidance for masking. But realistically, North Star isn't going to happen.
This was leaked in late January, but in general not given much publicity by either California nor Oregon that they had updated their guidelines online to leave it up to the infected to decide for themselves when they felt well enough (asymptomatic) to resume going out and back to work or school. Rather outrageous that it seems the CDC will go along with the general public having decided that precautions are no longer necessary. Extremely frustrating.
As a high risk older person who, along with my even more high risk husband, has been masking and taking precautions against COVID infection for almost 4 years, my stomach reeled when I read the news about this in the Washington Post the other day.
Honestly, I should have seen it coming; Dr. Michael Osterholm, in his recent “Osterholm Update” podcast said, “We have to get the most out of what people are willing to do.”
I appreciate your review of the push and pull of public health challenges. But let’s be real about WHY the challenges exist in the first place. Those responsible for communicating facts throughout the pandemic (CDC, especially) have spectacularly failed in their mission of disease control and prevention.
With the exception of the herculean efforts of a few notable science communicators (yourself, Osterholm, Dr. Emily Smith, Nerdy Girls, etc.) the communication from government health officials was noisy and convoluted, often backtracking, resulting in a loss of public attention, and ultimately, public trust. I don’t know how that gets reversed; as the damage has been so great.
What I do believe is that capitulating to the scientific ignorance of a public who, by and large, have moved on from any sort of COVID precautions, will not result in greater adherence to whatever new lower guidelines the CDC sets. My guess is that they will be ignored altogether.
Some history informs my pessimism:
Masking dropped after Dr. Rochelle Walensky said the vaccinated couldn’t get COVID and could unmask. That announcement resulted in everyone, vaccinated or not, taking off their masks.
After the CDC reduced the isolation days from 10 to 5 (at the behest of Delta airlines), the CDC said those infected with Covid should mask for the subsequent 5 days until day 10. Most people, even public school nurses I know, seemed unaware of that part of the guidance. It just never happened. And nobody knows that they should mask for 10 days if they’ve had a known COVID exposure.
Even HCW don’t seem to understand the facts around COVID. My grandkids’ different pediatricians have told my kids that rapid tests stay positive as long as PCRs, and that masks don’t really work. Many high risk friends over 60 have not been able to get a Paxlovid prescription because their doctors think they are unnecessary.
I was in the hospital recently for an emergency, and while the hospital had a mandatory mask policy for staff and visitors, most staff were unmasked or wearing them under their noses or as chin straps. Most patients were unmasked. The only N-95s in sight were the ones worn by my husband and me.
I had high hopes for the Biden administration to do what was necessary to reduce Covid infections. After all, he made promises during his campaign “to shut down the virus,”
He even held a memorial at the start of his presidency to honor all those who had died. The deaths have continued, with more dying under this administration than the previous. Are we really okay with the current number of 2000 weekly deaths? As Mike Osterholm says, “These are our mothers and fathers, our sisters and brothers, our neighbors and friends.” And some are our children.
The politicization of the pandemic response has been heartbreaking. Biden’s PR firm told him in February of 2022 that he and others in his party need to move on from COVID: https://punchbowl.news/wp-content/uploads/IMPACT-COVID-positioning-strategy-memo.pdf It’s obvious that the party has taken the hint. COVID prevention is a non-starter. The recent Senate committee hearing on Long Covid is one dim light of hope, but it mostly focused on the after-effects of infection, rather than prevention.
For heaven’s sake, even Trump’s surgeon general Jerome Adams is speaking out against lowering the isolation days for Covid. It’s upside down world time!
I’m disillusioned with public health. And mad as hell.
the virus is not controllable. Nothing we have done in 4 years has controlled the virus. It's like trying to control the wind. Biden saying he was going to "shut down the virus" was stupidity.
Could you please let us know if the CDC recommends a booster with the new vaccine after 6 months? Thank you.
Yes, I really want that, too. My husband and I are elderly and have various comorbidities (I spent much of yesterday in a nearby ER). We want to boost as often as science says (real science, not "science" undermined by right-wing politics).
Science may say too many boosters is not good either.
There is a theoretical limit where getting the same shot over and over at a high enough frequency stops working -- Dr. Jetelina has written about this. Every six months, with the vaccine updated at least once a year, is pretty far away from that. That's already been recommended for some groups and if it had an adverse effect we'd know by now.
I'm still hoping for better vaccines. For now, from the science we have, it looks like we need regularly update vaccines and boosters at least every 6 months.
And Martians may land in New Jersey tomorrow.
They might. But, we cannot say that boosting every 3-4 months is safe or scientific at this point. Maybe it is, but then I would like to see the data.
I'm not going to play the game of you asking me to disprove your claim., especially when it's so vague. Please define what you mean by "too many boosters" (I don't know of anyone recommending "every 3-4 months" for example; my PC doc certainly doesn't) and "not good".
Otherwise, it's just dueling opinions, and I don't have time for that.
The original poster said they “want to boost as often as science says.” My point is that science may not say boosting in small intervals is the best course. Once a year? Fine. Multiple times a year? We don’t know. And that is the truth. We don’t know.
Currently on if you're 65 or older. Because the rest if us don't matter.
