The CDC has released new mask guidelines for the vaccinated
May 13, 2021 1:49 PM   Subscribe

You can resume activities without wearing a mask or staying 6 feet apart, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations including local business and workplace guidance.

What We’re Still Learning
How effective the vaccines are against variants of the virus that causes COVID-19. Early data show the vaccines may work against some variants but could be less effective against others.
How well the vaccines protect people with weakened immune systems, including people who take immunosuppressive medications.
How long COVID-19 vaccines can protect people.
As we know more, CDC will continue to update our recommendations for both vaccinated and unvaccinated people.
posted by craniac (386 comments total) 30 users marked this as a favorite
 
I'm happy the federal government is starting to tie activity restriction recommendations to vaccination rates rather than case rates. Individuals can influence their own vaccination status, but can't influence the case rates of others. This is positive news, and I hope it results in a broader acceptance of vaccination as a public health tool to reduce the risk of COVID-19.
posted by saeculorum at 1:51 PM on May 13, 2021 [13 favorites]


Do we have any idea yet about spread? I feel like I haven't seen any big updates about whether people who are vaccinated can still carry things to others.
posted by corb at 1:51 PM on May 13, 2021 [3 favorites]


This is so fucking stupid, though. They should be telling people to keep the fucking masks on until 90% are vaccinated. The god damn elephant in the room is that dingdongs who don't wanna wear masks will just say "IM VAXXED FUCK OFF" whether they're vaxxed or not. (Probably not.)

The CDC may have good science? but they're terrible with human behaviour.
posted by seanmpuckett at 1:53 PM on May 13, 2021 [162 favorites]


I was going to post to ask.mefi about why mask restrictions were in place for the vaccinated, because my wife keeps arguing that it's ridiculous, so now I'm bracing myself for a nuclear-grade "I told you so--nobody ever listens to me!" when I walk in the front door [cue sitcom laugh track].
posted by craniac at 1:53 PM on May 13, 2021 [6 favorites]


I'm not sure this is a good idea. I think this policy also encourages the unvaccinated to disregard precautions such as masks and distancing, because who knows whether any particular person is vaccinated.
posted by NotLost at 1:53 PM on May 13, 2021 [52 favorites]


So, what they're saying is that we're okay with the continued spread of Covid to the willfully unvaccinated and we are fine taking the risk that the virus will mutate as a result.

Coolcoolcool.
posted by teleri025 at 1:56 PM on May 13, 2021 [31 favorites]


I don't know if this is a good idea or not, but I am pretty sure that the willfully unvaccinated aren't wearing masks anyway.
posted by craniac at 1:58 PM on May 13, 2021 [50 favorites]


Do we have any idea yet about spread? I feel like I haven't seen any big updates about whether people who are vaccinated can still carry things to others.

It's not fully confirmed yet, but the evidence shows that vaccinated people either cannot spread the virus or have an extremely minor degree of infectiousness.
posted by SansPoint at 1:58 PM on May 13, 2021 [20 favorites]


Well immunocompromised people for whom the vaccine doesn't work are completely fucked now. I have no way of trusting whether the person not wearing a mask in the grocery store is a jerk or a vaccinated person. Great job, CDC. Thanks for continually reaffirming the fact that I do not belong in society because I was unlucky enough to be born disabled.
posted by twelve cent archie at 2:01 PM on May 13, 2021 [123 favorites]


Do we have any idea yet about spread? I feel like I haven't seen any big updates about whether people who are vaccinated can still carry things to others.

Here's the science brief related to the recommendations. There is strong evidence that the vaccines protect against infection, including asymptomatic infection, which means that vaccinated individuals are unlikely to transmit the disease. Table 1b summarizes some of these data. References 21-23 are interesting, but I'd take a look at all of the work cited in this section.
posted by mr_roboto at 2:02 PM on May 13, 2021 [26 favorites]


You can resume activities without wearing a mask or staying 6 feet apart, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations including local business and workplace guidance.

Except that the previous CDC guidelines supporting universal masking were the thin thread by which a lot of those state and local laws (and company policies) were hanging. Expect the floodgates to open now.
posted by jedicus at 2:07 PM on May 13, 2021 [28 favorites]


I'm 100% fine with this. I got fully vaccinated a couple months ago and immediately went on vacation to Florida, a place I've been talking shit about for months because they've been so irresponsible with almost no public health measures. But now that I'm vaccinated that's exactly what I wanted. And it was great. I got to go to a drag show in a gay bar full of handsome men and chat and share fellowship with my community. I didn't know how much I needed that.

It's hard to get re-adjusted to living life back at normal. I chose to jump right into the deep end of the pool and after a day or two it felt great and normal. Other approaches may work better for others. There's a good recent article on this: Post-vaccination Inertia Is Real: Readjusting our ideas about what’s safe is going to take time.

But we have to get back to normal life. The vaccine seems to work very very well; 100% at preventing serious illness, 70%+ at preventing any illness (90%+ for the mRNA), greatly lowered transmission (we think). There's probably a new endemic risk in our society now, but with luck and a working vaccine it will be less serious in the long term than the yearly influenza risk we've all accepted our whole lives without much questioning. (Or getting the yearly vaccine for.)

Save your anger for the people who can be vaccinated but are choosing not to because they think they know better. Or even more reprehensibly, scumbags who would actively lie about being vaccinated. They're the ones putting our society at risk, particularly the small fraction of folks who really can't be vaccinated. I did my part to keep society safe and the least I want in exchange is to able to go to a bar and have a drink.

(Stridently worded because apparently that's now Metafilter comment style. When I'm being a more reasonable person I admit I carry a mask around with me everywhere and will gladly put it on if it's required or makes someone more comfortable. I also wouldn't mind seeing new infection rates get even lower before declaring open season on maskless indoor gatherings. But I'm no expert on risk profiling. And I respect that CDC is trying to balance a line between safety, reasonableness, and also just encouraging people to get vaccines.)
posted by Nelson at 2:07 PM on May 13, 2021 [49 favorites]


I don’t want to risk being mistaken for a Republican. #mask4eva
posted by double bubble at 2:08 PM on May 13, 2021 [71 favorites]


Do we have any idea yet about spread? I feel like I haven't seen any big updates about whether people who are vaccinated can still carry things to others.

There's no evidence that any of the current Covid-19 vaccines can completely stop people from being infected – There are a bunch of stats and studies mentioned in that article, including that the Moderna vaccine might be able to prevent two-thirds of asymptomatic cases after one shot.
It seems likely that vaccination will significantly reduce but not eliminate the possibility of passing the virus to others.
posted by Lanark at 2:10 PM on May 13, 2021 [5 favorites]


Do we have any idea yet about spread? I feel like I haven't seen any big updates about whether people who are vaccinated can still carry things to others.

Bit of a pet peeve of mine. The whole "can you infect others" is a hard-to-measure but mostly theoretical possibility. Any sane model of a disease like this says that if you simultaneously increase the immune response and reduce symptoms, you have drastically reduced viral load. It's true that we'd like better data to quantify how vastly reduced the spread is but why this concern is so amplified vs others leaves me scratching my head.

We do have some data confirming an actual reduced risk of infection (not just symptoms) and of course of spreading to others. The data that comes in keeps being consistent with my prior paragraph. Not sure how or what to expect as "enough." There won't ever be one big press release I suspect.

This is so fucking stupid, though. They should be telling people to keep the fucking masks on until 90% are vaccinated.

So for ever?

Vaccinated people going unmasked are probably well below flu levels of risk. We're probably never hitting herd immunity. That's where we are. I'm not sure that guidelines that imply the vaccine doesn't change risk factors help at all. Certainly the CDC is taking lots of criticisms from both sides here.

FWIW I *am* in favor of mandatory masking in what I'd call "indoor non-voluntary spaces." If you want to go grocery shopping in person put on a mask. Want to go to the gym, restaurant, bar, casino? I think if you're vaccinated and comfortable then go for it, if you're not comfortable then just don't go.
posted by mark k at 2:11 PM on May 13, 2021 [27 favorites]


There's no evidence that any of the current Covid-19 vaccines can completely stop people from being infected

That article is over three months old. There is evidence now; see the science brief I linked to above.
posted by mr_roboto at 2:12 PM on May 13, 2021 [25 favorites]


I've decided that from now on, I'm going to trust the CDC when it delivers bad news, but distrust the CDC when it delivers good news.
posted by Faint of Butt at 2:12 PM on May 13, 2021 [44 favorites]


Take off covid mask, put on gas shortage mask
posted by Going To Maine at 2:15 PM on May 13, 2021 [14 favorites]


I've decided that from now on, I'm going to trust the CDC when it delivers bad news, but distrust the CDC when it delivers good news.

They're probably not wrong inasmuch as fully vaccinated people are at low risk both to themselves and others in those situations. But I think they're very wrong inasmuch as it will rapidly tilt the already precarious laws and social norms regarding masking, at a time when barely half the eligible US population is vaccinated.

A lot of willfully unvaccinated people will grudgingly put on a mask if it's legally required or if it's a company policy and everyone else is doing it. If the vaccinated stop doing it, I expect the non-vaccinated to do so as well, especially since we don't have any kind of vaccine passport system.
posted by jedicus at 2:21 PM on May 13, 2021 [17 favorites]


I’ll be interested to see how hospitals respond to this. It might have been better if the CDC relaxed mask requirements in a more incremental fashion, leaving mask requirements in place for higher risk environments like hospitals and nursing homes.

I’m also annoyed that it will give cover to all the Republican governors who have been relaxing restrictions left and right, while throwing the Democratic governors that have been trying to keep restrictions in place under the bus.
posted by TedW at 2:22 PM on May 13, 2021 [9 favorites]


A friend of mine pointed out the CDC, out of an abundance of caution, recommends not eating runny eggs. Yes, Salmonella is serious but I eat runny eggs.

Why does this relate? Covid is the largest health crisis in our history in scale and effect in this era of scientific possibility. Any announcement by the CDC here would be heavily reviewed, scrutinized, analyzed and met with serious resistance from internal scientists if this announcement was unacceptably dangerous.

I trusted the science when it told me to be safe and stay home, to wear a mask and to get the vaccines. I trust the science now. We have to.
posted by glaucon at 2:23 PM on May 13, 2021 [20 favorites]


I like this. But I also don't want to go back to the office full time. That part of me says, Nooooooooooooooo!
posted by tiny frying pan at 2:25 PM on May 13, 2021 [17 favorites]


A friend of mine pointed out the CDC, out of an abundance of caution, recommends not eating runny eggs.

????

That's not what the document you've linked to says. It says, " If you like your eggs runny or cook a recipe that typically calls for raw eggs (such a Hollandaise sauce or a Caesar salad dressing) make sure you use only pasteurized eggs."
posted by mr_roboto at 2:28 PM on May 13, 2021 [2 favorites]


Good thing I like my eggs over well.
posted by Faint of Butt at 2:29 PM on May 13, 2021


my eggs come out over reluctantly

I need a new spatula


anyway, the reporting on this isn't so hot because a lot of people will now just ignore local policy, and stores will not want to engage.
posted by snuffleupagus at 2:31 PM on May 13, 2021 [7 favorites]


Yeah, here the city/county will require masks at the airport, for workers in retail spaces, etc. but beyond that it’s up to the stores to decide if masks are required.
posted by Huffy Puffy at 2:31 PM on May 13, 2021


TedW: The linked webpage explicitly says: "These recommendations can help you make decisions about daily activities after you are fully vaccinated. They are not intended for healthcare settings." They have a separate set of recommendations for healthcare settings that are much more detailed and include many circumstances where they still recommend "source control."
posted by ElKevbo at 2:32 PM on May 13, 2021 [10 favorites]


That article is over three months old. There is evidence now; see the science brief I linked to above.

Assuming you mean the CDC summary: Vaccine effectiveness or risk reduction. Asymptomatic infection: rates between 80% and 94%

However the 94% figure is from Israel where just about everyone is vaccinated (so theres nobody to infect).
If we take the 80% figure as likely for the US, that still leaves you with a 20% chance of passing on an infection to others.
I don't know how that compares with asymptomatic infection rates from unvaccinated people?
posted by Lanark at 2:34 PM on May 13, 2021 [2 favorites]


If you're going to continue wearing a mask, it's probably time to invest in respirators like N95/KF94 which are significantly better than cloth/surgical. The N95 shortage is definitely over (except for people with smaller faces, where supply is still very limited).
posted by meowzilla at 2:36 PM on May 13, 2021 [4 favorites]


Ducked into the grocery store last night real quick, and two white guys were arguing with a black security guard that they didn't have to wear masks. They had a three-ring binder they were referring to. They did not look like they were from the neighborhood. Really looking forward* to this new front in the culture wars.


* nope
posted by curious nu at 2:38 PM on May 13, 2021 [65 favorites]


I’ll be interested to see how hospitals respond to this. It might have been better if the CDC relaxed mask requirements in a more incremental fashion, leaving mask requirements in place for higher risk environments like hospitals and nursing homes.

The looser recommendation applies to non-healthcare, non-congregate settings.

That said, I think this is a terrible idea, particularly with recent (in vitro) data suggesting reduced efficacy against newer variants.

Masks should be like condoms. A coworker you know and trust? OK to go maskless. Walking past a random dude in Food Lion? Mask up.

(I do not recommend sleeping with your coworkers, nor with random dudes in Food Lion. This is not medical advice.)
posted by basalganglia at 2:38 PM on May 13, 2021 [21 favorites]


Do we have any idea yet about spread? I feel like I haven't seen any big updates about whether people who are vaccinated can still carry things to others.

Here's the science brief related to the recommendations. There is strong evidence that the vaccines protect against infection, including asymptomatic infection, which means that vaccinated individuals are unlikely to transmit the disease. Table 1b summarizes some of these data. References 21-23 are interesting, but I'd take a look at all of the work cited in this section.



To restate the question with a bit more explicit emphasis on the idea of transmission...

The last I had read was that being vaccinated -- and even if you did not have Covid -- did not necessarily prevent you from spreading the virus to others, because the vaccine did not confer mucosal immunity. I.e., you might have systemic protection from getting infected yourself, but the virus could still live in your mucosa, and therefore could conceivably be transmitted to others even by someone who was vaccinated and who did not have Covid.

So, even if you were vaccinated and asymptomatic, the guideline was that you should still wear a mask, because you could still infect other people who weren't vaccinated.

Is this explicitly discussed in the latest research? Or is it that this kind of transmission is so low a possibility that even if it might still occur, the CDC doesn't consider it to be significant enough to warrant telling vaccinated people to continue to wear a mask?
posted by darkstar at 2:38 PM on May 13, 2021 [4 favorites]


This is a mistake.
posted by EatTheWeek at 2:43 PM on May 13, 2021 [17 favorites]


The CDC may have good science? but they're terrible with human behaviour.

Sending the message that being vaccinated does not materially change one’s life was also a pretty bad idea from a human behavior perspective. I do agree that this one - guidelines for what to do in public - is tricky primarily because of the “honor system” aspect for the unvaccinated.
posted by atoxyl at 2:43 PM on May 13, 2021 [26 favorites]


From a public health and purely scientific standpoint, I'd argue that this seems like terrible messaging, signaling that the CDC has effectively caved to the right-wing on "freedom" and other manipulative political language around the pandemic.

As it stands, only so many are vaccinated. Upon getting a second shot earlier this week, I was told that the campus I visited is accepting walk-ins for vaccinations, which would be offered free-of-charge even for those not in my health service. There appears to be well more supply than demand, and we need to push vaccination to the hesitant.

Further, there are more strains of SARS-CoV-2 each day, for which existing vaccines are less efficacious. Those strains for which current vaccines do provide protection against are imperfect.

Then there is the looming threat of influenza, for which mask-wearing, social distancing, and hand-washing behaviors did much to effectively zero out since March 2020. There would be other benefits from continuing with the previous policy.

This decision seems foolish: not so much evidence- or fact-driven as political.
posted by They sucked his brains out! at 2:44 PM on May 13, 2021 [10 favorites]


twelve cent archie, I’m right there with you. My particular medical cohort currently has a 28% mortality rate when we catch covid. No good. I’m thrilled that the genpop can go about their lives, and I genuinely hope this news helps convince more people to vax up (I think the $5M vax lottery in Ohio is brilliant), but I’m pretty much convinced I’ll never step foot into a restaurant or public space until well into 2022 or beyond.
posted by mochapickle at 2:45 PM on May 13, 2021 [13 favorites]


Or is it that this kind of transmission is so low a possibility that even if it might still occur, the CDC doesn't consider it to be significant enough to warrant telling vaccinated people to continue to wear a mask?

The current best guess - scientifically informed best guess - is that the risk of transmission exists but is much reduced, on the level that the risk of illness exists but is much reduced.

we need to push vaccination to the hesitant.

That’s why they are doing this.
posted by atoxyl at 2:49 PM on May 13, 2021 [9 favorites]


If the CDC had not come to this conclusion, they would have been roundly (and correctly) criticized for not following their own scientific conclusions, which would have further reduced their legitimacy.
posted by PhineasGage at 2:49 PM on May 13, 2021 [40 favorites]


Further, there are more strains of SARS-CoV-2 each day, for which existing vaccines are less efficacious.

Cite, please ?
posted by tiny frying pan at 2:49 PM on May 13, 2021 [9 favorites]


For the foreseeable future I’ll continue to mask up in any enclosed space shared with strangers. And continue to eat outside as long as the option is available.
posted by Insert Clever Name Here at 2:51 PM on May 13, 2021 [8 favorites]


Then there is the looming threat of influenza

So masks forever then? I encourage you to continue masking if you want to, and seek out business which intend to require masks forever, but it is beyond the risk parameters of society for the government to enforce masks in all places until influenza magically vanishes from the planet. Feel free to lobby for this but you're not going to get any more traction than you would for a universal all-time 25 mph speed limit.
posted by 0xFCAF at 2:51 PM on May 13, 2021 [31 favorites]


why this concern is so amplified vs others leaves me scratching my head

I think it's because it affects my moral calculus. I don't need to know what's safe for /me/ to do, I need to know what's safe for the /community/ for me to do. We're in a collective crisis and those of us who prefer to act collectively would like to do so in a helpful way.
posted by corb at 2:52 PM on May 13, 2021 [30 favorites]


we need to push vaccination to the hesitant.

That’s why they are doing this.


Unfortunately I think it's not going to work as intended, and just give people who were on the fence about vaccination an excuse to just forgo it and tell everyone they got vaccinated anyway.
posted by tclark at 2:53 PM on May 13, 2021 [10 favorites]


In my (anecdotal) experience the idea that hedging too much on additional precautions for the vaccinated sends the message that the authorities don’t have much confidence in the vaccine is absolutely correct.
posted by atoxyl at 2:53 PM on May 13, 2021 [13 favorites]


not so much evidence- or fact-driven as political

I don't think you can separate the two. Regardless of how fact-based we want to be, deciding what to do in response to those facts requires value judgements, and balancing the value judgements of diverse groups of people is inherently political.
posted by jon1270 at 2:54 PM on May 13, 2021 [4 favorites]


On a tangent RE the Ohio lottery:

As with all lotteries, I wish there were more, smaller prizes to make it mathematically more likely that people could benefit from winning.

