Why Have the CDC's Covid Communications Been So Confusing?

The CDC surprised Americans and the world - again - when it abruptly announced that masks are no longer necessary in most settings for the vaccinated. 

While the news was largely welcome, its nature and timing - out of nowhere, based, seemingly, on no evidence - may serve to further undermine its authority. It is sometimes difficult for government agencies to serve the politicians and their mission, especially under someone as immoral and self-serving as 'the previous guy.' But the reality is that most Americans took - and still take - this pandemic seriously. The only way to bolster scienced-based decision-making and the attendant belief in government is to treat such announcements with the deliberation and gravity they deserve. .

Derek Thompson reports in The Atlantic:

The CDC has a hard job. But it’s approach to guidelines has been tardy, timid, and tangled. In lieu of clear guidance, it has routinely delivered confusion and surprise, complicated our ability to grok this virus, and mostly done so in a way that followed the science—with a six-month lag. That’s how you get lurching shutdowns, hundreds of millions of dollars spent on hygiene theater, bans on beach walks, rules against outdoor bars, closed playgrounds, mass confusion about protecting ourselves, and a large number of Americans who have tuned out public-health officials entirely.

The CDC announced that fully vaccinated Americans can stop wearing masks in most indoor and outdoor places. The new guidelines still advise the fully vaccinated to mask up when entering certain public areas, such as doctor’s offices.

This is a moment to celebrate. It is not quite the pandemic’s equivalent of V-E Day; after all, thousands of people are still dying around the world each day from a virus that, far from surrendering, may be endemic. But it could be the closest we get to a formal announcement from the federal government that, after months of death and sacrifice and ingenuity, something has been won. Call it normalcy.

If you’re surprised by the agency’s free-your-face announcement, you’re not alone. State officials had no idea it was coming. Businesses were caught off guard. Even White House officials were reportedly surprised by both the timing and the substance of the new advice, according to CNN. The CDC is notionally in the business of offering public-health guidance. But when a government agency’s recommendations consistently surprise or confuse members of its own government, one wonders if it’s serving as a particularly effective guide.

So while this is an opportunity to cherish a sort of liberation from pandemic restrictions, it’s also a moment to reflect on America’s 16-month public-health communication strategy, which has lurched from overcaution to overpromising and back again, often within the same 24-hour period.

Indeed, throughout the health crisis, the CDC has been so slow to issue guidance in line with the research consensus on COVID-19 that it’s brought new meaning to the concept of “follow the science.” The CDC was several months late to the idea that surface transmission of the coronavirus is largely mythical. It was months late to the notion that the disease rarely spreads outdoors. Until this week, it continued to issue byzantine advice for vaccinated individuals even as evidence piled up that inoculated people are at extremely low risk of serious disease or transmission.

On vaccines and masks, the agency has been all over the place. In March, the CDC’s initial recommendations for the fully vaccinated encouraged them to wear masks and socially distance around the unvaccinated. In April, the CDC loosened those guidelines but spread confusion by putting out a color-coded matrix of activities and recommendations that was so hard to follow, even scientists admitted they couldn’t understand it. Now it’s declaring “Masks off” in a way that is welcome but weird, and frankly—I can’t believe I’m saying this—potentially too broad.

The CDC came into the pandemic as “the gold standard” of public health. But it is emerging from the pandemic as something akin to the actual gold standard: rickety, inflexible, and struggling for coherence in the modern age.

What the United States needed, and still needs, is a simple and clear thesis statement about the virus and the vaccines, no more than 20 words long, that’s memorable and contains some nuance that people can use to guide their own behavior. Japan settled on a “Three C’s” rule, advising its citizens to avoid close spaces, crowded places, and close-contact situations. Perhaps the CDC could do even better, numerically speaking, with the “Two Commandments of COVID-19.” They could go something like this:

1. COVID-19 is an indoor aerosol disease.

2. Vaccination protects you; more vaccinations protect everyone.

How far do those 13 words get you? They don’t contain every nook and cranny of epidemiological nuance, but they get you awfully close.

The first commandment tells you that the virus spreads through aerosols—or verbal spray particles that we especially produce when we talk, sneeze, or breathe heavily—that can linger in the air. It suggests that, because of the aerosolized nature of the virus, masks probably work to protect you and others. It tells you that unventilated indoor spaces are especially high-risk and that being outside—or being inside masked, without talking too much, for a brief period of time, when your total exposure to aerosols is low—is low-risk, with or without vaccination.

The second commandment’s seven words get you pretty far too. They tell you that the vaccines probably work to block infection and serious illness. They suggest that your personal risk calculus should adjust after getting a shot. They also tell you that when a place has more vaccinations, everything becomes safer. And they allow you to expect and predict that as vaccinations pass certain thresholds in a city or state, pandemic restrictions will come down and normalcy will return.

Finally, the two commandments interact in a way that offers more clarity and reasonableness than the CDC’s announcement yesterday. For example, the U.S. is not being vaccinated in a uniform manner. More than 70 percent of adults in New Hampshire have received at least one dose, compared with less than 45 percent in Idaho. The CDC’s announcement seems to treat both states as equally safe when, in fact, states with more vaccinations are obviously much more protected. Following the CDC announcement, the White House released an Instagram message saying, “Fully vaccinated people can stop wearing masks.” But that’s not what the CDC said! The agency carved out exceptions for many places, including doctor’s offices, public transportation, and airports, which collectively employ or receive tens of millions of workers, travelers, customers, and patients. Those exceptions are being steamrolled by a Liberation Day narrative that feels like it came out of nowhere.

Am I being unfair to the CDC? Maybe. Regulations ought to loosen as more people become vaccinated and as we learn more about the science of post-vaccine transmission. The agency has a hard job.

But the CDC’s approach to loosening its guidelines has always been tardy, timid, and tangled. In lieu of clear guidance, it has routinely delivered confusion and surprise, complicated our ability to grok this virus, and mostly done so in a way that followed the science—with a six-month lag. That’s how you get lurching shutdowns, hundreds of millions of dollars spent on hygiene theater, bans on beach walks, rules against outdoor bars, closed playgrounds, mass confusion about protecting ourselves and our families, and a large number of Americans who have tuned out public-health officials entirely. Guidance is overrated. We needed an actual guide.