Dear Katelyn and the CDC, we urge you to provide a clear direction for public health. It is concerning to see public health officials distancing themselves from science, as this only further undermines trust in science and public health. How can the CDC create credibility if it succumbs to the limited understanding of science in a population with low scientific literacy? Our leaders need to convey the standard and indisputable facts and hold their ground, so that society can make necessary adjustments. The pandemic demonstrated that society will adapt, even if political and public health officials are dismissive. Any message that contradicts sound scientific guidance erodes confidence in the CDC. Let's take a cue from Pfizer's Superbowl ad and celebrate science and facts. The world would be a better place with more science and facts.
The CDC has lost all credibility. That happens when you lie to the public repeatedly. Things like "stand 6 feet part" weren't "science"....it was based on nothing. When you rip apart society over a virus and lie over and over, it's a long road back.
Reality has finally set it and exposed all the propaganda. These viruses are not controllable in any way.
Yep. And it is no wonder that childhood vaccination rates are plummeting and other public health guidance is being ignored.
I think each individual has to make their own decisions based on the information provided and their personal health status. For me, Long Covid has been a life changer, I will continue to isolate and keep myself as healthy as possible until we know more through research.
As a regular person, I don't think I had much direct awareness of CDC recommendations prior to the pandemic. Sure, I was raised to always wear a seat belt, but the messaging from the CDC was being delivered through local governments, agencies, and other types of messaging (I was pretty young in the 80s, so I don't know for sure).
Today, the CDC recommendations are intended to inform state health departments (which, in turn, establish guidelines for school districts), employers' policies, and physicians' guidance for patients. But when they are recommendations and not laws, there's not much behind the guidance UNLESS these health agencies choose to promote them.
And I think Dr. Jetelina is correct that we need to look at the reality and logistics of 5 days of isolation; even salaried employers in high-paying jobs are unlikely to have more than 6 days of allotted sick time a year. So, if you have two kids and each gets covid, it's infeasible to take 10 days of sick time... not to mention that leaves none for yourself if you also get sick. So then we have parents going to work sick because they don't want to "waste" sick days on themselves, and kids in school with covid, flu, RSV, strep, etc. because the parent simply can't take enough time off to be home with the child, at the risk of losing their own job.
Not to mention that most schools figured out in 2020 how to turn on a dime and shift to remote learning, almost instantly. In 2020-21, and even 2021-22, most schools that were in person had a remote option where students could watch live-streamed classes remotely if they were sick, so that they could still participate in class and wouldn't be behind if they had to miss a few days of school. I can't speak for every district, but where I live in the Northeast, there is no longer any option for remote learning. An older student (middle school or high school) who misses more than one or two days of school at a stretch is (for lack of more eloquent language) screwed. It's very difficult to make up work, and it causes a ton of stress for kids. So they refuse to stay home, because the consequences of missing school and the stress of the makeup work is too much -- and that's why kids are going to school sick.
So, this is less about how the public hears the CDC, in my opinion. It's about whether employers, state governments, and school districts are hearing what the agency is saying, and whether they are going to comply. It has to come from the top, which is the employers and school districts. If they make it feasible for someone to take five days off for covid (or for a child with covid), and if the schools make it reasonable for a child to be out for five days without consequences, maybe over time this will become normal. But until then, it's not going to matter what the CDC advises, because people still need to go to work and school, as the personal consequences of taking that much time off are too great. I am not saying I agree with this; but I think it's the reality for most Americans.
I think what CDC does matters. But I do agree that there is a much bigger issue. We need to build a society that cares about people and people's health, survival and flourishing more than profits. Otherwise, we won't ever effectively address public health, the climate crisis or a million other things. And people will be stuck making ridiculous decisions that no one should have to make.
I can tell you once mandates were lifted. My school district had no isolation guidelines, didn't know what the rules were for what constituted an outbreak, or gave ANY notices regarding potential exposure to COVID for 2 years. Nothing was recommended- no masking, testing, telling anyone anything about COVID. You could do what you want. Our school district is 30-40 percent chronically absent for the last 2 years. The kids are sick all the time, the parents are sick and what it looks like from hospitalizations and death is that the infants and grandparents then get hospitalized and some die. So my school district has done the experiment already and this is what we get. I think all school districts have been doing that because those turning in data on average nation wide is 30% chronically absent (18 days out of the school year).
This seems to be the mantra--"The root causes of chronic absenteeism are vast. Poverty, illness, and a lack of child care and social services remain contributors to poor attendance, and some communities continue to struggle with transportation challenges; the pandemic has brought on a youth mental health crisis that has caused students to miss school; parents have reframed how they think about illness, ready to keep their children home at the slightest signs of sickness." https://www.vox.com/2024/1/9/23904542/chronic-absenteeism-school-attendance However when I look at the ER visits for respiratory illness for children alone and the potential effects of COVID on serotonin levels ( https://www.nature.com/articles/s41577-023-00966-7 https://www.news-medical.net/news/20231020/Low-serotonin-levels-observed-in-long-COVID-and-other-viral-infections.aspx) and therefore children's mental health.... I think there is no way this is not effecting absenteeism at school.
My son missed six days with Covid last year- the most days he has ever missed previously. It was insanely stressful. That wouldn’t be allowed this year. Guidance from our district last month said it is ok to come to school if you don’t feel well. And if you Covid, as there is no longer a required isolation period by our local health department, so they won’t require it either. Schools want bodies to have good attendance, good report cards, and keep funding.
Is it feasible to develop a tablet to drop a toilet to test for Covid 19? Can sewer analysis be adapted for use by an individual or household? If not, why?
Doug