So, I'd rather Ohio was offering the chance for a hundred winners of $50,000. Or a thousand winners of $5,000. A lot more people could benefit from the smaller prize, rather than showering $1M on only a handful of winners.

But I understand that's not the mentality of a lot of people who play the lottery, in which the larger jackpots help to drive the interest.

/derail
posted by darkstar at 2:56 PM on May 13, 2021 [19 favorites]


And in my opinion the level of hedging on the effectiveness of the vaccines has been excessive. Yes, they will probably need to be updated at some point. People are working on that.
posted by atoxyl at 2:57 PM on May 13, 2021 [6 favorites]


We're in a collective crisis and those of us who prefer to act collectively would like to do so in a helpful way.

Except people in a collective crisis hoard toilet paper, fill plastic bags with gasoline, break the arms of store employees who are attempting to enforce masking….

Collectivism is a much harder sell than we thought.
posted by mochapickle at 2:57 PM on May 13, 2021 [10 favorites]




Because of vax+mask deniers, we're now entering a window of time where those of us that have young kiddos are SOL until vaccination is approved for them.

Before, I could take Microscone Jr. with me into the grocery store if necessary.

Now? Hell No.
posted by microscone at 2:58 PM on May 13, 2021 [49 favorites]


For the past year, my philosophy has been EVERYONE HAS COOTIES, including myself. It’s easier to just wear the fucking mask than to suss out the integrity and or sincerity of the people around me. There is no harm in acting as if everyone around you is potentially infected. As a side note, the CDC has been a total fuckup handling this kind of information. Yes. No. Maybe. Are not sufficient answers regarding masks during this plague. They and the politicians are just pandering to the masses to get popularity points. Wear a mask. Period.
posted by njohnson23 at 3:01 PM on May 13, 2021 [24 favorites]


Yeah, COVID's legacy will be of societal failure to deal with a big, deadly, discomfiting crisis.
posted by Slackermagee at 3:01 PM on May 13, 2021 [6 favorites]


I have been extremely careful since the beginning of the pandemic. I live in a place where most people have not been careful and I have been an outlier as far as caution. Luckily, many things happen outdoors since I’m in the Caribbean, I think it is the one factor that helped keep things from being much worse here.

I am fully vaccinated now, and anyone on my island can do it for free if they want (rates are still sadly low). I still go beyond the norm as far as masking when around others, but I think it is good to have reasonable, science-based advice about masking for vaccinated people. The people who are vaccinated, and are probably the same people who have been careful and respectful all along, are not the problem. They aren’t going to be driving the spread and here is no reason to make them keep wearing a mask if it really isn’t necessary. It doesn’t do anything to make other people safer. The people who don’t take covid seriously are already not taking masking and other measures seriously, and making vaccinated people go through the motions is not really going to improve that.

I would actually like to see acceptance of mask wearing as a thing people do if they have the sniffles or whatever in general, as is done in some countries.
posted by snofoam at 3:02 PM on May 13, 2021 [18 favorites]


Cases are down. [1]

As long as cases stay down, we can see what we can do about opening more things up and reducing restrictions. Cases go up, we can stop opening things up for awhile. This is the summer when we get to stop wearing masks...as much.


[1] Sorry Michigan; and we’re not talking about the rest of the world. Those places aren’t affected by local regulations, which is where the mask rules actually are.
posted by Huffy Puffy at 3:02 PM on May 13, 2021


Cite, please ?

Here are a couple preprints of some recent work: [1] [2] that suggest that the B.1.617.1 variant out of India is more resistant to the antibodies that current mRNA vaccines trigger one's body to make. There is also some work out of Israel done on the South African variant B.1.351, where the Pfizer vaccine may be less effective. In fairness, these are preprints, not yet fully reviewed, and they note that patients were still able to clear the virus, or that the strain prevalence was low enough that vaccine effectiveness was still high, overall.
posted by They sucked his brains out! at 3:04 PM on May 13, 2021 [4 favorites]


Unfortunately I think it's not going to work as intended, and just give people who were on the fence about vaccination an excuse to just forgo it and tell everyone they got vaccinated anyway.

If they are taking on the risk themselves, and they get sick, then they deserve it. Because we Americans are dumb, we're never going to get to herd immunity (unless by right-wingers having "COVID parties" to purposefully expose themselves). But the vaccines DO seem to be spectacularly effective. Like 99.99%. I just hit my two weeks after second shot this week, and it's so weird to be able to go places again. But it's really, really nice.

Frankly, I think the government should be forcing everyone who can to get the vaccine. But that's not going to happen, and I don't have a lot of patience for regulations to protect people who refuse to protect themselves. Who I DO feel for are the people who can't get the shot because of real health reasons. That super sucks and the government should pay them handsomely for the duration of this (but that's not going to happen, either).
posted by rikschell at 3:04 PM on May 13, 2021 [6 favorites]


Please remember, though you’re vaccinated and feel free to go maskless, the rest of us, as strangers, will probably assume you’re a maskless buffoon spreading contagion.
posted by njohnson23 at 3:07 PM on May 13, 2021 [33 favorites]


I'll tell you one thing, I'm never going through winter cold season again without masking. This is the first time in YEARS I haven't ended up with a miserable bout of bronchitis in January or February.

Because of vax+mask deniers, we're now entering a window of time where those of us that have young kiddos are SOL until vaccination is approved for them.

Yeah, this part is really stressful. All the adults in our orbit are vaxxed, but I don't know how many random people at Target are vaccinated! And my four-year-old asked me the other day, "Why don't we ever go outside?" and I said, "We go outside all the time," and she said, "No, why don't we go outside to a building." The only places she can remember going outside our home and my brother's home (we shared a bubble when it was allowed in our state) are the dentist and to get her flu shot. At the beginning of the pandemic, she cried a lot because she wanted to go with to the grocery store (as she always had!), and kept begging to go shopping for groceries or just to "do errands." She doesn't remember stores anymore.

Last week I took my 9-year-old to Old Navy b/c he's grown a lot since the beginning of the pandemic and we're past the point of guessing on sizes and ordering online. Tomorrow I'm taking my 11-year-old for the same reason. I'm glad we'll be done tomorrow, though, because if mask mandates are repealed locally, I really, really don't want to have to take my kids into stores. (But I'm also really sick of ordering three sizes of the same pant online and having to return all three because they're all wrong.)

"Unfortunately I think it's not going to work as intended, and just give people who were on the fence about vaccination an excuse to just forgo it and tell everyone they got vaccinated anyway."

I keep thinking that at some point, some state or court is going to open up tort liability when someone who CAN get vaccinated but chooses not to and infects someone vulnerable and they fall seriously ill or die, or touches off a(n expensive!) local cluster. I mean, the "personal choice!" anti-vaxxers thing is fine, but it's not just as personal risk calculus; it's like choosing to drive drunk. Right now, anti-vaxxers get to free ride on pro-vaxxers' willingness to take a small risk for the greater good. That will have to stop, and the traditional American way to stop stuff like that is lawsuits.
posted by Eyebrows McGee at 3:08 PM on May 13, 2021 [33 favorites]


Question at this point is: Do you trust the health authorities to weigh the details and make the right decision?

I've come around to feeling I can trust them. There have been so many failures, but covid as it stands in the US is mostly manageable, its details are well understood. It's the kind of thing they're institutionally able to deal with, unlike the early days.

So I'm gonna keep an eye on the case numbers just in case, but as long as they're not going badly wrong, I'm no longer trying to understand preprints on subjects I'm not qualified for, or reading opinion peices about "this one trick that could end the pandemic", or spending time immersed in all the stats and graphs and etc. Or weighing tradeoffs like the I think really complicated one involved in this mask guidance. If I wanted to do that, I'd pursue a career in public health. But if this pademic has made one thing clear to me it's that I don't want to do that.

Mask off here, unless there's a sign that says wear one, or I'm feeling sick, or interacting with someone who's wearing one.
posted by joeyh at 3:12 PM on May 13, 2021 [5 favorites]


No shoes
no shirt
no mask
no service.

That needs to be a widespread message among private businesses. Everyone is used to shoes and shirts being mandatory. Now? Masks are mandatory, too.

I don't know why this simple mnemonic device and messaging never caught on. I cannot say I "invented" this, but I've long thought that this should be the messaging on doors to private shops and other businesses. It's familiar, it's simple, and 2/3rds of it has been commonly respected just about everywhere (in the USA at least) for decades.

The CDC is terrible with messaging.
posted by SoberHighland at 3:14 PM on May 13, 2021 [15 favorites]


I don’t want to risk being mistaken for a Republican. #mask4eva

Is there nothing you people can't turn into a ridiculous culture war? The rest of the world mostly just listened to the scientific and medical advice they received without turning it into a ridiculous partisan political battle.
posted by atrazine at 3:16 PM on May 13, 2021 [46 favorites]


I intended that to be tongue-in-cheek but the answer is probably not. And by “you people” I have to assume you mean all people because I’ve got plenty of right-wing friends who have literally mocked people who adhered to mask mandates from day one.
posted by double bubble at 3:23 PM on May 13, 2021 [17 favorites]


"The world may have undercounted Covid-19 deaths by a staggering margin, according to an analysis released Thursday by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine. The actual count may actually be 6.9 million deaths, more than double official tolls.

"The United States alone is estimated to have had 905,000 Covid-19 fatalities, vastly more than the 579,000 deaths officially reported, and more than any other country." -- How the world missed more than half of all Covid-19 deaths, Vox, May 6 2021

Crummy CDC messaging bears some responsibility for these last 18 months of misery.

Moreover, some Americans couldn't stay in one place even during 'official' lockdowns -- how is the new guidance going screw over everyone outside of this country, who have different rates of vaccination (partly due to our hoarding) and have to share the planet with our reliably selfish asses?
posted by Iris Gambol at 3:23 PM on May 13, 2021 [21 favorites]


Is there nothing you people can't turn into a ridiculous culture war?

/gestures at last several centuries
posted by Celsius1414 at 3:24 PM on May 13, 2021 [33 favorites]


This is so fucking stupid, though. They should be telling people to keep the fucking masks on until 90% are vaccinated.

We're just not going to ever hit that number. There is a huge amount of people here who seem to not accept reality - I'm not talking about science, or what the CDC is saying, but just American human behavior and what it's actually like out there.

I'm not saying that we shouldn't be angry about it - I mean it sucks that people aren't going to get vaccinated, just like it sucked that people refused to wear masks when we needed to, but the reality is that covid is here to stay. We botched it, almost 600k died, we could have demonstrated that we were a collectively minded country but obviously we were never going to come close to that, because we just aren't. It is going to mutate regardless of what we do because billions of people living in poverty across the globe do not have access to the vaccine yet. We are not magically going to become a collectively minded country any time soon; we can and should push and vote and advocate for more collectively-minded social policy that other comparably-developed countries in Europe and Asia do a whole lot better than us. But simply asking, begging, demanding every single American to "do their part" and do XYZ doesn't work here...I'm sure smarter people know of ways that we could have done it better, but we didn't.

Stewing over the fact that vaccinated people are not going to continue to wear masks for the next X-however many years comes off more like a projection of anger at having failed that test so hard. I get it, kind of, but I'm also kind of over it. If you're vaccinated and still only comfortable wearing a mask everywhere, you should do it! If you're vaccinated and a business or immunocompromised person asks you to put one on, you should be respectful to them! But continuing to engage in the mask culture wars at this point seems like a pretty fruitless attempt to feel like you're Doing Your Part when it kind of seems like there's...not much more to be done here.

Sucks, but going to have to chalk covid up as an L! Obviously we should keep fighting it how we can, get as many people vaccinated as we can, strengthen our public health system as much as we can, encourage as many people possible to mask up/social distance if we experience another spike. But also, time to move on with life. If the CDC says as much, I'm good with it until noted otherwise. #BelieveInScience and such, etc.
posted by windbox at 3:24 PM on May 13, 2021 [63 favorites]


The CDC is terrible with messaging.

To be fair, they have been in a tough spot since the political aspects of the pandemic first moved them further away from their public health mission, e.g., mixed and confusing messages on mask guidance from the very start.
posted by They sucked his brains out! at 3:25 PM on May 13, 2021 [10 favorites]


Is there nothing you people can't turn into a ridiculous culture war?

Nope. Mrs Inflatablekiwi recently posted to a local mother's group here in a relatively blue part of Utah, asking if the school district was going to keep the mask mandate for the start of the new school year. The responses were so aggressive (like "haha -go ahead and send your kids to school with a mask and my kids will bully the shit out of them you libtard"), the group owner had to delete the thread entirely.
posted by inflatablekiwi at 3:27 PM on May 13, 2021 [22 favorites]


As a former long-suffering Falcons fan, allow me to make an analogy from the last NFL game I ever watched: 28-3 with 8:31 left to play in the 3rd quarter. This is positively Falconsian premature jocularity. Georgia will be lucky to get to 65% vaccinated.
posted by ob1quixote at 3:27 PM on May 13, 2021 [5 favorites]


I think I would be more comfortable with this announcement if children under twelve weren’t still prohibited from getting the vaccine. I know why this isn’t a good attitude, but my general feeling is if you don’t want to get vaccinated it’s your own funeral. *Except* there is literally a group of people who cannot get a vaccine no matter how much their parents might want them to have it.
posted by double bubble at 3:29 PM on May 13, 2021 [31 favorites]


The CDC guidelines are actually the rational conclusion to a post-vax world.

But...

I've been fully vaccinated since January, but I've been keeping my mask on just to model good behavior. I live in a state with one of the lowest vaccination rates. So I wear my mask and will continue to do so until vaccination rates in my state are no longer abominable. A lot of people have been extra asinine about COVID and I don't intend to give them the slightest edge the grasp upon as justification for their sociopathic stupidity.
posted by Panjandrum at 3:42 PM on May 13, 2021 [14 favorites]


If you're vaccinated and a business or immunocompromised person asks you to put one on, you should be respectful to them! But continuing to engage in the mask culture wars at this point seems like a pretty fruitless attempt to feel like you're Doing Your Part when it kind of seems like there's...not much more to be done here.

But here’s the thing. I’m immunized but it’s not effective on me. With masks, until now if I entered a place and saw someone not wearing a mask, I knew immediately who to steer clear of. If I entered a place where no one was wearing masks, I would just walk out to eliminate my risk. Now I have to assume that no place is safe because I have no markers to help me weigh the risk.

People with little kids have the same issue.

This isnt about virtue signaling. It never was. It was about doing a small, easy, nonintrusive thing to help your neighbor. And now even people who are community minded and willing to mask up are being encouraged to relaaaaaax.

I just checked my local county numbers. We had 7 deaths yesterday and 258 positive cases. We’re not even close to safe.
posted by mochapickle at 3:45 PM on May 13, 2021 [68 favorites]


New York Yankees Somehow Have 8 COVID Cases in Vaccinated Staff

This is because people, the CDC included, are being absolute morons about understanding risks.

If you had a 95% effective bullet proof vest would you walk in front a firing machine gun? Hopefully not!

Yet this is precisely the CDC guidance. You hear 95% effective and think that you risk is just 5% if exposed but that is not what the 95% means. It means that all things being equal the vaccinated got infected just 5% of the time that the unvaccinated did UNDER THE CONDITIONS THAT EXISTED AT THE TIME OF THE TRIAL. Very few of the volunteers in the vac trials probably engaged in systematically negligent and reckless behaviors during the trial because everyone was scared, it was mostly against the law, and most opportunities to do so were taken away. Even if you are willing to extrapolate the demonstrated relative risk reduction to all circumstances, which is a leap, you still need to factor in the baseline risk that the relative risk is supposed to act on. If you spend a 40/week in a room with an infected person you're not going to be 95% protected in total because your baseline risk could be something absurd like 90000%. Particularly if the person is a super-spreader (if you believe there is a super-spreader type and it is not simply timing, severity of infection and behavior).

The CDC is there very finite wisdom has decided to drastically alter the base risk of infection by authorizing all out recklessness for the vaccinated (and those who chose to pretend they are vaccinated). They are announcing that people can fire the machine guns all they want and not to worry about themselves and others. I already have friends who are dining in restaurants thinking they are safe even though only 35% of the city is fully vaccinated and a NYTimes survey had 50% of the indoor diners admitting they were dining in completely unvaxed.

The Yankee staff got infected because they thought they were 95% immune. They were not. They were 95% less likely to get infected than an unvaxed person. That is all. If you go swimming in covid for 8 hours a day every day it won't matter if you are vaccinated or not because even with a huge relative risk reduction your baseline risk is too high and you are rolling the dice too often and it will come up snake eyes just by chance because you gave it 5000 chances.
posted by srboisvert at 3:45 PM on May 13, 2021 [51 favorites]


Just a couple quick notes:

1. The word "hesitancy" conceals an important distinction between people that don't want to get vaccinated (at this point, mostly white Republicans) and people that want it, but don't have the time to either get vaccinated or lose working hours to recovery. The way to combat "hesitancy" among the latter group isn't with more incentives- they already want it!

2. PLEASE pay attention to the voices of the disabled. Like, all the time, but especially around this. In this thread and elsewhere.
posted by Jpfed at 3:46 PM on May 13, 2021 [43 favorites]


TAPPER: "How are restaurants, airlines, others, supposed to know if the people coming to their establishments [are vaccinated]?"
FAUCI: "Well, Jake, they will not be able to know. You're gonna be depending on people being honest enough to say whether they are vaccinated or not."
(source)

I... have my questions about whether "You're gonna be depending on people being honest" (to say nothing of actively motivated) is a strong enough assumption to hinge public policy on; but I'm getting enough people saying that if you're reluctant to give up your mask it's anti-science, so it must be fine.
posted by CrystalDave at 3:47 PM on May 13, 2021 [11 favorites]


The Yankee staff got infected because they thought they were 95% immune. They were not. They were 95% less likely to get infected than an unvaxed person. That is all.

The yankee staff got infected because they were vaxed in april and didn’t wait for the two week period to reach full protection.
posted by mochapickle at 3:48 PM on May 13, 2021 [18 favorites]


Please remember, though you’re vaccinated and feel free to go maskless, the rest of us, as strangers, will probably assume you’re a maskless buffoon spreading contagion.

People assumed I was a hoarder when I purchased enough groceries and supplies in February to tide my household through a possible 2-3 week illness without leaving the house. People assumed I was overreacting when I started wearing masks before any mandate came down. People assumed I was living in fear when I backed out of every event in 2020 and early 2021. People assumed I jumped the line when I lucked into an early vaccine appointment because of a medical condition I have.

I am fully vaccinated, I have read almost every article about the vaccines I can get my eyes on, and once my state lifts the mask mandate, I will be following the recommendations and going without it. Do you think it bothers me anymore what strangers assume about me?
posted by kimberussell at 3:48 PM on May 13, 2021 [35 favorites]




>I'm sure smarter people know of ways that we could have done it better, but we didn't

since this is a nation with a large cohort of toddlers, reverse psychology would have worked better. Maybe that was what they were going for with the "masks, eh" initial guidance.

The flimsy blue procedure mask I wear in stores is such a minimal burden to bear, but said toddlers among us are fighting a to-the-death culture war against any form of collectivism.

These are the same people who considered gov't involvement in polio inoculation programs creeping socialism.

WASHINGTON, June 14 [1955]-- Mrs. Oveta Culp Hobby branded a Democratic plan for free poliomyelitis vaccine to all children today as a possible "back-door" approach to socialized medicine.
posted by Heywood Mogroot III at 3:51 PM on May 13, 2021 [13 favorites]


I haven't seen anyone talking about this yet, but my county is beginning clinics in high schools starting tomorrow, and I've heard that at the high schools in my area, signup has been quite high. Now that it's approved for 12-and-up, local junior high students are being invited to planned clinics in the high schools and they're planning further clinics targeted at junior highs (although usually in the town hall, because 12/13 year olds need a parent present to get a Covid shot. 14-15s need signed permission; 16+ can consent themselves, in my state). But that's obviously a great idea, signing up an entire high school at once and using high schools themselves to push vaccination, make it convenient, and add in some peer pressure. And even if they're not doing clinics in the junior highs (yet), pushing signups through school districts where they're getting information to every family in the district and making signups really easy. My little suburb of 35,000 is expecting to vaccinate more than 2000 teenagers tomorrow, which is AMAZING.

I'm kind-of hoping that come September, when they're hoping to approve the Pfizer vaccine for 5-11 year olds, they'll do the same at elementary schools, and I'll just drop in to the school nurse's office, and they'll bring in my kids and give them the shot, and I'll come back a month later and they'll do it again. Polio style!
posted by Eyebrows McGee at 3:58 PM on May 13, 2021 [20 favorites]


WASHINGTON, June 14 [1955]-- Mrs. Oveta Culp Hobby branded a Democratic plan for free poliomyelitis vaccine to all children today as a possible "back-door" approach to socialized medicine.

I wonder if she's related to the Culp in Washington State, who seems to share a similar outlook regarding how to (not) handle mass outbreak of disease.
posted by They sucked his brains out! at 4:02 PM on May 13, 2021 [3 favorites]


Anti-Maskers Ready to Start Masking—to Protect Themselves From the Vaccinated #nottheonion


As a biochemist and a college professor, I am torn between rejecting this new trend as outrageously ignorant, and provisionally overlooking this messaging as a way to get a few million reluctant USian anti-vaxxers to at least wear a mask so that we can save some lives.

But mostly it just makes me tired and want to go lie down for a bit.
posted by darkstar at 4:03 PM on May 13, 2021 [42 favorites]


It was about doing a small, easy, nonintrusive thing to help your neighbor.

Yeah and unfortunately this type of "please individual, do your part!" stuff isn't - and was never - a replacement for any kind of actual federal public health policy in the face of an airborne pandemic, so it's just not going to happen. I'm encouraging people to just be realistic about actual, human behavior. You're right to be mad that we never made it close to reaching any kind of collective social consensus, and no dispute that people like you have been failed the hardest! That said, yeah, people are probably going back to the bar to have a maskless drink this summer no matter how hard people give them the stink eye or think they are Trumpers or against #Science, etc.
posted by windbox at 4:04 PM on May 13, 2021 [3 favorites]


I’m fully vaccinated. I work in a public facing environment. My state still has a mask mandate. I’ve had some very unpleasant encounters while enforcing my workplace mask policy. Leadership at my workplace is scrambling as I write this to figure out how we will handle unmasked patrons.

I’m scheduled to work this weekend and am really close to having an anxiety episode.
posted by bookmammal at 4:05 PM on May 13, 2021 [24 favorites]


Hundreds of Epidemiologists Expected Mask-Wearing in Public for at Least a Year
“Unless the vaccination rates increase to 80 or 90 percent over the next few months, we should wear masks in large public indoor settings,” said Vivian Towe, a program officer at the Patient-Centered Outcomes Research Institute.

The responses came from 723 epidemiologists, submitted between April 28 and May 10, before the new guidance from the Centers for Disease Control and Prevention. The survey asked epidemiologists about being outdoors in groups of various sizes, and about being indoors with people whose vaccination status was unknown. The situations were consistent with the new guidance, which governs behavior in public places, regardless of size, where it is impossible to know the vaccine status of others...

Epidemiologists are, on the whole, very cautious when it comes to Covid-19, by nature of their training in understanding risk and preventing the spread of infectious disease. Nearly three-quarters described themselves as risk-averse, and they are likely to have been able to work from home over the past year, unlike many Americans. But they also have the same training as many of the scientists at the C.D.C. who devised the new policy, and about one-third of the survey respondents work in government, mostly at the state level.
*shrug*
posted by They sucked his brains out! at 4:09 PM on May 13, 2021 [28 favorites]


Thanks, windbox.

This year has been so isolating for so many of us. I’m genuinely glad people are seeing some kind of normalcy, but it just makes me feel all the more isolated because it’s even less safe to participate in small ways, like having anyone in my house or sneaking into a grocery store in the early morning for the small, sweet luxury of picking out my own produce.
posted by mochapickle at 4:11 PM on May 13, 2021 [6 favorites]


I intended that to be tongue-in-cheek but the answer is probably not. And by “you people” I have to assume you mean all people because I’ve got plenty of right-wing friends who have literally mocked people who adhered to mask mandates from day one.

I meant all Americans.
posted by atrazine at 4:17 PM on May 13, 2021 [1 favorite]


Has anyone seen any CDC guidance for parents of children too young be vaccinated?
posted by MrJM at 4:30 PM on May 13, 2021 [6 favorites]


If you spend a 40/week in a room with an infected person you're not going to be 95% protected in total because your baseline risk could be something absurd like 90000%.

You seem to be implying that immunity is simply an X% reduction of infection risk per exposure, such that with infinite exposures everybody’s risk approaches 100 percent.

I am not a medical professional, so I’ll let somebody who is address this more authoritatively, but I am pretty sure this is not an accurate understanding of immunity. Not with any sort of realistic exposure conditions, anyway.

It means that all things being equal the vaccinated got infected just 5% of the time that the unvaccinated did UNDER THE CONDITIONS THAT EXISTED AT THE TIME OF THE TRIAL. Very few of the volunteers in the vac trials probably engaged in systematically negligent and reckless behaviors during the trial because everyone was scared, it was mostly against the law, and most opportunities to do so were taken away.

The trials included thousands of people, so as to capture a realistic range of behavior. It’s possible that there’s a difference in behavior between people who would enroll in a trial and people who would not. But acting as if everybody was living super cautiously last year is as silly as right-wingers acting as if America was under hard-core lockdown. It’s just not the reality on the ground. The bigger possible deviation from the conditions of the trials is different strains of virus.

You hear 95% effective and think that you risk is just 5%

A 95 percent risk reduction over the trial period is almost certainly much better than a 5% absolute risk per exposure.
posted by atoxyl at 4:34 PM on May 13, 2021 [13 favorites]


So cases are already ticking up in the UK due to the India variant - and they're locked down. There is of course going to be another wave here in the US, maybe an enormous one, which will be made much worse by ending the mask mandate. Of course, we can try to reinstate it when we get a monster wave of cases, but it will be a bit late then. This is incredibly stupid and awful and has completely changed my plans for the summer - I was just getting back into, like, dipping into a bookstore or going to the grocery store in the middle of the day instead of at 6am when they open, but no more of that. I had just been going to go to the dentist and I really should have booked that appointment as soon as I was fully vaccinated because now the dentist's office will be full of infectious unmasked idiots.
posted by Frowner at 4:51 PM on May 13, 2021 [18 favorites]


Has anyone seen any CDC guidance for parents of children too young be vaccinated?

I emailed the CDC about this a few weeks ago. Their response was largely unhelpful, but boiled down to 'unvaccinated kids are the same as any other unvaccinated people.' So, permitted to go maskless around vaccinated people but if anyone else is unvaccinated, masks and social distance, preferably outdoors.
posted by scottcal at 4:53 PM on May 13, 2021 [1 favorite]


It means that all things being equal the vaccinated got infected just 5% of the time that the unvaccinated did UNDER THE CONDITIONS THAT EXISTED AT THE TIME OF THE TRIAL. Very few of the volunteers in the vac trials probably engaged in systematically negligent and reckless behaviors during the trial because everyone was scared, it was mostly against the law, and most opportunities to do so were taken away.

We don't need to restrict ourselves to the conditions of the trial however because we now have large-scale real-world vaccination data. See Table 1a here. We're looking at ~90% effectiveness. The number I find most interesting is the infection effectiveness from Israel. 92% is pretty damn impressive.

The other thing to keep in mind is that the baseline infection rate is something like 1%, so we're talking 5% of 1% which is 5 in 10,000. And case rates are falling from the peak, so the baseline is dropping. I'm in a county with 0.7% testing positivity and a daily case rate of about 0.003% (overall case rate since the start of the pandemic like 38%, though!). As a vaccinated individual, my risk is miniscule.
posted by mr_roboto at 4:54 PM on May 13, 2021 [17 favorites]


My sister's immunocompromised and a Trumpie. So we have fun conversations.
posted by kirkaracha at 4:58 PM on May 13, 2021 [6 favorites]


There have been countless other pandemic threads here on MetaFilter, including this most recent one on the changing scientific understanding and evolving communications about aerosol spread of the coronavirus.

Nevertheless here we are, a community of mostly good spirited rationalists, with a - forgive me - meta example of the challenges of accurate and clear communicating by the science community.

CDC undermined public trust over the last year with inaccurate, lagging, and overly cautious guidance. Now when most medical experts (not that random mish-mash of epidemiologists in the NYT's informal "survey") support today's CDC recommendations, apparently many here on MetaFilter don't accept them.
posted by PhineasGage at 5:00 PM on May 13, 2021 [16 favorites]


It was inevitable: Trump politicized the CDC and made them untrustworthy (in the same way NOAA hurricane forecasters had to apologize for telling the truth after the sharpie incident). Now no one can fully trust them. This is what Republicans do: discredit all government agencies so they can be destroyed or turned into grift machines. Democrats can't just undo that; it will be the work of generations (and bad state actors like violent racist police have to be dismantled to win trust from the opposite end).
posted by rikschell at 5:15 PM on May 13, 2021 [42 favorites]


I’m going to do it where allowed, but I am concerned about the non-vaccinated piggybacking and being misleading.
posted by Selena777 at 5:21 PM on May 13, 2021 [2 favorites]


So my church board is having to do a lot of calculations now that things are opening up. Can we let vaccinated people hold church? Only if you don't mind barring under-12 kids (and their parents). What about when most of our people are vaccinated? We still have to watch local rates, because we are open to visitors, and they might not be vaccinated.

And most worryingly: if someone gets sick after we open, could we be liable and will our insurance cover us? No one knows the answer.
posted by emjaybee at 5:22 PM on May 13, 2021 [5 favorites]


I don't get why the approach wasn't "Good news! Once we get 70% of the country fully vaxxed, we won't need masks indoors" - that way there is a clear carrot to encourage more people to get the vaccine. And 70% seems like a reasonable target, especially now that teens can get it.

I just heard Fauci on the radio within the last week saying we'll need masks until cases decline more - I'm generally on the side of trusting the good news that the vaccines work, but this seems a few weeks too soon.
posted by coffeecat at 5:32 PM on May 13, 2021 [24 favorites]


I think everyone’s personal experience is different and we all live in different places. I live in a place with high vaccine skepticism. It is a small community where many people know me and haven’t seen me in a year, or maybe only masked on rare occasion. When I am walking through town now, unmasked, I end up in lots of conversations about what I’ve been up to and I always mention how I am doing more stuff now that I have been vaccinated. Does it make a difference? Who knows? It is pretty interesting, though. In line at the water company, many people were pretty knowledgeable about the vaccines, even the differences between different ones, but few had done it. One person suggested getting vaccinated now, while it is free, in case they start charging. People were also persuaded by seeing “big men” like politicians doing it. Where I am, there are legit historical reasons not to trust the colonizers, so it is a complex issue.

On a personal level, I am really looking forward to it being over enough to not talk about it. I have so many friends who have taken approaches I would not. For sure there are some people that I don’t want to hang with anymore, but there are also a lot that I really love in lots of ways that have been really dumb and I just don’t really want to know about or talk about it.

Part of the approach my partner and I are taking is just really managing our social situations. Like, we will visit other vaccinated people and went out to eat once outside. I am totally enjoying not wearing a mask outdoors, and I am fine still avoiding 80% of the places where I used to hang out with people.

I feel like it is just natural to cherry pick info that fits into what we want to believe, which is why good advice from places like CDC is so important. In this thread there are a number of comments that seem to misunderstand risk for vaccinated people, which seems to be very low, especially for the mRNA vaccines, so far, for both getting and transmitting. I hope it continues to be that way. I am totally willing to change my behavior if the situation changes.
posted by snofoam at 5:42 PM on May 13, 2021 [10 favorites]


I have no idea what to make of this, or anything, any more. It's one thing to say "Hey, the vaccinated are probably like 90% safe!" but at the same time, saying they all can go mask free means that everyone who was anti-vax/Trumpy/whatever was going to do that anyway, and now that everyone's mask free, then we can't tell the difference between ANYBODY and uh...THAT'S ALSO SUPER BAD.

Basically, the CDC is effed no matter what they say because it's either Too Soon or Too Slow.
posted by jenfullmoon at 5:48 PM on May 13, 2021 [4 favorites]


If you spend a 40/week in a room with an infected person you're not going to be 95% protected in total because your baseline risk could be something absurd like 90000%.

This is not how immunity works. Immunity works by affinity to the antigen. If you spend 40/week in a room with an infected person your blood is eventually going to be flooded with antibodies matching their antigen. If you are vaccinated and spend 40/week in a room with an infected person there's a ~5% chance that your antibodies won't match their antigen because there's a weak or no affinity between your antibodies and their antigen. In those cases the severity will come down to how much affinity your existing antibodies have, whether you need to engage the adaptive immune system, and how long it takes the rest of your immune system to get into gear while the virus attempts to build a beach head.

If your antibodies generated from the vaccine have weak affinity they will still lower the number of cells the virus infects and will slow down the replication of the virus overall. Sometimes the innate immune system might be able to clear the infection up without even having to engage the adaptive system. Sometimes it might be overwhelmed and have to call in the second line. Sometimes it might be a wait on your B-cells generating the right antibody with a strong enough affinity to contain and push the virus back and that might now come for days.

So no, spending 40/week in a closed room with someone infected isn't going to get you infected even if you're vaccinated. It's either 95% chance the existing humoral immunity and antibody affinity is strong enough to basically stop the virus from the outset or you then generate an adaptive immune response which can vary in severity based on how well your existing antibodies neutralize the virus.
posted by Your Childhood Pet Rock at 5:58 PM on May 13, 2021 [34 favorites]


In a lot of areas CDC recommendations are superseded by state, local or private guidelines. I may actually get to go in the office again in the next month, but we'll be 100% mask mandatory and distancing guidelines too. At least at the moment retail stores in my county need to maintain masks. CDC still says wear masks on public transportation (including airplanes), which is probably the longest inside-space you'll be exposed to random people.

If I (as I type this from my couch) were inventing nationwide guidelines I'd probably be a bit more restrictive than the CDC. But it doesn't seem to me that they are being "morons" or that my thinking it's roughly OK means I don't understand risk.

We've had a year where, generally speaking, "more concerned about Covid" meant "more rational and more committed to the well being of fellow Americans." With vaccines is becoming less true and it's going to get harder to identify the right course of action. But I don't think we can just rely on the muscle memory this shithell of a year has given us to judge what's best for others.
posted by mark k at 6:01 PM on May 13, 2021 [10 favorites]


I don't know where it's like where you all are, but I live in a red state, and the people who don't want to wear masks stopped wearing them awhile ago, except at a few hardcore and very well managed places like Costco. I just don't see this changing a lot of behavior among willfully unvaccinated people.

I'll keep wearing a mask at the grocery store until I see most of the staff stop wearing them, but I really don't feel like it's an appreciable risk at all at this point. I worry more about getting into a car accident on the way there.
posted by skewed at 6:02 PM on May 13, 2021 [13 favorites]


we need to push vaccination to the hesitant.
That’s why they are doing this.


Yeah, my take is that is very likely an attempt to poke falling vaccination rates. At this point pretty much everybody who was going to get vaccinated regardless has gotten a shot, or at least is able to. The low hanging fruit has been picked and rates are plummeting. The next fruit to go after is those people who aren't anti-vaxx wackadoos or Trumpian nihilists - people who will never get vaccinated voluntarily - but will take some convincing.

And one thing making it hard to convince them is probably the fact that up to now, vaccination didn't do anything for you (apart from making you less likely to get sick, obviously, but we're talking about people who apparently aren't overly concerned about that). Up til now, if you got the vaccine, you still had to wear a mask everywhere, stay six feet apart from people, not go to social events, etc. etc. exactly as if you'd never been vaccinated at all. So if it's not going to change your day to day life in any way, why take the risk?

So this offers those people a carrot. Whether it's the right carrot or not I can't really say. It will mean widespread dumping of restrictions, and there will be a lot of unvaccinated people taking their masks off. Those people were always going to be a problem. And it may help push us toward that 70 percent figure the administration wants to reach.
posted by Naberius at 6:05 PM on May 13, 2021 [5 favorites]


Since this the closest we're gonna get to an Period at the end of the pandemic in the US, I'm celebrating by streaming Alvin Lucier's 90th Birthday Celebration, a day long mass performance of "I Am Sitting in a Room". People sitting on zoom listening to people sitting on zoom ad infinitem. (previously)
posted by joeyh at 6:16 PM on May 13, 2021 [2 favorites]


everybody who was going to get vaccinated regardless has gotten a shot, or at least is able to

Unless you've had issues finding a place which won't check ID/immigration status, or if you've been turned away because you couldn't find the right insurance information (since if you have some sign of insurance that means you can't be processed as not having insurance), or if you can't take the time off to get the shot (and deal with side-effects), or...

There's still a lot of gaps out there people've fallen into while still wanting to get a vaccination. The rollout's been messy, and "This policy says that shouldn't be an issue" doesn't actually make it change on the ground.
posted by CrystalDave at 6:17 PM on May 13, 2021 [9 favorites]


Leadership at my workplace is scrambling as I write this to figure out how we will handle unmasked patrons.

My spouse just said at her library, they're no longer going to ask patrons to wear masks. She's going to keep wearing hers though, she's immunocompromised (though fully vaccinated).

I'm hoping my employer allows me to just keep working from home, for multiple reasons beyond COVID.
posted by Foosnark at 6:24 PM on May 13, 2021 [4 favorites]


Unless you've had issues finding a place which won't check ID/immigration status, or

The vaccine is available to all immigrants, regardless of status. That said, I’m betting that many undocumented immigrants would still be hesitant to step forward.
posted by mochapickle at 6:31 PM on May 13, 2021 [5 favorites]


Once again CDC is undermining itself by the mixed & contridictary messaging. It was just over a week or so ago that they put out a complex chart on masking rules much to everyones ridicule. Would have been much nicer if the CDC just maintained a strict stance saying that every x months it will share data gathered so far, set milestones, update guidances etc and follow a predictable path. This really feels like shooting from the hip. I understand that we are learning new info everyday but it will build confidence if the guidance rollout is more structured.
posted by asra at 6:33 PM on May 13, 2021 [13 favorites]


no mask
no service.

That needs to be a widespread message among private businesses. Everyone is used to shoes and shirts being mandatory. Now? Masks are mandatory, too.

I don't know why this simple mnemonic device and messaging never caught on.


Because people working retail and usually being paid terribly do not want to risk confrontations with customers, especially when they turn violent.
posted by doctornemo at 6:36 PM on May 13, 2021 [16 favorites]


"especially when they turn violent."

Especially when local police departments have leaned right and can't be arsed to enforce local mask rules or won't arrest guys who take a swing at retail workers.
posted by Eyebrows McGee at 6:38 PM on May 13, 2021 [22 favorites]


It's been a long and intense day, so please forgive me that my first reaction was:


Camilla: You, sir, should unmask.
Stranger: Indeed?
Cassilda: Indeed, it's time. We all have laid aside disguise but you.
Stranger: I wear no mask.
Camilla: (Terrified, aside to Cassilda) No mask? No mask!
-Act 1, Scene 2 of The King In Yellow
posted by doctornemo at 6:39 PM on May 13, 2021 [37 favorites]


From the reading I've done in the past year I've learned there is a difference between "efficacy studies" for vaccines and "effectiveness studies". It seems like a lot of people in this thread are describing vaccine "effectiveness" when they think they are talking about "efficacy".

I found a Lancet Editorial that describes "efficacy studies and clears up a common misconception regarding how to interpret them:

The mRNA-based Pfizer1, 2 and Moderna3 vaccines were shown to have 94–95% efficacy in preventing symptomatic COVID-19, calculated as 100 × (1 minus the attack rate with vaccine divided by the attack rate with placebo). It means that in a population such as the one enrolled in the trials, with a cumulated COVID-19 attack rate over a period of 3 months of about 1% without a vaccine, we would expect roughly 0·05% of vaccinated people would get diseased.

If we vaccinated a population of 100 000 and protected 95% of them, that would leave 5000 individuals diseased over 3 months, which is almost the current overall COVID-19 case rate in the UK. Rather, a 95% vaccine efficacy means that instead of 1000 COVID-19 cases in a population of 100 000 without vaccine (from the placebo arm of the abovementioned trials, approximately 1% would be ill with COVID-19 and 99% would not) we would expect 50 cases (99·95% of the population is disease-free, at least for 3 months).

The New York Times also has a fun activity, but I'm not sure if you'll hit a paywall: New York Times Link.

Vaccine "effectiveness" is a more nebulous concept. It attempts to capture the "real world" performance of a vaccine at a given time within a given population. Unlike vaccine efficacy trials, which use randomized control designs, studies that look at effectiveness have more varied designs.

More on the difference here: Link.

When the vaccines first released we really only had information about their efficacy. I imagine we're now seeing more evidence of their effectiveness, which may be what is driving decision-making in this case.

Still, I'm somewhat surprised at the abrupt change. I suppose this means I'll run of the risk of getting shouted at by someone whether or not I wear a mask now.
posted by eagles123 at 6:43 PM on May 13, 2021 [4 favorites]


Would have been much nicer if the CDC just maintained a strict stance saying that every x months it will share data gathered so far, set milestones, update guidances etc and follow a predictable path

The problem is, unless x is way less than one this is far too slow an update pace. This is more obvious (and important) if you imagine them trying to stick to it in the middle of the surge. It seems less harmful as the damage on a downswing but it's still basically abdicating its role.

I agree that they have certainly caused problems with their approach over the last year. The last update was both confusing and of questionable accuracy. Would sticking to it have increased public confidence in them? Probably not.
posted by mark k at 7:24 PM on May 13, 2021 [3 favorites]


In the short term, this only increases the risk to my children from indoor settings, so I guess it will now be even longer before I start bringing them into indoor spaces. In addition to fearing that an infected child may infect one of their various immunocompromised grandparents, people still seem to underestimate the risks to kids, perhaps due to comparing them to the incredibly high risks to adults. But the risks to kids are real: "between 0.1%-1.9% of all child COVID-19 cases resulted in hospitalization" (APA; hospitalization rate over the last week: 1.2%). A 1/100 risk of hospitalization if they catch Covid is still too high a risk for my tolerance when community rates in my state are still 5x what they were last summer, and indoor masking rates are now likely to be well below last summer.
posted by chortly at 7:37 PM on May 13, 2021 [16 favorites]


Regardless of what the CDC says, you can still be more cautious, for you and your children...

I used to play indoor soccer. I am a keeper. I can not do that in a socially distanced manner. I am fully vaxxed. But, the pandemic has made me wonder if I will be able to start playing in July. I lived to play, and now... shrug

Thankfully, my 15 and 1/2 yo was able to get his first shot today.

But, the "after times" are going to be weird
posted by Windopaene at 7:44 PM on May 13, 2021 [2 favorites]


I'm prepared for a day when I don't have to mask all the time. I'm fully vaccinated, and all that. I'm just not quite ready yet. Positivity rates in New York state have been hovering just above 1%. If we can get below 1% for a couple weeks, I think I'll be ready to unmask sometimes. But I will absolutely be masking up on the subway and in the store, and probably other places for a little while longer.
posted by SansPoint at 7:47 PM on May 13, 2021 [2 favorites]


I happily stopped masking outdoors as soon as my locality said it was OK. But now I have to wear sunscreen for the first time in more than a year. And my face gets cold!
posted by PhineasGage at 7:51 PM on May 13, 2021 [5 favorites]


And it may help push us toward that 70 percent figure the administration wants to reach.

I don't know whether the CDC did the right thing here (though I'm going to continue masking in public indoor spaces, despite being vaccinated), but you're probably right that it's a carrot for people to get vaccinated.

The thing is, though -- wouldn't we have gotten outraged if, under the previous administration, we had perceived the CDC to be making decisions for political reasons?
posted by nosewings at 8:04 PM on May 13, 2021 [2 favorites]


since this is a nation with a large cohort of toddlers, reverse psychology would have worked better.

I think it was just about this time last year that John Oliver observed that if 45 had arranged to have a billion red masks reading Make America Great Again airdropped all over the US, he likely could have won re-election (and, incidentally, saved tens or hundreds of thousands of lives).
posted by ricochet biscuit at 8:20 PM on May 13, 2021 [14 favorites]


The vaccine is available to all immigrants, regardless of status. That said, I’m betting that many undocumented immigrants would still be hesitant to step forward.

When I got my shot at the grocery drug store of a major chain, one of the first things they said was "I need to make a photocopy of your id and health insurance card". The online appointment portal did mention that immigration status didn't matter, but no signs at the counter. It may have said something about insurance but I didn't notice it, and had to specifically check online later. The store also has a bunch of signs about other vaccines that say "free with most insurance". I wonder if they get a higher reimbursement from the health insurance than the government. I can totally see why someone would be hesitant.

Some genuinely low hanging fruit to combat vaccine hesitancy would be to just require all vaccinations sites to have large signs in multiple languages stating that you don't need an id or health insurance.
posted by fruit sandwich at 8:26 PM on May 13, 2021 [6 favorites]


I keep thinking that at some point, some state or court is going to open up tort liability when someone who CAN get vaccinated but chooses not to and infects someone vulnerable and they fall seriously ill or die,

Misrepresenting one’s vaccine status to gain access to some place or event and then having that happen seems to me like the most likely way for that kind of liability to start being recognized.
posted by snuffleupagus at 8:30 PM on May 13, 2021 [1 favorite]


The thing is, though -- wouldn't we have gotten outraged if, under the previous administration, we had perceived the CDC to be making decisions for political reasons?

Are you implying that dropping mask mandates to encourage vaccination is a political decision? I don’t think so, it’s an attempt to make a public health tradeoff. It incurs some risk from non-vaxxers flaunting the “honor system” mask rule but if it does increase vaccine uptake that’s a far more powerful safety measure than the masks most people wear.
posted by atoxyl at 8:34 PM on May 13, 2021 [7 favorites]


By the way since it’s also being discussed here there’s a good NYT piece about the remaining vaccination gaps that are more access than “hesitancy.”
posted by atoxyl at 8:38 PM on May 13, 2021 [7 favorites]


Has the CDC or Fauci actually said that the decision to drop mask mandates right now is in order to encourage more vaccination uptake? We all believe that that's the reason (eg, this Harvard epidemiologist quoted in the Times) but have the authorities publicly said so? I might have missed it -- from authorities, I mostly hear that the decision was based on "the science," by which they seem to mean something about absolute risk: that the risk to the vaccinated is now known to be so small that masks are no longer beneficial. The part I haven't heard is "the science" showing that this will actually encourage vaccine uptake. I've actually never heard of the CDC or their team doing empirical social science or even surveys trying to measure the estimated effects of policy changes like this, and absent that, the effects on public behavior are purely speculative. Which is fine, sometimes you have to do that, but it isn't science. The CDC has generally been very reluctant to take actions unless there was actual, positive, published evidence in support of basic medical recommendations, but when it comes to tweaking policies in order to affect public behavior, I don't actually see the scientific conservatism any more, just shooting-from-the-hip guesses about what the always-unpredictable public might do. Which again, may be called for right now, but (a) is not consistent with the standard "follow the science" mantra, and (b) is something that is hard for them to publicly acknowledge, especially since on the other side of the equation, in the short term relaxing mask recommendations is almost certainly going to result in more contagion and more death. It may be that the lives saved by increasing vaccination rates outweigh those short-term costs, but I've seen no science behind that, nor even any explicit official acknowledgment that this is the trade-off they are accepting.
posted by chortly at 8:53 PM on May 13, 2021 [6 favorites]


The CDC's science brief for this change cites polling data and says "In summary, relaxing certain prevention measures for fully vaccinated people may be a powerful motivator for vaccination".
posted by joeyh at 9:02 PM on May 13, 2021 [13 favorites]


Awesome -- hadn't seen that! Ideally I'd like to see more than just a Harris poll, but I'll take what I can get -- thanks for the info and the link.
posted by chortly at 9:08 PM on May 13, 2021 [1 favorite]


But given that there's no way to validate that someone is vaccinated or not, how does this help? If you had to demonstrate that you were vaccinated in order to reap the benefit of going maskless in the grocery store or at work, yeah, I believe the new guidance would drive up vaccination. But given that it's toothless, I'll bet most states will use it as an excuse to ditch mandates, corporate managed stores certainly will (other than maybe a few frufru chains), and the unvaccinated will shrug and move on with life without getting vaccinated. This provides no actual inventive to get vaccinated to people that aren't but places the at-risk in greater danger.
posted by Candleman at 9:41 PM on May 13, 2021 [15 favorites]


I'm going to be hanging out with friends indoors unmasked for the first time this weekend, but I know they are all vaccinated and can trust them. I plan to wear a mask in any stores I go to for quite a while yet, because I expect they will be full of lying Trumpist assholes. And while I now have a very small chance of getting dangerously sick, I'd still prefer not to be flat on my back with a lesser case of Covid, and the J&J only gives you about 70 percent chance of avoiding that.
posted by tavella at 9:41 PM on May 13, 2021 [8 favorites]


The Yankees story doesn't mention cycle threshold (Ct) values of their positive tests.

The CDC has transitioned to using a Ct value of 28 or lower for investigation of breakthrough cases.
See the form 'Information for laboratories COVID-19 vaccine breakthrough case investigation' at https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html.
A Ct value above 25 is a low viral load, as it is. Many labs use a Ct value in the mid to high 30s.

Now, as far as transmission risk goes, 15-20% of infected people account for 80% of onward transmission. As a breakdown, around 10-12% infect >5 people, another 7-8% infect 5> N >1 people, and 10% infect 1 other person. 70% don't infect anyone else. And this is among the unvaccinated, based on contact tracing data from China, Hong Kong, Boston..etc. See 'Catch me if you can: Superspreading of SARS-CoV-2' at https://www.cell.com/trends/microbiology/fulltext/S0966-842X(21)00124-4#secst0015.

Household attack rates i.e. transmission from one person to another in a home is 15-18% i.e. 80% of primary cases don't infect anyone with whom they live. Note that peak infectivity is the 2 days around symptom onset. Cohabitants may become cautious after symptom onset but not before.

Now why is this very skewed infectivity the case. Probably because of the high skew in amount of bioaerosols expelled by the infected.

From

Exhaled aerosol increases with COVID-19 infection, age, and obesity
https://www.pnas.org/content/118/8/e2021830118
In our observational cohort study of the exhaled breath particles of 194 healthy human subjects, and in our experimental infection study of eight nonhuman primates infected, by aerosol, with SARS-CoV-2, we found that exhaled aerosol particles vary between subjects by three orders of magnitude, with exhaled respiratory droplet number increasing with degree of COVID-19 infection and elevated BMI-years. We observed that 18% of human subjects (35) accounted for 80% of the exhaled bioaerosol of the group (194), reflecting a superspreader distribution of bioaerosol analogous to a classical 20:80 superspreader of infection distribution.
'three orders of magnitude' means a 1000-fold difference !!

Now, what the vaccination does is reduce the viral load by a lot which reduces expelled bioaerosols, and that limits infectivity. So, a post-vaccination positive test is a red herring unless the Ct value is low.
posted by daksya at 9:52 PM on May 13, 2021 [10 favorites]


Was a bittersweet day for us. I have a more or less normal immune system. My partner is on anti-rejection meds. We're both fully vaccinated.

At first we were both relieved at the thought of giving masks up. And then today I found a paper released a week ago. It's an early summary of a study of how effective vaccines are in organ transplant recipients. 46% of the 658 participants had no antibodies present after 2 shots. 39% only had antibodies show up after the second shot. 15% had measurable antibodies after the first shot.

Antibody Response to 2-Dose SARS-CoV-2 mRNA Vaccine Series in Solid Organ Transplant Recipients

My partner took this news in stride, and understands this is an early study with more studies to come which might have completely different results, but it means the lockdown continues for her. And I'll keep masking because I don't know for certain that I won't bring anything home. It's frustrating because it feels like we came this close to having normality again, and then not so much.
posted by Teegeeack AV Club Secretary at 9:58 PM on May 13, 2021 [11 favorites]


This Week’s Real Time Canceled After Host Bill Maher Tests Positive for COVID-19: Fortunately for Maher, he was already “fully vaccinated” and is currently “asymptomatic and feels fine.” No one else on the show has tested positive for COVID as of yet, and HBO plans to reschedule the episode at some point in the future.
posted by Iris Gambol at 10:04 PM on May 13, 2021


^ Yep, Teegeeack… We’ve been watching those studies closely, too. Per my infectious disease doctor, they’re hoping the solution is perhaps as simple as giving us extra doses to boost the immune response, but there are more studies to be done before that gets decided, and that takes time. I’ve been testing for antibodies for a different virus and I havent been able to create any so far, so I’m just in waiting mode.

There’s some kind of a huge transplant conference in June and they are hoping to have more info/direction by then. Fingers crossed.
posted by mochapickle at 10:10 PM on May 13, 2021 [6 favorites]


There are also a surprising number of folks who think you can get covid from the vaccine itself.

Surprising only if you have no awareness of the rightwing and not-in-favor-of-the-US propaganda machines.

Look, the states are the laboratories of the United States. Several states have rolled back mask mandates before now. Has there been any increase in vaccination rates in those states?
posted by Candleman at 10:24 PM on May 13, 2021 [3 favorites]


Which states have done a clear "vastly reduced masking requirements, but for vaccinated people only" change?

Regardless, vaccine rates are dealing the fact that we've vaccinated the most enthusiastic population already. Trying to gauge the impact of a one element (whether masking, advertising, lotteries, etc.) can't be done just by looking at absolute rates.
posted by mark k at 10:35 PM on May 13, 2021


MrJM: Has anyone seen any CDC guidance for parents of children too young be vaccinated?

I'm a parent of young children, and I interpret today's new mask guidelines as a resounding "fuck you" to all parents and children. I was so looking forward to going to public, indoor, masked activities this summer after more people are vaccinated. If nobody's wearing a mask, hard pass. 57% of the people in my state aren't vaccinated. I can't trust an unmasked crowd.
posted by qxntpqbbbqxl at 10:40 PM on May 13, 2021 [32 favorites]


The Biden administration is heavily beholden to big business interests, who are presumably applying immense pressure-- as they have throughout the pandemic-- to swiftly get things "back to normal". As we've seen over the past few years, federal agencies-- including the CDC-- see their primary stakeholder as the administration, not the American people. With regard to this dynamic, unfortunately, I think the situation is 'not that deep'.
posted by dusty potato at 10:54 PM on May 13, 2021 [6 favorites]


Teegeeack AV Club Secretary: It's frustrating because it feels like we came this close to having normality again, and then not so much.

qxntpqbbbqxl: I can't trust an unmasked crowd.

This is an earnest question: What do you propose is the endgame here?

There are at least half-a-dozen families of virus endemic in the population, some with an appreciable mortality risk.

Some relevant info from Respiratory Viruses at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7149556/
HRSV is the single most frequent cause of lower respiratory tract infection (LRTI) leading to morbidity and mortality in children worldwide. Most children have been infected by HRSV at the age of 2, and reinfections are common throughout life.
...
An estimated 30% of all infants will have HRSV infection requiring medical attention and 2% of them will be hospitalized. Approximately 10% of all children will have bronchiolitis in the first year of life, and 60–90% of them are caused by HRSV. In certain regions, LRTIs caused by HRSV are responsible for up to 85% of hospitalizations in infants during seasonal outbreaks.

----

Primary HPIV infection occurs early in childhood and by age 5 virtually all children are seropositive. Reinfections are frequent, but disease severity in reinfections is inversely proportional to the titer of serum-neutralizing antibody elicited by the previous infection. HPIV-1 and -3 are the types most frequently associated with LRI in children, the immunocompromised, the chronically ill, and the elderly, whereas HPIV-4 causes mostly URI in children and adults.

----

By the age of 5 years, more than 90% of children have antibodies to HMPV, and the seroprevalence among adults is virtually 100%.
Although the incidence of HMPV disease may vary significantly from year to year in one location, this agent is generally detected in 5–10% of samples from ARI patients. Of note, this percentage can be much higher during peak months, when it reached up to 45% in some studies.
The peak age of hospitalization for HMPV is from 6 to 12 months and males seem to be at greater risk of LRT involvement.

----

Infections by adenoviruses types 4 and 7 are usually epidemic, with attack rates of 6–16% per week in newly assembled military recruits, whose adenovirus carriage rate may be as high as 18%. In this group, the adenoviral syndromes vary from mild colds to severe LRI, but overall attack rates may reach 80%, with 20–40% of the individuals needing hospitalization.

----

HCoVs have been found throughout the world and are considered to be the second most frequent cause of common colds, accounting for an average rate of 15% of ARI in the general population in the United States. However, the rates may be quite variable from year to year, ranging from 1% to 35% in years of peak activity.
...
In the United States, seropositivity to HCoV-OC43 and -229E rises during the first 5 years of life, and around 40% of adults are seropositive.
...
The usual manifestations of HCoV infection are typical common colds, but more severe disease can be seen in the very young, the elderly, and immunocompromised hosts.


As you can see, respiratory pathogens, viral or bacterial are a fundamental part of life and have always been.

"Eight percent of our DNA consists of remnants of ancient viruses, and another 40 percent is made up of repetitive strings of genetic letters that is also thought to have a viral origin."
(https://www.cshl.edu/the-non-human-living-inside-of-you/)

Indefinite NPIs? They would have to be indefinite because otherwise, the outbreaks of endemic viruses will be much larger than normal.

From
Large, delayed outbreaks of endemic diseases possible following COVID-19 controls at
https://www.sciencedaily.com/releases/2020/11/201109184906.htm
They found that even relatively short periods of NPI measures could lead to large future RSV outbreaks. These outbreaks were often delayed following the end of the NPI period, with peak cases projected to occur in many locations in winter 2021-22. "It is very important to prepare for this possible future outbreak risk and to pay attention to the full gamut of infections impacted by COVID-19 NPIs," Baker said.

The authors also considered the implications of COVID-19 NPIs for seasonal influenza outbreaks and found results qualitatively similar to RSV. The dynamics of influenza are much harder to project due to viral evolution, however, which drives uncertainty over future circulating strains and the efficacy of available vaccines.
...
"NPIs could have unintended longer-term impacts on the dynamics of other diseases that are similar to the impact on susceptibility we projected for RSV," he said.

A similar effect of pandemic-related NPIs on other pathogens was observed following the 1918 influenza pandemic. Historic measles data from London show a shift from annual cycles to biennial outbreaks following a period of control measures implemented at that time.
posted by daksya at 11:05 PM on May 13, 2021 [8 favorites]


The resurgence of RSV has already been seen in Australia.

The Interseasonal Resurgence of Respiratory Syncytial Virus in Australian Children Following the Reduction of Coronavirus Disease 2019-Related Public Health Measures
https://pubmed.ncbi.nlm.nih.gov/33594407/
posted by daksya at 11:15 PM on May 13, 2021 [4 favorites]


Why would you want to show your face in public?
posted by yonega at 11:15 PM on May 13, 2021 [7 favorites]


The endgame is vaccinate kids after the FDA approves it, and use masks and vaccines to bring the community transmission rate down low enough that the flu is a good analogy. It’s not right now. There are too many willfully unvaccinated adults right now, and COVID-19 is an order of magnitude more contagious than other viruses among that lot.
posted by qxntpqbbbqxl at 11:19 PM on May 13, 2021 [20 favorites]


I have a friend who works at Trader Joe's (where customers apparently like to get up close and personal with you, six feet mandate or not), and she's both pissed and scared about this for reasons already covered above. Fortunately she's already vaccinated, but depending on how TJ's will handle the to-still-require-or-not-to-require-the-masks issue, she might in for a severe clusterfuck regarding a certain percentage of the shopping public.
posted by gtrwolf at 11:19 PM on May 13, 2021 [7 favorites]


I'm a parent of young children, and I interpret today's new mask guidelines as a resounding "fuck you" to all parents and children.

This, completely. As if we weren't already getting it from our employers who are wondering why we aren't going completely back to normal overnight now that "everyone" is vaccinated, now the federal government is climbing on the bandwagon too.

I had a long rant here but like...what's the point. I'm so tired, and on my children's behalf, so angry. They have sacrificed so much this year already and I wasn't expecting this until US residents of all ages at least have the option to get a vaccine.
posted by potrzebie at 11:49 PM on May 13, 2021 [22 favorites]


qxntpqbbbqxl: COVID-19 is an order of magnitude more contagious than other viruses among that lot.

No, it is not. SARS-Cov-2 has an estimated R0 of 2.87 and in the same range as many other endemic viruses. See Tables 3 and 4 of 'Distinguishing Viruses Responsible for Influenza-Like Illness ' at https://www.medrxiv.org/content/10.1101/2020.02.04.20020404v2

> bring the community transmission rate down low enough that the flu is a good analogy.

It's already lower than that right now.

The CDC publishes annual estimates of influenza burden at https://www.cdc.gov/flu/about/burden/past-seasons.html. Final estimates are available upto 2016-2017 season which had 29M symptomatic infections. Three-quarters of influenza infections are asymptomatic which leads to an estimate of ~120M total infections, leading of an average of 340000 infections daily (80000 symptomatic). The current US 7-day average for SARS-Cov-2 is ~40000.
posted by daksya at 12:01 AM on May 14, 2021 [12 favorites]


So cases are already ticking up in the UK due to the India variant - and they're locked down

Depends what you mean by locked down, because we're mostly open again. Shops, restaurants and pubs are all open and the travel restrictions are relaxed. Young people are clearly fed up, no longer so worried about their more fragile relatives because they've been vaccinated, and are jammed into to beer gardens shoulder to shoulder and back to back, without masks on. I see it every day on my ride home, and if that's their choice it's their choice. We are absolutely going to see an unsurprising bounce in cases because of that sort of behaviour, but our hospitalisation rates are actually still waaaaaay down compared to comparable case loads before.

I use this tracker for Scotland, and you can scroll down to see the vaccination by age group, and our uptake is very high. Our cases are mostly, unvaccinated people now. We are still wearing masks in public areas, because a lot of people aren't vaccinated yet, and how do you know? But at the point where everybody who wants the vaccine has had it, I can't imagine we will continue. If it remains endemic that is a risk we may just have to live with at some point.
posted by stillnocturnal at 12:32 AM on May 14, 2021 [9 favorites]


So cases are already ticking up in the UK due to the India variant - and they're locked down

Cases are ticking up, and the fraction of cases due to that variant is increasing but it is not clear that the former is entirely due to the latter.

There are a number of forces acting at the same time.

First, many restrictions have been and will likely continue to be relaxed. I'm not sure that I would call current restrictions "locked down".

Second, even in the absence of de jure changes to restrictions, people are less compliant with them.

Third, the weather is getting warmer (impact unclear).

Fourth, the vaccination programme continues to progress.

Fifth, the population of virus in the population is changing (not clear whether causal but certainly possible).

There was always an expectation that over the course of May and June, cases would rise slightly due to restrictions being loosened. The question is whether the variants are sufficiently phenotypically different to have much of an effect but the answer to that is still unknown.
posted by atrazine at 3:27 AM on May 14, 2021 [2 favorites]


So leaving aside the whole "we're going to be in trouble if/when there's a variant that beats the vaccines" thing, the India variant is at least 60% more infectious than the Kent variant. Without masks, we're going to have an absolutely incredible surge of cases. Now I don't think it's clear whether all those young people dying in India are dying because the variant is worse or because the hospitals have collapsed, so in theory since our hospital system is stronger we might be able to prevent that kind of death - but I'd rather not roll those dice.

And of course, if the hospitals are overwhelmed that means that vaccinated people still won't be able to get surgery or treatment for emergency conditions even if we don't get covid, so that's not very good either.
posted by Frowner at 4:24 AM on May 14, 2021 [5 favorites]


I'm confused about how an incentive is supposed to operate in the absence of being asked to, or being able to, prove that you are vaccinated. Those little paper cards don't support a good evidence chain, and moreover it's just not reasonable to expect public-facing workers to card everyone in their spaces.

Honestly, when I heard about this change, especially coming as quickly as it did on the heels of the previous policy document, my knee-jerk reaction was that it felt like a Hail Mary pass. I'm now worried that the CDC doesn't think a good level of voluntary vaccination is in reach and so it's grasping at straws.

I felt pretty despondent about this yesterday and I'm trying to work out why. Locally, we have good vaccine uptake, and infection rates are continuing to fall. We do have a young child (and one who may be at elevated risk, to boot) but we were planning to keep Little eirias' activities pretty conservative/outdoor-only all summer anyway. So I'm not panicking for myself. I think it's that stink of desperation that has me down -- and also, a certain coldness in moving away from a regime in which what we owe to each other is the guiding principle, and it was possible, at least for people in office jobs like mine, to get leeway from employers on the basis of a norm of needing to protect the vulnerable. I know that privilege was unevenly available in the first place, but I think that's going to go away for the rest of us, now.
posted by eirias at 4:38 AM on May 14, 2021 [15 favorites]


I'm not sure this is a good idea. I think this policy also encourages the unvaccinated to disregard precautions such as masks and distancing, because who knows whether any particular person is vaccinated.

There are two groups of unvaccinated: Procrastinators who are willing to get the shot but haven't done so yet, and those for whom the pandemic is policiticzed (because the Trump Administration and others need to distance themselves from how badly they botched it).

The latter group isn't getting vaccinated and can't be persuaded by reason.

The former group, we've seen, will get vaccine if there's something more in it for them besides just "it's a good idea and the right thing to do." So this CDC guidance is a carrot -- it encourages people to get vaccinated by emphasizing that doing so is the path back to something resembling normalcy.

(As for the latter group, the guidance doesn't stop any organization from requiring masks anyway, and I hope the freedom of association guaranteed in the Constitution allows people of good will to shun the deliberate laggards in perpetuity.)
posted by Gelatin at 4:47 AM on May 14, 2021 [3 favorites]


daksya, the real difference between flu and covid (as per my guidance from infectious diseases docs) is that we have an annual flu vaccine that’s pretty functional.

Vulnerable populations like mine can get a flu shot and take precautions during traditional flu season (staying away from crowded spaces, handwashing, etc) and many people can avoid the worst of it. In my medical cohort, we’re expected to get flu and pneumonia shots annually. We have to take lots of precautions for other things, and flu is just one of many.

With covid, once we have a vaccine that’s workable for these vulnerable populations, we’d be approaching a situation similar to the flu. That’s a workable risk. That’s really the best we can hope for, as covid was never realistically ever going to fully go away.
posted by mochapickle at 4:56 AM on May 14, 2021 [4 favorites]


The trick here is to get the non-vaccinated-for-political-reasons to start wearing masks. So if a rumor was to catch on that the unmasked vaccinated are shedding bill gates nanobots or what-have-you, maybe that would get them to put on masks.

Reversing the polarity works in Star Trek, so maybe here?
posted by condour75 at 5:11 AM on May 14, 2021 [3 favorites]


I don't have a lot of patience for regulations to protect people who refuse to protect themselves.

My 10 and 11 year olds would like a word with you.
posted by chasles at 5:11 AM on May 14, 2021 [21 favorites]


There are two groups of unvaccinated: Procrastinators who are willing to get the shot but haven't done so yet, and those for whom the pandemic is policiticzed (because the Trump Administration and others need to distance themselves from how badly they botched it).

Uh, I'm pretty sure there's a third group - those who would like to get vaccinated but have been unable to do so yet due to work/personal/vaccine appointment schedule problems. (I suspect this group also includes a lot of the people who have gotten one shot (which is better than nothing) but not the second.)
posted by soundguy99 at 5:14 AM on May 14, 2021 [16 favorites]


If you see me wearing a mask outside, I will likely go inside a public place pretty soon and do not want to remember to raise my mask at the last minute, ensure its adjustment, and deal with whatever or whomever I encounter at the entrance all at the same time.

Preparation takes too much time.

it bugs me seeing constant tuggers tugging constantly
posted by filtergik at 5:15 AM on May 14, 2021 [4 favorites]


Uh, I'm pretty sure there's a third group - those who would like to get vaccinated but have been unable to do so yet due to work/personal/vaccine appointment schedule problems. (I suspect this group also includes a lot of the people who have gotten one shot (which is better than nothing) but not the second.)

Exactly. I'm about two weeks away from my second shot because my state considered me completely ineligible until April 19th. as I was neither old enough nor vulnerable enough nor sufficiently essential. And that is not kvetching; I am more than happy to say that if other people needed it more than I did, it was the right call to let them have it first. Period.

I put myself in the lottery queue for my local hospital system, which seemed like the logical first choice to go for medical care... and heard nothing back. Still haven't, nearly a month later. Not "You haven't been called yet," not "Thank you for signing up," not "kiss my ass." I ended up getting shot #1 at a grocery store pharmacy, which gave me some initial irrational skeevies until I told myself that this isn't their store-brand vaccine, this is as legit as a name-brand pharmacy. My GP had been sending me messages for weeks saying "We don't have doses, get it elsewhere if you can"; it was only this past week that they started alerting me that they had vaccine appointments available.

As a nation, are a decent percentage of us on the right track towards vaccination? Yeah. But we're not there yet.
posted by delfin at 5:37 AM on May 14, 2021 [10 favorites]


mochapickle: the real difference between flu and covid (as per my guidance from infectious diseases docs) is that we have an annual flu vaccine that’s pretty functional.

Functional against what? Symptomatic disease or spread? The COVID vaccines are very effective against disease, more so than the flu vaccine. As for spread? People have lived with ~30M annual symptomatic flu infections with no NPIs. SARS-CoV-2 has already dipped below that incidence (with asymptomatic infections also included within).
posted by daksya at 5:38 AM on May 14, 2021 [4 favorites]


The talk of differences in masking in different contexts is frustrating to me personally because the CDC is located in my context here in DeKalb County, Georgia. The people making these decisions are literally my neighbors, and they know full well that our governor has basically done nothing to fight the pandemic since lifting restrictions in April 2020 (not 2021, 2020). We have not had a state mask mandate, and he actually took municipalities to court to try to prevent local mandates.He gave up that particular fight, and both the municipality where I live and the one where the CDC is located have had mask mandates since summer 2020. However, will they lift them now? Who knows? Many public schools have never had mask mandates, and the University System of Georgia was only allowed to set one begrudgingly. Will Kemp now force the USG to remove the mask mandate? Who knows?

Georgia remains at ~28% vaccinated. That number has struggled to increase. We remain at the very bottom of US vaccinations levels. Kemp will not allow vaccination mandates for public schools or universities. Context matters. And our context absolutely sucks. I'm delighted for those of you who feel safe. I do not.
posted by hydropsyche at 5:39 AM on May 14, 2021 [24 favorites]


So leaving aside the whole "we're going to be in trouble if/when there's a variant that beats the vaccines" thing, the India variant is at least 60% more infectious than the Kent variant.

The latest evidence, based on very patchy data, is that it "may be" 60% transmissible. That's very far from "at least 60% more".

The most recent data from areas of the UK where this variant is rising is that virtually all the rise is in younger and probably unvaccinated cohorts.
posted by atrazine at 5:57 AM on May 14, 2021 [9 favorites]


As for this announcement by the CDC... I think it is completely and utterly the wrong call on many levels.

I feel like the intended purpose of the ubiquitous cloth mask is being forgotten. It is not on my face to protect me from your germs; it is better than nothing at doing so, but it is not a cure-all. It is on my face to protect YOU from MY germs, including germs that I don't know that I may be carrying. And if some maskless yahoo infects me because he didn't know that he was infected and even minor precautions are COMMUNIST TYRANNY, a "Sorry about that" wouldn't cut it afterwards even if they felt remorseful enough to provide one.

At a time when herd immunity is unreachable, vaccination numbers are rising but not to where they need to be, new variants and mutations are emerging, countries like India are drowning in massive COVID spikes, and children and many immunocompromised are unable to get vaccinated, it is imperative for personal health and for the public good to encourage the populace to continue to be vigilant, to practice smart safety behaviors and to control the few variables in our daily life that we can influence.

What this is going to do is raise pressure on public places -- restaurants, grocery stores, shopping centers, places that people go for many everyday needs -- to relax their own voluntary mask mandates. To reduce the sign on the window from "Masks required" to "Masks encouraged." To begin welcoming back the people whose view of the pandemic has been "Am I infected? I don't think so? Then nothing should have to change for me" from the beginning. And as others have noted, that will turn more and more places into viral crapshoots.

Some say "Well, we have to return to 'normal' sometime soon." ...Why? The world around us has changed. The virus is not going to magically disappear or be capable of eradication. Whether we are vaccinated or not, many people around us are still vulnerable. Many are explicitly choosing to remain as vulnerable as possible, and don't care what impact that may have on anyone else. We can continue to adapt to our new reality... or we can hang up a big MISSION ACCOMPLISHED banner and act like the war's been won already.
posted by delfin at 6:00 AM on May 14, 2021 [17 favorites]


There are two groups of unvaccinated
There are literally disabled people in this thread for whom the vaccine doesn't work. Stop erasing us and stop forgetting us. We exist. We do not deserve to be shut in our homes for the rest of eternity because we had the temerity to be born without functional immune systems for one reason or another. This is what we mean when we say people should listen to people with disabilities. We are right here. We exist.
posted by twelve cent archie at 6:08 AM on May 14, 2021 [79 favorites]


daksya, are you assuming that the vaccine is fully effective for all populations? I’m speaking specifically about vulnerable populations with immune issues or on immunosupporssants, where we are finding that the current vaccines do not offer full benefit.

As a transplant patient, doctors knew before I took both doses of moderna that the vaccine would most likely not provide full protection. As it stands, it provides some protection for some, and none for others. That Johns Hopkins study that Teegeeack linked to is fascinating (there’s more emerging from this if you’re following it) and we’re all talking about it in the transplant community.

That said, this was more or less predicted by medical teams. Flu vaccines arent as potent for us either. We buy the ticket, we take the ride.

I wasn’t even given clearance to take the vaccine until February because my cohort understandably hadn’t been part of the initial testing and we just didnt have enough data to confirm it was safe for us. The team decided to allow us vax in the hopes that it would have at least some effect so we’re not just blowing in the wind. The result is uneven at best right now. So we wait.

From your tone, it’s genuinely hard for me to tell if you’re asking this in good faith out of legitimate curiosity or if you’re trying to challenge the guidance of medical teams in charge of keeping us alive through this. I hope you’re acting in good faith.
posted by mochapickle at 6:10 AM on May 14, 2021 [17 favorites]


Georgia remains at ~28% vaccinated. That number has struggled to increase. We remain at the very bottom of US vaccinations levels. Kemp will not allow vaccination mandates for public schools or universities. Context matters. And our context absolutely sucks. I'm delighted for those of you who feel safe. I do not.

hydropsyche, thank you for this. Perhaps this explains why a Hail Mary pass seemed necessary to those running the CDC.
posted by eirias at 6:13 AM on May 14, 2021 [1 favorite]


I think that people who live here and work at the CDC should know that our neighbors who treat not being vaccinated and not wearing a mask as a badge of honor are not going to suddenly change their minds because the CDC said vaccinated people don't have to wear a mask.
posted by hydropsyche at 6:17 AM on May 14, 2021 [4 favorites]


> There are literally disabled people in this thread for whom the vaccine doesn't work. Stop erasing us and stop forgetting us.

This, 100% this.

I also don’t think I’ve seen anyone mention the fact that the vaccines probably don’t work as well for fat people. Data suggests that people with a high BMI may produce half the antibodies from the jab as thin people.
posted by EXISTENZ IS PAUSED at 6:35 AM on May 14, 2021 [7 favorites]


There are a lot of unvaccinated people who are required to wear a mask at work and don't want to. (This became clear to me when I was at a fast food restaurant, and an employee went on break, came out from behind the counter and got in line to order, removing his mask in the process.)

One way this *could* pan out is that the businesses that are requiring mask use by employees adopt the CDC guidance, and either check vaccination status of the employees who stop masking, or just ask "oh, so you got the shot?"

Some number of antimaskers will just lie, but if you just didn't get vaccinated because you don't care, and you dislike being forced to wear a mask all day at work, and you don't want to lie to your boss and possibly lose your job if you get caught, that seems to me to be a pretty good incentive to seek the vaccine.

However, businesses are probably going to balance following the CDC guidance with keeping employees masked because customers think it means they're safer.
posted by joeyh at 6:37 AM on May 14, 2021 [1 favorite]


Don't worry, apparently NOW the antimaskers are going to start masking and distancing to "protect" themselves ...from the vaccinated.
posted by We put our faith in Blast Hardcheese at 6:58 AM on May 14, 2021 [2 favorites]


There are two groups of unvaccinated: Procrastinators who are willing to get the shot but haven't done so yet, and those for whom the pandemic is policiticzed

Well I guess it’s time to have a come to Jesus talk with my lazy politicized infant child...
posted by donut_princess at 6:58 AM on May 14, 2021 [27 favorites]


Sending the message that being vaccinated does not materially change one’s life was also a pretty bad idea from a human behavior perspective

Clearly the vaccination will materially change our lifes, once a critical mass of people have been vaccinated. That last part is kinda important. It's not over until it's over for all of us and sending the message that you can forget about Corona the moment you personally got your jab could actually be disastrous.

I've gotten my first dose of Astra Zeneca. I do think it already materially changed my life, because I do feel a lot less anxious now. But the protection from the vaccination is not forever, and if we don't reach heard-immunity fast enough, new variants might render it ineffective. My life is not "back to normal" now and the fact that I'm still expected to wear a mask in public transport or at work is really the least of it. I can't go to the cinema, because the cinemas haven't opened yet for instance. I hope they will in in the summer, once the numbers are better, but it would be silly to expect the cinemas to open the moment some people got vaccinated, and it would be equally silly to not get the vax just because I still won't be able to see a movie in the cinema immediately afterwards.

Sure, we'll return to our "normal" at some point, but the timing is crucial. Just as there's a danger in opening up too much too fast, there's a danger in lifting the mask-mandate too quickly. As long as we haven't reached herd immunity, masks in public are a useful norm (to deny cover to anti-maskers) and I will gladly do my part to uphold it.

Pretending to normalcy when normalcy isn't actually restored is dangerous. This is really the sort of exercise where trying to rush the outcome just postpones it indefinitely.
posted by sohalt at 7:01 AM on May 14, 2021 [11 favorites]


Hey daksya, if there were no covid, I'd be able to go into stores, eat in restaurants, and my own vaccinated mother could come into my house because right now she's terrified of getting me sick. I'd see friends. I could travel (which would be particularly great after four years tethered to a dialysis machine). I'd be able to have more options for returning to work, as I've been relying on disability and that runs out next month, so right now I'll have to find something part time/flex that allows me to work from home. I have a 106-year-old grandmother and an auntie in poor health who I'm not quite sure I'll be able to see again, so I'd go see them.

With any transplant patient, the rest of the norms and pathogen fears are the same that they have been for patients for years. I obviously wouldn't be able to be around any sick people -- like, my dad was a transplant patient when I was younger and I'd have to avoid him if I had a cold. He'd avoid crowds. We can't swim in public pools, we can't have sushi, certain pets and livestock are out of the question, and our meals must all be cooked well done regardless of how much a server might roll their eyes. We have plenty of things to look out for, and you kind of get used to it.

You were asking earlier about flu vs. covid, and now I have some coffee, so: Here in the US, there's about 9-45 (what a range) million cases of flu every year, per the CDC. The mortality rate for flu for transplant patients is 4.3 out of 1000. The US has had about 33 million covid cases total, and the covid mortality rate for transplant patients is a little over 1 out 4 right now -- officially 28% which has greatly improved over this past year as teams have learned more. Per the CDC, covid is more communicable than flu among certain populations.

So yes, there's reason for alarm among the immunocompromised. If I were to get sick, if I didn't die I'd be at risk of damaging or losing the kidney, which would mean waiting seven long years for another match. Sometimes that's what scares me the most -- to go through the transplant process during this time of shutdown and not being able to enjoy this second chance, only to find myself so much worse off from where I was a year ago. It would feel like the gift of this kidney was wasted somehow.

(there was a comment I was replying to, but it's gone)
posted by mochapickle at 7:02 AM on May 14, 2021 [32 favorites]


It seems like mask wearing at this point isn't about protecting the vaccinated, since that's what the vaccine is for, and it's not about protecting the unvaccinated from the vaccinated, since the vaccine also seems to help with that, but it's really about protecting the unvaccinated from each other by continuing to enforce the mask wearing social norm?

If you have a combo of the vaccinated not wearing masks and unvaccinated jerks who never wore masks, then the remaining unvaccinated will feel pressure to also go maskless and infection rates may rise in the unvaccinated.

I realize that at some point this is going to happen because we're probably never going to vaccinate the 30% or so jerks. But do we really want to start eroding the social norm while we're still only at ~36% fully vaccinated and ~47% with a single dose? That's still a lot of unvaccinated people who are still vulnerable. Shouldn't we hang on with masking until we're at least at 60-70% vaccinated? Would that perhaps take just 2-3 more months?
posted by delicious-luncheon at 7:02 AM on May 14, 2021 [8 favorites]


The CDC seems unable or unwilling to grapple with the fact that it's communicating to a public so heavily propagandized that a not-insignificant proportion of it is more comfortable with mass shootings in grocery stores than it is with the prospect of being asked to wear a mask while inside of one.
posted by mandolin conspiracy at 7:02 AM on May 14, 2021 [19 favorites]


I was expecting the requirements to be loosened (because the previous rules were increasingly out of step with both science and what people are doing) but I didn't think they'd just throw their hands in the air and give up on it, either. I thought there would be some kind of interim step between where we were and where we are now. The lack of explicit attention to the question of "what about kids who aren't yet eligible?" is disappointing, too.

As others have said, the fervent anti-vaxxers aren't going to change their behavior based on this announcement (though I also expect some percentage of them to quietly get vaccinated over time because the personal benefits are so clear). If this can give an incentive or nudge to the many millions who are either "hesitant" or in that category of wanting the vaccine but too busy with work, concerned about paperwork and immigration status, etc., then that is good.

I do really wish that they had thought to tie restriction-loosening to the vaccine uptake rate earlier, to make that connection really solid. It seems like a good way to solidify the link between doing the right thing (getting vaccinated) and getting a good result, and in the process helping to ensure protection for the people who can't get vaccinated or for whom vaccines don't work.

The grocery store yesterday still had the signs up requiring masks and everyone was complying. I do wonder how local businesses will respond, and how many will keep mask requirements in place. I suspect it will be necessary to carry a mask around for quite some time yet in order to enter some places.
posted by Dip Flash at 7:10 AM on May 14, 2021 [4 favorites]


(I mean I'm also going to keep wearing the mask once I get my second dose, until we have reached heard immunity. I do realize that after just one dose, I do actually still have to purely for my own sake.)
posted by sohalt at 7:11 AM on May 14, 2021


If you see me wearing a mask outside, I will likely go inside a public place pretty soon and do not want to remember to raise my mask at the last minute, ensure its adjustment, and deal with whatever or whomever I encounter at the entrance all at the same time.
Agree totally. I don’t wear a mask when I’m out walking the dog because I’m going nowhere but back home. But if I’m going to the grocery store, I’ll just throw the thing on on my way out the door. It bugs me how many helpful people I’ve had condescendingly tell me I don’t need to wear a mask in the car, but you know, I don’t technically need to be wearing pants til I get there either, and yet here we are. I’d be more comfortable without those too, if we want to get picky about it. Plus, if I’ve already got a mask on, I’ve eliminated the chances of getting to the door of the grocery store, going “fuck, mask,” and having to turn around and go back to the car.
posted by gelfin at 7:48 AM on May 14, 2021 [24 favorites]


"I'm confused about how an incentive is supposed to operate in the absence of being asked to, or being able to, prove that you are vaccinated."
"There are two groups of unvaccinated: Procrastinators who are willing to get the shot but haven't done so yet, and those for whom the pandemic is policiticzed (because the Trump Administration and others need to distance themselves from how badly they botched it). The latter group isn't getting vaccinated and can't be persuaded by reason."


So, leaving aside children and the immunocompromised and people who can't access medical care (big groups!), among the voluntarily unvaccinated Trumpers, there are some people who are absolutely racing to get vaccinated. I'm still in a lot of online community groups from when I lived in Peoria -- political groups, environmental groups, "support this park" groups, volunteer groups. And I saw a lot of noisy Covid deniers last fall who got real quiet in January and quietly got vaccinated as soon as the vaccine was available to them. But there are a lot of unvaccinated-by-choice politicized Trumpers running around, and in general they fall into two groups: People who have totally bought the propaganda, and people who know exactly what they're doing.

These are wealthier suburban or ex-urban Republicans, with white-collar jobs, with college degrees, who understand exactly how Covid works, how vaccine work, how infectuous diseases work, but who gain status in the local community by loudly vomiting Fox News talking points and being loud-and-proud Covid deniers and insisting masks are an infringement on liberty. They drive big fancy extended-cab luxury pickups, though they have never done manual labor in their lives. These guys are loudly protesting mask mandates and insisting they won't get vaccinated, and going on the local news to complain vociferously about local and state rules, but they are quietly driving 30 miles to shop at the Whole Foods where all the subaru-driving environmentalists wear masks and are already vaccinated rather than shopping at their local grocery store among the Covid deniers.

Yesterday, I watched a bunch of these guys pop up in nonpartisan online community groups that nevertheless lean left, where they thought other GOPers wouldn't see them -- "support X park" (lots of environmentalists), the local indie book store, etc. -- asking rather frantically where vaccines were available locally today. They clearly thought they were going to get to free ride on other people masking and being vaccinated all summer. They knew exactly what they were doing. And now that they personally were going to be at risk, because they couldn't be sure everyone at Whole Foods would be masked, they needed to get vaccinated right away. They don't care about community risk, risk to others, or even really about the community reopening safely so the economy can recover -- they care about their PERSONAL risk. And now that their free-riding is coming to a very abrupt end, they're freaking out, and willing to take the very small risk of vaccination to avoid the much larger risk of being amongst unmasked people who aren't vaccinating.

I'm going to be watching with great interest the vaccination rates in downstate Illinois and how fast they climb in various counties -- I think uptake in suburban red downstate counties that are bedroom communities for Peoria, Bloomington/Normal, Springfield, etc., and have a lot of these wealthier Republicans is going to climb relatively quickly as the free-riders re-assess their personal risk, but much more slowly in more poorer red regional centers and rural areas where there are more "true" Covid deniers and conspiracy theorists.

I don't know how big the "cynical deniers" are compared to the "true deniers," and my guess is that it will vary a lot by state and local community. Ohio's lottery says to me that they think they have a lot of procrastinators and a number of "cynical deniers" who are pretty easy to reach with an incentive, which sounds correct to me based on Ohio's demographics. North Dakota's public health department, otoh, appears to be preparing to have virtually no additional uptake of vaccines combined with people giving up all masking and social distancing, and they're expecting disaster, which says to me they think they have a lot of "true deniers."
posted by Eyebrows McGee at 7:53 AM on May 14, 2021 [36 favorites]


This change in CDC policy is a shit sandwich for us vaccinated parents of small kids. I'm guessing we won't see emergency-use approval of the Pfizer mRNA vaccine for 2-11 year olds until October, at least.
posted by Jubal Kessler at 7:59 AM on May 14, 2021 [8 favorites]


Uh, I'm pretty sure there's a third group - those who would like to get vaccinated but have been unable to do so yet due to work/personal/vaccine appointment schedule problems.

In other words, people who are willing to get vaccinated but haven't done so yet, so in the first group.
posted by Gelatin at 8:08 AM on May 14, 2021 [2 favorites]


(Sorry, "procrastinators" was a poor choice of words, and I apologize for it.)
posted by Gelatin at 8:11 AM on May 14, 2021 [1 favorite]


Anecdata: I spoke with my mother last week, for the first time in several months. She is a card-carrying CHUD of the highest order, but I still call my mother on her birthday like a good son should.

The usual "how are you doing" chatter went back and forth. I mentioned that I was a couple of weeks out from my second Moderna shot... and there was a long pause. "We're just going to have to disagree on that," she replied. "I wouldn't touch those shots with a ten-foot pole."

For reference, she is 70+ years old, has had an assortment of chronic medical problems, and our last two conversations revolved around "it's time to end all of these lockdowns and masks and restrictions and get the country moving again." (One of those was last May, one was in December.) So one might hope that she'd be willing to do whatever it might take to move towards that goal...

...but, no. "Nobody knows what these EXPERIMENTAL DRUGS will do to your body down the road," she insists. "They're changing your DNA and RNA and nobody knows what they're doing. [My husband] is staying away from them, too."

Your husband... the 70-something lifelong smoker, cancer survivor, heart surgery survivor, who has one lung left?

"Yeah. He won't get the shot. But he's got a bottle of hydroxychloroquine, just in case."

Not for the first time, I feel like Graham Chapman in the Argument Clinic. "Argument's an intellectual process. Conservatism is just the automatic gainsaying of anything the other person says."
posted by delfin at 8:12 AM on May 14, 2021 [20 favorites]


It really does seem to me that this is a no-win thing from the CDC’s point of view. Either you keep the mask guidance and idiots say “see, the vaccines don’t work,” or you just truthfully report the science that says vaccinated people are probably OK without, which realistically indicates progress, but you’ve unleashed a shit storm on service workers who were having this fight with the idiots daily already.

It kind of sucks that they’re even put in this position at all. Rarely does the CDC need to make public policy so… publicly. Normally they can just be about the science and somebody else is in charge of herding cats. Questions like “how does the greeter at a grocery store know whether a maskless customer is vaccinated” are not in their wheelhouse. They’ve provided certification to vaccinated people. There’s just this huge “okay, now what” policy gap, and we’re all just making this up as we go along anyway.
posted by gelfin at 8:14 AM on May 14, 2021 [10 favorites]


Totally anecdotal but went out to get a burger at Five Guys last night (my local one is fairly quiet and has been super good about masks and curb side and all that). Staff all wearing masks and behind perspex shields, but none of the other 10 or so customers other than myself wearing one, and the peanut boxes were suddenly back and open and everyone was just diving in with unwashed hands grabbing handfuls of peanuts....and they no longer had packaged condiments but were back to everyone pumping their own sauce into the little cups. And the customer hand sanitizer pump was empty.

I mean I guess it would all return to "normal" at some stage, but it felt super weird. TLDR: It's a bold strategy Cotton, let's see if it pays off for em us.
posted by inflatablekiwi at 8:17 AM on May 14, 2021 [1 favorite]


"Not for the first time, I feel like Graham Chapman in the Argument Clinic. "Argument's an intellectual process. Conservatism is just the automatic gainsaying of anything the other person says.""

The philosophy/rhetoric term for this is "eristic" argument (related to Eris, goddess of chaos), the goal being just to refute whatever the other guy says, rather than searching for truth or having a dialogue. It's a terrifically useful term for the modern GOP.

(Also when you talk to one of those really self-important, glib Republicans who loves to move the goalposts and talk about Greek ideals of disputation, and they're just trying to get you to argue because it's fun for them, you can say, "No. I find your argument eristic here," and they almost universally don't know what it means and either quit right then rather than ask, or they ask, and you can say, very innocently, "It's in Plato!" and they're forced to retire rather than admit they don't know shit about Plato.)
posted by Eyebrows McGee at 8:24 AM on May 14, 2021 [33 favorites]


This is all going to end up as a Far Side comic.

Just replace the top with "What the CDC Says" and plug in its latest directive, then replace the bottom with "What Conservatives Hear" and "blah blah blah blah blah resume activities without wearing a mask or physically distancing blah blah blah blah."
posted by delfin at 8:37 AM on May 14, 2021 [5 favorites]


I was texting my mom who now no longer lives in Ohio about the lottery.

“Survival of the fittest.”

“Still don’t agree...sorry my opinion” (should be read as “not sorry it’s my opinion deal with it”)

“I just don’t think it’s right”

“It’s bribery in a way...I think a million dollars can be spent somewhere else.”

Ok, on what? Where? In what way? What would move the needle? What suggestions do you have? It’s really just let people eke it out?

So frustrating.
posted by glaucon at 8:39 AM on May 14, 2021 [2 favorites]


That didn't take long. We just got official guidance from the University System of Georgia:
Social Distancing Fully vaccinated individuals can resume campus classes and other activities without physically distancing. Unvaccinated individuals are strongly encouraged to continue socially distancing from others when possible.

Face Coverings Fully vaccinated individuals can resume campus classes and other activities without wearing a mask. Unvaccinated individuals are strongly encouraged to continue wearing a face covering while inside campus facilities.
No indication of how unvaccinated students are meant to continue social distancing on a campus full of classes without social distancing. We are so screwed.
posted by hydropsyche at 8:41 AM on May 14, 2021 [10 favorites]


you can say, very innocently, "It's in Plato!" and they're forced to retire rather than admit they don't know shit about Plato.)

I realized what you meant by forced to retire, but not before I imagined some guy in a suit and a MAGA hat dolefully packing up his desk and taking his nameplate off the office door.
posted by We put our faith in Blast Hardcheese at 8:45 AM on May 14, 2021 [10 favorites]


The University of New Mexico has proposed a policy to requires everyone on campus to be vaccinated. Not sure how they would check or enforce that.
posted by NotLost at 8:45 AM on May 14, 2021


Not sure how they would check or enforce that.

Here in Wisconsin, the state tracks vaccinations, and I can see an electronic record going back to the Polio vaccine I got when I was two months old. It also shows the Yellow Fever shot I needed several years back for international travel, back before "vaccination passports" were the panic du jour.

It's also telling me that I never got my third HepB shot, so that's handy.

The state has a form (PDF) that people can send in to request that their record be sent to a third party. I'm assuming other states have similar systems, and I had assumed that these were going to be used for verification as restrictions were lifted. C'est la vie.
posted by Nonsteroidal Anti-Inflammatory Drug at 8:51 AM on May 14, 2021 [5 favorites]


They same way they check and enforce that everyone has an MMR or any one of the dozen other vaccinations required to be a student.
posted by hydropsyche at 8:51 AM on May 14, 2021 [15 favorites]


FYI, the proposed New Mexico policy is not just for students. It also includes members of the faculty and staff, vendors, contractors, visitors ...
posted by NotLost at 8:57 AM on May 14, 2021


Requiring a vaccine that is under EUA is legally difficult for schools. It needs to be approved for schools and other such settings to require it.
posted by OldReliable at 8:57 AM on May 14, 2021 [3 favorites]


Outbreaks and overwhelmed hospitals in 3 ... 2 ... 1 ...
--
Cynically, I have to note: there has been such a great outcry over All The Things Our Children Are Missing from not being in schools in person, with seemingly almost complete disregard for the adults involved and required to provide school in person, and the families at home, because Children Are Safe!!! Open The Schools!!!

And only now that CDC says "oh hey everyone, go for it and let's see what happens", I'm hearing a great outcry over But My Children Aren't Safe.

These are likely not the same people, I realize, but still.

--
I'll also report that the rabidly evangelical anti-vaxxer family member whose social media posts I read, instantly declared mask-wearing to be over for them.
posted by Dashy at 9:04 AM on May 14, 2021 [3 favorites]


The University of New Mexico has proposed a policy to requires everyone on campus to be vaccinated. Not sure how they would check or enforce that.

My university expanded the student health information infrastructure to all employees and used that to record testing and vaccinations (the same mechanism they already had in place to verify other vaccinations for students). Vaccinations given on campus are recorded automatically; you have to upload proof of vaccination if you get it elsewhere. They then tied this database to an app that issues campus passes (QR codes scanned at the entrances). It's gone surprisingly well.

They've been requiring flu vaccination since January. They're not making COVID vaccination a requirement until the vaccines move out of emergency use. Right now, you need to test weekly (biweekly for students) to get onto campus unless you're fully vaccinated.
posted by mr_roboto at 9:09 AM on May 14, 2021 [6 favorites]


Just 12 People Are Behind Most Vaccine Hoaxes On Social Media, Research Shows. "The 'Disinformation Dozen' produce 65% of the shares of anti-vaccine misinformation on social media platforms,"
posted by 1970s Antihero at 9:17 AM on May 14, 2021 [8 favorites]


>>Teegeeack AV Club Secretary: It's frustrating because it feels like we came this close to having normality again, and then not so much.

This is an earnest question: What do you propose is the endgame here?

Perhaps I should have qualified the "we" in my statement. By "we", I meant it on a personal level. Just my partner and myself. She and I came close to being normal again. I didn't mean the collective "we" of everyone. Because of my partner's immuno-suppressed status, she'll remain near-quarantined and I'll still take precautions.

I'm ok with the rest of the vaccinated going back to near-normal. Things don't have to stop or slow just because of my situation. I cannot tell you how thrilled I am that many of you will get to toss the mask away and go out worry-free.

And between the protection I personally get from the mask & the high unlikelihood of a vaccinated person being a carrier, I'm not even worried about the assholes out there who will pretend to be vaccinated so they aren't pressured to wear a mask. I take simple precautions. Partner stays home. And we'll get through this until they find a better solution for people like us.
posted by Teegeeack AV Club Secretary at 9:23 AM on May 14, 2021 [4 favorites]


So leaving aside the whole "we're going to be in trouble if/when there's a variant that beats the vaccines" thing, the India variant is at least 60% more infectious than the Kent variant.

This is not how variants work. Variants don't "beat" vaccines. Breakthrough infections occur when the variant is different enough that the body doesn't have an antibody with strong enough affinity for the antigen to defeat it before it can establish a foothold. Because every person is different and the antibodies they create as part of the vaccination process are different everyone has a small chance of a breakthrough infection. HOWEVER. With breakthrough infections there's usually some measure of affinity, it just wasn't strong enough to eliminate it from the outset.

All of the major variants so far have seen far less severe outcomes even with breakthrough infections and that's because not only do existing antibodies still work to some degree, but your body keeps around other candidate antibodies that don't work so well for this exact case. Combined with SARS-CoV-2's relatively slow mutation rate, this is probably why we're seeing the current vaccines stacking up really well against the variants even though in vivo against monoclonal antibodies the virus seemed like it would win.
posted by Your Childhood Pet Rock at 9:40 AM on May 14, 2021 [15 favorites]


Requiring a vaccine that is under EUA is legally difficult for schools. It needs to be approved for schools and other such settings to require it.

Pfizer/BioNTech and Moderna have both begun the process of getting full FDA approval for 16 and up. The process is expected to take a few months but should be done well before the fall term. I'm not sure what schools are doing for the summer.
posted by jedicus at 9:54 AM on May 14, 2021 [1 favorite]


Just 12 People Are Behind Most Vaccine Hoaxes On Social Media, Research Shows.

"The 'Disinformation Dozen' produce 65% of the shares of anti-vaccine misinformation on social media platforms"


These people have blood on their hands.
posted by darkstar at 9:57 AM on May 14, 2021 [9 favorites]


Here are some facts about how many colleges already have announced they're going to require students to be vaccinated.
posted by PhineasGage at 9:58 AM on May 14, 2021 [2 favorites]


My university announced requiring the vaccine, but has significant carve outs for religious, personal, or other beliefs, which basically comes down to "if you're willing to file the exemption paperwork it's not actually required."
posted by nakedmolerats at 9:59 AM on May 14, 2021 [3 favorites]


(I of course support rare and genuine exemptions, but it's broadly written enough that they'll take "because I don't want to" as an exemption)
posted by nakedmolerats at 10:02 AM on May 14, 2021 [2 favorites]


I would love for universities to come down on the side of "if you're not willing or able to sort fact from fiction in the research on vaccines, you're not a good fit for our institution of higher learning and we wish you the best of luck in your future endeavors" as a response to antivax bullshit exemption requests, it only seems appropriate. I understand why they can't and I hate that it's the reality (I mean, the deep pockets funding big splashy lawsuits to advance right wing narratives alone...), but it would be nice.
posted by jason_steakums at 10:10 AM on May 14, 2021 [14 favorites]


My university announced requiring the vaccine, but has significant carve outs for religious, personal, or other beliefs, which basically comes down to "if you're willing to file the exemption paperwork it's not actually required."

Same here. I'm at a small college with not much money to spare on legal fees. The places I've seen place hard requirements are clearly only those willing/able to fight it in court.
posted by coffeecat at 10:36 AM on May 14, 2021 [1 favorite]


A friend asked me immediately upon announcement if I’d be wearing a mask as I walk into a bar or restaurant - I hadn’t really thought about it like that. Just felt I’d be safe to myself and not spreading to others. But it made me pause and realize how much I still envisioned myself wearing a mask in many situations.

I hope one day soon we get to a vaccine that protects against all coronaviruses or flus (not impossible by the way).

For the disabled and transplant communities - your perspectives have really made me think over the last day. I am at a loss as to how I can support. If you have any suggestions please share.
posted by glaucon at 11:20 AM on May 14, 2021 [5 favorites]


I hope one day soon we get to a vaccine that protects against all coronaviruses or flus (not impossible by the way).

That's the beauty of mRNA vaccines. Throw whatever you want in there. We'll probably eventually have a universal flu vaccine that will basically have mRNA for all known and circulating hemagglutinin and neuraminidase types instead of having to pick the type before the season and grow them in eggs.
posted by Your Childhood Pet Rock at 12:00 PM on May 14, 2021 [6 favorites]


Until January I worked at Target, and I used to keep myself sane some days by tracking how many times in a minute I had to remind people to fix their masks. It was usually one a minute, often three, and occasionally five. The Washington Post reported today that Target is one of a number of companies currently planning to maintain mask requirements in stores. I do not envy retail workers, who are already under a lot of stress and often inadequately supported, who still have to enforce corporate or municipal mask requirements. This news stressed me out and I don't even work in that environment anymore.
posted by fedward at 12:11 PM on May 14, 2021 [13 favorites]


I’m sure the crowd who brought us “Corporations are people!” and “Companies should legally be allowed to discriminate!” will be sensible and non-confrontational when companies mandate mask wearing*.

*Heavy, sad, syrupy sarcasm
posted by glaucon at 12:14 PM on May 14, 2021 [7 favorites]


So here is a Guardian article which says that SAGE, which as I understand it is the government advisory body doing all the vaccine advising, anticipates that if the Indian variant is more than 30% more transmissible than the Kent variant and they continue to open up, there will be another wave which will exceed the winter one. If it's 50% more transmissible, they anticipate 10,000 hospitalizations daily. And they're saying that at least 60% is a possibility.

Watching from the US, the UK covid wave was absolutely terrifying. If there were another, worse wave I can't believe the hospitals would hold at all - how could they, when they just barely coped with the winter? It would be like India.

And they seem to think that many of the hospitalized would be vaccinated people in whom the vaccines didn't work well enough.

So we could anticipate something similar in the US. I personally don't want to bet my life on the vaccine having worked well enough for me.

This reminds me so much of last winter when anyone could see that there was going to be a horrible wave because of the Kent variant but people kept sticking their fingers in their ears and shutting their eyes and pretending things were fine.
posted by Frowner at 12:16 PM on May 14, 2021 [6 favorites]


For the disabled and transplant communities - your perspectives have really made me think over the last day. I am at a loss as to how I can support. If you have any suggestions please share.

Thank you for this. Do you know people in these communities? If you do, offering to do things with them adhering to stricter guidelines would probably be appreciated. I almost cried I was so touched when some of my vaccinated fencing friends volunteered to fence with me masked and outside when my doctor deems it safe (which will be in about three weeks, two weeks after my second dose). Our club is probably going to open soon, but I won't be able to go.

Other than that, if I decide I can venture into indoor public places (I really need to mail some packages), I'm going to be very appreciative of everyone who still wears a mask. And probably walk out if I see unmasked people.
posted by FencingGal at 12:18 PM on May 14, 2021 [12 favorites]


Frowner, that Guardian article is very, very speculative about the India variant. It's good to stay true to one's moniker, but for your own peace of mind - and all of ours - I'd recommend not taking every "well, this maybe could happen" as an opportunity to predict doom.
posted by PhineasGage at 12:31 PM on May 14, 2021 [11 favorites]


The dance of death and lockdown has been sufficiently distressing and frankly traumatic that I would think we should want to prevent a repeat at all costs. I'm afraid that if we're going to settle for re-opening at a 60%-70% vaccination rate and frame vaccination as personal protection rather than as collective containment, we will remain at risk of being overwhelmed by outbreaks, from the still ample reservoirs in which the virus continues to circulate, for years to come. I suppose I could learn to live with the virus (whatever that means), but I don't know that I can learn to live with the specter of lockdown every 6 months. With reports like the below from Professor Christina Pagel* I worry about having Freedom Summer turn into Vaccine Surge followed by Forever War:
So England growth is entirely consistent with increased transmissibility & a situation where B.1.617.2 is rapidly gaining dominance.

We don't yet know enough about vax & B.1.617.2 but there are reports now of some breakthrough symptomatic cases
* In the Guardian: Indian Covid variant calls in question 17 May reopening in UK, say experts
posted by dmh at 12:42 PM on May 14, 2021 [2 favorites]


U.K. is a different vaccine and delayed second dose rollout scheme so I wouldn’t even necessarily assume their results would transfer.
posted by atoxyl at 12:48 PM on May 14, 2021 [4 favorites]


Also having got my second mRNA dose yesterday... man, I bet a lot of people postpone this shit because they don’t want to have to take a sick day (which, yes, is rolling the dice on actually getting sick but people do that a lot).
posted by atoxyl at 12:51 PM on May 14, 2021 [1 favorite]


The CDC's role is to inform the public about the risk of certain activities, not to anticipate and manipulate the behavior of individuals who choose to ignore their advice.

If the CDC has concluded it is safe for fully vaccinated people to go about their days without masks, and that this won't contribute meaningfully to community spread, then that is exactly what they should communicate. Anything else would be completely inappropriate.

I really don't understand arguments that suggest the CDC should avoid making a determination of safety regarding this activity or that because people who ignore the CDC's advice might behave recklessly and dishonestly.
posted by dsword at 1:21 PM on May 14, 2021 [25 favorites]


Also having got my second mRNA dose yesterday... man, I bet a lot of people postpone this shit because they don’t want to have to take a sick day (which, yes, is rolling the dice on actually getting sick but people do that a lot).

This is a huge issue for people who can't take time off and/or have irregular work schedules -- you aren't just looking for an appointment any time, any place; you need one that is on, say, Friday evening after work and where you don't lose the appointment if your boss keeps you for another half hour. The switch to walk-in appointments in pharmacies and grocery stores (as well as churches, pop-up locations, etc) will help a lot with this kind of access issue.

Vaccines have been available for all adults in the US for almost a month now, but it is much more recent that access has expanded to the point you aren't refreshing the websites and having to travel to the other side of the county for a midday appointment on a weekday.
posted by Dip Flash at 1:41 PM on May 14, 2021 [11 favorites]


I really don't understand arguments that suggest the CDC should avoid making a determination of safety regarding this activity or that because people who ignore the CDC's advice might behave recklessly and dishonestly.

A properly warn mask is a signal that the wearer cares about limiting community spread. In a community where the expectation is that everyone will wear a mask to limit viral spread, people who aren't (properly) wearing masks stand out and other people (such as people with compromised immune systems, or people who live with people who have compromised immune systems) can at least try to avoid them.

Without a universal mask policy there is no reliable way of determining on sight whether the person in front of you is vaccinated (and presents a low risk to you) or unvaccinated (and thus a higher risk). Even if you ask them they can lie. Even if they present a card it could be faked. What the CDC has done may be scientifically sound (people who have been vaccinated are at low risk of catching and transmitting the disease), but it is socially unsound, as it has made the world unsafe for people who can't effectively be vaccinated. Without that guidance, as vaccinated people go without masks they will remove the utility of that signal for at-risk populations.

Some vaccinated people will surely continue wearing masks even as rules are eased, because they realize that the signal that they care and are taking steps to limit community spread is important to others. One way to support people who are immune compromised or can't be vaccinated for allergic reasons is to continue properly wearing masks, and to support other people who model safe behavior, to allow others to travel more freely in a society that will otherwise threaten too much danger, if not death.
posted by fedward at 1:54 PM on May 14, 2021 [19 favorites]


A properly warn mask is a signal that the wearer cares about limiting community spread.

No, a properly worn mask is an item of PPE.

Without a universal mask policy there is no reliable way of determining on sight whether the person in front of you is vaccinated (and presents a low risk to you) or unvaccinated (and thus a higher risk).

With or without a universal mask policy, there is no reliable way of determining on sight whether the person in front of you is vaccinated.
posted by atrazine at 2:25 PM on May 14, 2021 [7 favorites]


Without a universal mask policy there is no reliable way of determining on sight whether the person in front of you is vaccinated (and presents a low risk to you) or unvaccinated (and thus a higher risk).


To address this on the few forays out of the house, I bought this shirt. But I can't wear an orange t-shirt everywhere I go (the college leadership tends to frown on that sort of thing in official functions).

So I'm thinking about making up a bunch of nametags that say "Hello, I'm..." and writing in colorful marker "... vaccinated!" Or maybe get some of these buttons.

But I'm hoping I'm not basically putting a target on my shirt for idiots and militants to harass me.
posted by darkstar at 2:26 PM on May 14, 2021 [7 favorites]


No, a properly worn mask is an item of PPE.

It's both.

With or without a universal mask policy, there is no reliable way of determining on sight whether the person in front of you is vaccinated.

This is true, but when everybody was expected to wear masks it didn't matter if other people were vaccinated. Now it does.
posted by fedward at 2:35 PM on May 14, 2021 [9 favorites]


Masks were the brown M&M's of the pandemic: while probably not as important as social distancing, not eating at indoor bars and restaurants, cutting out interactions with other households, and so on, masks were very visible and you could assume that if someone couldn't be bothered to put on a mask they were probably doing all sorts of other bad stuff and they were high risk people who didn't give a fuck about others.

There was not guarantee that a mask wearer was safe; avoiding everyone was a good idea but if you had to prioritize the non-maskers were worth expending more energy on staying away from.

That doesn't apply anymore. Not wearing a mask when it will improve others' safety says something about you; not wearing one when it won't doesn't say anything at all. There are obviously a lot of people who want this to keep being a signifier, so they want people to keep wearing masks even when it won't improve public health. I don't think this is going to be tenable. It'd be like trying use the brown M&M's as a marker when they weren't actually in your rider; they stop meaning anything.
posted by mark k at 2:38 PM on May 14, 2021 [26 favorites]


I really don't understand arguments that suggest the CDC should avoid making a determination of safety regarding this activity or that because people who ignore the CDC's advice might behave recklessly and dishonestly.

The CDC's announcement yesterday was all about vaccinated people.

It was missing a statement such as: Unvaccinated people continue to be at risk from each other, as the virus continues to circulate. Unvaccinated people should continue to mask, especially indoors, until they can be fully vaccinated.
posted by Dashy at 2:51 PM on May 14, 2021 [1 favorite]


It was missing a statement such as: Unvaccinated people continue to be at risk from each other, as the virus continues to circulate. Unvaccinated people should continue to mask, especially indoors, until they can be fully vaccinated.

Unvaccinated people, wear a mask, stay six fee apart, wash your hands.

We've chosen to only talk about the section about vaccinated people, but the page I linked to was also released yesterday and crosslinked from the CDC site.
posted by mark k at 2:55 PM on May 14, 2021 [9 favorites]


When federal health officials said on Thursday that fully vaccinated Americans no longer needed to wear masks in most places, it came as a surprise to many people in public health. It also was a stark contrast with the views of a large majority of epidemiologists surveyed in the last two weeks by The New York Times.

"Yet most said mask-wearing continued to be necessary for now, because the number of vaccinated Americans had not yet reached a level that scientists consider necessary to significantly slow the spread of the virus. Until then, there are too many chances for vaccines, which are not 100 percent effective, to fail, they said."

I get they're trying to brag about how effective the vaccine is, and push people to get it, but you know what will stop people from getting it? If they think it's ineffective because they know vaccinated people who still got covid.

(Sorry if it's already been linked above.)
posted by subdee at 3:00 PM on May 14, 2021 [2 favorites]


8 questions answered
posted by tiny frying pan at 3:02 PM on May 14, 2021


That NYT "survey" of epidemiologists is nothing of the sort, and that article should never have been published. It is unsystematic and even includes - as quoted in the article - at least one Ph.D. student.
posted by PhineasGage at 3:14 PM on May 14, 2021 [8 favorites]


I'm going to make a quantifiable prediction.

I live in Memphis (Shelby County), Tennessee. We have about a million people, and we're about a third vaccinated, and about 10% have had COVID already. As of Saturday, the city and county no longer require most people to wear masks most places.

The county health department tweets out case and vaccine information every day. Accordingly, I've been tracking the cases since last spring. Here's a graph of cases. Peak 7-day total was 6083, for the week ending December 18. We were over 2000 new cases per week from July 3 to August 7 (mostly), and every day from November 9 to February 8. We've been bouncing around 1000 cases a week since the middle of February. We're at 878 new cases this week (Saturday through Friday).

I don't think we see 2000 cases in a week again. (Any contiguous 7-day period). Since I don't want to wait forever, I'll time-bound this by saying I don't think we see 2000 cases in a week, through July.

If I'm wrong, I'll donate $20 to the Memphis Food Bank.
If I'm right, I'll eat a delicious barbecue sandwich... and probably still donate to the Memphis Food Bank.
posted by Huffy Puffy at 3:31 PM on May 14, 2021 [4 favorites]


FTFY: At the bottom of the page, if you scroll past the icons: Unvaccinated people, wear a mask, stay six fee apart, wash your hands.

That needed to be up top, right next to the bulled about vaccinated people.
That needed to be stated by Walensky, in the very next sentence following vaccinated freedom.
That needed to be in every media article, in the top paragraphs.
That needed equal (or greater) billing, proportional to the percent of people who are still unvaccinated, to whom it applies.

It wasn't.

Messaging matters. CDC flubbed -both- the choice, and the message. All of America heard, by all indications, we're done with masks.
posted by Dashy at 3:45 PM on May 14, 2021 [11 favorites]


There are obviously a lot of people who want this to keep being a signifier, so they want people to keep wearing masks even when it won't improve public health.

Less than half the population of the US has had even one dose of a vaccine, and only 36.3% of people in the US are fully vaccinated, per Our World in Data (and global numbers are much lower). The daily vaccination rate is slowing, and a quarter of US residents say they won't get vaccinated (with another 5% still "undecided").

As we've seen with measles outbreaks, a high enough concentration of anti-vax people will defeat the effect of herd immunity that protects vulnerable populations. People who can't get vaccinated (kids under 12, or people with allergies), people with compromised immune systems, and people who are at high risk for other reasons aren't yet well enough protected against Covid-19 by the current vaccinated population. With vaccine rates being what they are, I don't think it's accurate to say that continued wearing of masks "won't improve public health."
posted by fedward at 3:53 PM on May 14, 2021 [15 favorites]


When federal health officials said on Thursday that fully vaccinated Americans no longer needed to wear masks in most places, it came as a surprise to many people in public health. It also was a stark contrast with the views of a large majority of epidemiologists surveyed in the last two weeks by The New York Times.

Yeah, this article is a train wreck. It reads as straight-on disinformation.
posted by mr_roboto at 3:54 PM on May 14, 2021 [5 favorites]


With vaccine rates being what they are, I don't think it's accurate to say that continued wearing of masks "won't improve public health."


It won’t improve public health for vaccinated people to wear masks. The rate of infection and transmission for vaccinated people is so low that the masks make no difference. Mask or no mask, vaccinated people are not getting sick and not infecting anyone else.

Unvaccinated people still need to wear masks and socially distance because those are the best measures we have, aside from vaccination.
posted by chrchr at 4:56 PM on May 14, 2021 [2 favorites]


But as always, the problem is unvaccinated people (and currently that includes many people who want to be vaccinated, or are in the process of being vaccinated) have no idea who is vaccinated, and cannot trust others when forced to go indoors to an area with a large number of unmasked people.

Already yesterday I noticed several unmasked people in the grocery store, which is very unusual here in Los Angeles [and despite no change in the law]. I'm not fully vaccinated yet, almost no one I know is, even though we all rushed to get vaccinated as soon as we can (but its a 5-6 week process unless you got J&J, and California didn't open up to most people until April 15, 4 weeks ago).

While the CDC is almost certainly correct that vaccinated people can safely go without a mask, that should not change the policy/mandates until most people have had a real chance ot get vaccinated. That has NOT happened yet. But unfortunately, many people seem to take the CDC statement as a removal of laws/mandates (which of course it is not!), and stores are understandably reluctant to enforce masks given the violence we saw last year.
posted by thefoxgod at 5:16 PM on May 14, 2021 [6 favorites]


Unvaccinated people still need to wear masks and socially distance because those are the best measures we have, aside from vaccination.

The guidance is unfortunate for being done before there are means to verify status. So people can go without their shots and without wearing a mask, whatever the fine print says. As the NYT survey shows, this change in guidance values political concerns over the real expertise of scientists.
posted by They sucked his brains out! at 5:19 PM on May 14, 2021


So much of this thread seems to forget or ignore the proven reality that masks also protect the wearer. A good mask makes it pretty darned safe to make a brief visit to a large, well-ventilated public place like a supermarket. Yes there are some other public spaces that are more problematic, but a lot of the anxiety being expressed here is understandable but not warranted.
posted by PhineasGage at 5:22 PM on May 14, 2021 [8 favorites]


I understand the concern about verification. The fear is that we’ll be on the honor system, that unvaccinated people will just lie about their status and not wear masks. Much depends on how state and local governments and businesses implement the guidelines. My state has indicated that businesses that wish to allow vaccinated people to not wear masks will have to have verification. We don’t know what that looks like yet.
posted by chrchr at 5:34 PM on May 14, 2021


There’s going to be no implementation of the guidelines at the state/local/business level beyond whatever fig leaf is required to keep these entities from legal trouble.
posted by Don.Kinsayder at 6:10 PM on May 14, 2021 [1 favorite]


So much of this thread seems to forget or ignore the proven reality that…

I’m just sitting here gobsmacked that after so much thoughtful, candid discussion here from at-risk patients and parents of small children, your genuine takeaway from all this is that we’ve all just casually forgotten or ignored details and medical guidance that have been drilled into us for the past 15 months.

Look, I know you don’t mean any harm. But honestly. This one took my breath away.
posted by mochapickle at 6:12 PM on May 14, 2021 [12 favorites]


So much of this thread seems to forget or ignore the proven reality that masks also protect the wearer.

Fun fact: children under 2 are not allowed to wear masks cause they can choke or suffocate.
posted by donut_princess at 6:36 PM on May 14, 2021 [3 favorites]


chrchr: It won’t improve public health for vaccinated people to wear masks. The rate of infection and transmission for vaccinated people is so low that the masks make no difference. Mask or no mask, vaccinated people are not getting sick and not infecting anyone else.

Cites? Because the actual epidemiologists who did the studies on the vaccine I took found that it only provided about 70 percent protection, which suggests that in fact quite a few people were still contracting infections. What it *did* do was almost eliminate the chance of getting hospitalized or dying. And that's important! That's why I feel fine with hanging out unmasked with my other vaccinated friends. But I also do not want to get non-hospitalized sick, and I do not want to get a non-symptomatic case that I pass on to my friends' kids or other vulnerable people. And I know that there is no way even a well-meaning business can actually verify that non-masked people actually got vaccinated, because cards can be forged and covid deniers lie without shame.

So I plan to continue wearing masks in stores and other indoor public places as long as there is substantial community spread in my area, and I will in fact be improving public health by doing that.
posted by tavella at 6:42 PM on May 14, 2021 [20 favorites]


I'm sorry, mochapickle, that my comment came across as gainsaying the concerns of at-risk patients, which is not my view - that is why I said "some."

I spent much of the past year doing COVID contact tracing, out of concern for the most vulnerable in my community. We saw the different risk profiles, where the most elderly and those with co-morbidities were at highest risk of catching the disease and being made very sick by it. Young kids are at lowest risk and are statistically very safe, especially if they are big enough to wear their own masks in public places. Meanwhile many adults at highest risk should no doubt continue to wear stringent PPE even after being vaccinated themselves.

We are talking here about the change from public spaces where everyone has been masked to public spaces where some unvaccinated assholes may -- no will -- go unmasked. For many, many people who have expressed concern upthread, wearing a mask themselves will provide appropriate protection and safety.

Is 100% safety possible? No. But the CDC's reasoned judgment is that for the vast majority of people, universal masking is no longer the necessary way to ensure the safety of society as a whole.

(On preview:) tavella's plan is great.
posted by PhineasGage at 6:48 PM on May 14, 2021 [7 favorites]


The CDC’s page about vaccine effectiveness. There’s a lot there. The short version is that the vaccine is highly effective at preventing infection and there’s an increasing body of evidence that shows that it effectively prevents transmission of the disease. Vaccinated, asymptomatic people don’t have enough viral load to transmit infection.
posted by chrchr at 6:51 PM on May 14, 2021 [3 favorites]


Kids and variants are still a huge question mark.
posted by tiny frying pan at 7:02 PM on May 14, 2021


The short version is that the vaccine is highly effective at preventing infection and there’s an increasing body of evidence that shows that it effectively prevents transmission of the disease. Vaccinated, asymptomatic people don’t have enough viral load to transmit infection.


"the" vaccine? There's several different vaccines, with varying levels of effectiveness at preventing transmission; as it happens, the one I was given is the least effective of those approved in the US.

And I will point out from your link:

"A growing body of evidence suggests that fully vaccinated people are less likely to have asymptomatic infection and potentially less likely to transmit SARS-CoV-2 to others"

"less likely" and "potentially less likely" are not exactly the flat statement of "Vaccinated, asymptomatic people don’t have enough viral load to transmit infection" that you are claiming as the basis to criticize people who make the personal choice to keep masking.
posted by tavella at 7:14 PM on May 14, 2021 [7 favorites]


I'm old (58). I used to play indoor soccer. I am a goalkeeper.

That's a position I can't do socially distanced. We haven't played since this all started. The facility we play at has been sending emails since like last summer, saying how it's all fine and safe. Yeah, no.

And tonight I got an email saying that fully vaxxed folks can play, without masks!!! Ugh.

And my teammates (all now vaxxed). have been going back to our sponsor bar and hanging out indoors, eating and drinking. And they seem to be ready to start playing next season. This is going to be hard...
posted by Windopaene at 7:26 PM on May 14, 2021 [1 favorite]


In Canada, public health restrictions are provincial, but the federal public health agency is taking a more cautious approach than the CDC, recommending that restrictions remain in place until at least 75% of adults have received at least one dose of the vaccine. PHAC modelling shows that if measures are lifted when only 55% of adults are vaccinated, there's likely to be another large surge in the fall of 2021. With enough COVID-19 vaccine coverage, restrictions can start to lift by mid-summer, PHAC says. Graphic.

Zeynep Tufekci: Maybe We Need Masks Indoors Just a Bit Longer. She argues that it'd be better to keep indoor mask mandates in place until vaccination rates reach benchmark levels - for example, North Carolina was planning to lift mandates when two-thirds of adults had at least one dose.
It might have been better to have kept up indoor mask mandates to help suppress the virus for maybe as little as a few more weeks.

The C.D.C. could have set metrics to measure such progress, saying that guidelines would be maintained until the number of cases or the number of vaccinations reached a certain level, determined by epidemiologists.

... Only about two weeks ago, the C.D.C. said that fully vaccinated people should still wear masks, even outdoors, if they were around crowds. Now we are told they need not even distance themselves in most settings, even indoors.

That outdoor rule for the vaccinated seemed too timid, especially given how rare outdoor transmission seems to be. I’m even on board with telling the fully vaccinated their personal risk from this pathogen is no greater than any number of normal everyday risks. But why this big shift so soon? We shouldn’t just get new rules, we should get explanations.

The C.D.C. shift does not seem to fully account for the risks to the great number of unvaccinated people or the immunocompromised, especially those working indoors.

... In the early days of the pandemic it made sense for everyone to wear a mask, not just the sick — as the C.D.C. and the World Health Organization were recommending — if only to relieve the stigma of illness. Now, as we head toward the endgame, we need to apply the same logic but in reverse: If the unvaccinated still need to wear masks indoors, everyone else needs to do so as well, until prevalence of the virus is more greatly reduced.
Derek Thompson: The CDC’s Big Mask Surprise Came Out of Nowhere.
posted by russilwvong at 8:16 PM on May 14, 2021 [9 favorites]


The CDC changed policy too quickly, unfortunately, and faster than scientists would have recommended.
posted by They sucked his brains out! at 8:18 PM on May 14, 2021


So the way that I learned about flu vaccines and actually, PrEP antiviral injection, is that just because such prophylactics are about affecting groups and communities, not about guaranteeing individual protection, so it doesn't mean you stop doing the other, low-tech, behaviors that mitigate risk.

Like in this article about flu shots:
In a commentary published last month in The BMJ, Del Mar argues that public health measures should focus more attention on hygiene. The influenza vaccine “doesn’t seem to be a terribly good horse to back” when it comes to fighting flu epidemics or even protecting yourself as an individual, he told me, and putting so much emphasis on the vaccine may give people a false sense of safety. “We should stop promising what we cannot deliver.” People who get the vaccine should realize that that’s only a first step.

So I think unless it's kind of explained explicitly as I was by the nurse on whether to use PrEP and what that meant, people are led to have this silver-bullet, technocentric impression of vaccines.
posted by polymodus at 12:19 AM on May 15, 2021 [2 favorites]


The CDC changed policy too quickly, unfortunately, and faster than scientists would have recommended.

I mean, clearly not since it was the recommendation of CDC scientists to make the change? There are others who disagree of course. But I don't think this guidance is obviously wrong the way a lot of people seem to.

The best counterargument is that from the parents who can't get their kids vaccinated yet. I'm not sure if that's dispositive but it does give me pause.
posted by Justinian at 1:06 AM on May 15, 2021 [5 favorites]


Mod note: A couple deleted. If you are posting in order to nitpick and gainsay an immunocompromised person's own self-reporting of their severe, life-threatening medical condition and the advice of their actual specialist doctors, just stop. Whatever point you are trying to make is null here. If you think people should lighten up about this whole covid thing, you're free to feel that way, and voice your opinion within reasonable parameters (please check the site guidelines) . You are not free to badger someone facing a drastically different risk assessment than your own and demand that they somehow defend their personal medical choices to your satisfaction. Stop.
posted by taz (staff) at 1:14 AM on May 15, 2021 [33 favorites]


for example, North Carolina was planning to lift mandates when two-thirds of adults had at least one dose.

WAS planning to, but then yesterday, the governor pretty much threw up his hands and said, "y'all do what you want":

NC Gov. Cooper lifts most coronavirus mask, distancing requirements
...North Carolina went a step further Friday, by lifting mask requirements for everyone, regardless of whether they have been vaccinated or not....Cooper also did away with all limits on the number of people who can gather in one place or patronize businesses...As of Friday, about 46% of adults 18 and older in North Carolina have been fully vaccinated, according to the state Department of Health and Human Services.
posted by oakroom at 6:33 AM on May 15, 2021 [4 favorites]


Walking through the downtown yesterday evening, we saw a number of families where the kids were wearing masks and the parents weren't. While correct per the new guidance (assuming the adults were vaccinated), that seems extra crummy for the kids and highlights how this abrupt change before kids are even eligible leaves a lot of people hanging.

The more I think about it, the more I wish they had announced an in-between step instead, with this full demasking coming a few weeks later (maybe tied to a realistic vaccination percentage goal). More lead time for businesses would have been good, and that delay would have given teenagers at least a chance to get their first shots. Also, I understand why politically a national "vaccine passport" was a non-starter, but it would have made this transition period more coherent.

But I'm in a place where mask compliance has been very high and mask mandates have been strict (and vaccine uptake has been reasonable); in much of the country that was never the case at all and the change in guidance just caught up with where many people were already at and won't change much other than making vulnerable people even more vulnerable.
posted by Dip Flash at 6:57 AM on May 15, 2021 [7 favorites]


“The CDC changed policy too quickly, unfortunately, and faster than scientists would have recommended.”

I mean, clearly not since it was the recommendation of CDC scientists to make the change? There are others who disagree of course.


This is one thing that’s increasingly driving me totally batshit about The Discourse: “follow the science.” Science is rarely univocal. The evidence favoring the efficacy (and I think also the effectiveness) of these vaccines, in people who can receive them, is really quite strong, and it’s about as close as science ever gets to unanimity. But evidence from social sciences is basically never univocal! And to have a public health policy that was obviously right, where disagreeing could correctly mark you as anti-science, that’s what we’d need — because public health is about shaping human behavior. I’m not anti-science (my job title is literally “scientist,” for heaven’s sake). I think the Moderna vaccine has reduced my personal risk by a lot and I am so grateful. But that’s not all that public health policy is about.

We’ll know soon enough what happens to vaccination rates in late spring and early summer 2021. We may or may not learn something from that that lets us assess whether this was a good choice. That’s the agony and the ecstasy of observational science.
posted by eirias at 7:32 AM on May 15, 2021 [13 favorites]


I can see the public service ads now to get the attention of those grumpy ol' Republican men: a perky female nurse with a little needle and a grin on one side vs. a gray, wrinkled hand holding out a little blue pill and a smudged glass of water.
posted by PhineasGage at 9:10 AM on May 15, 2021 [4 favorites]


“COVID: Even Viagra won’t make it work”
posted by glaucon at 9:26 AM on May 15, 2021 [2 favorites]


I feel we haven’t sufficiently promoted the news that a COVID infection, even an apparently-asymptomatic one, increases your risk of erectile disfunction by 600%.

Where are you getting that number from? I can’t find it in the article you linked to or in the review paper that article is sourced from. And the review paper seem emphatically about *symptomatic* COVID that results in endothelial cell damage.
posted by mr_roboto at 9:28 AM on May 15, 2021 [1 favorite]


Science is rarely univocal

In this case, it seems like many in the medical, research, and public health communities outside the CDC are scratching their heads, if not worried.

That’s the agony and the ecstasy of observational science.

Speaking as someone who also does science for a living, I'm not sure this is an experiment in that way. There are no controls, no treatments. They just picked up and changed their guidance, that's all, and states have been scrambling to figure out what to do about their own policies and how to reimplement them.
posted by They sucked his brains out! at 10:21 AM on May 15, 2021 [5 favorites]


The more I think about it, the more I wish they had announced an in-between step instead, with this full demasking coming a few weeks later (maybe tied to a realistic vaccination percentage goal).

Yeah, if part of the point of public health is to keep the public trust so you can influence their behavior, this clearly was a bit of flop. I'd add that it seems odd to me they didn't make any effort to distinguish between types of indoor businesses. I mean, the rule of putting a mask on when you get up from your table with indoor dinning was always magical thinking–bars and restaurants have essentially been maskless for months now. Then there are essential businesses and non-essential - I doubt any immunocompromised person was eager to go to say, go to a movie theater even if people were wearing masks. So let movie theaters drop the mask requirement. But grocery stores, pharmacies, etc. - these should be places kept safe for everyone, with higher-standards of mitigation.
posted by coffeecat at 10:25 AM on May 15, 2021 [3 favorites]


I'm not sure this is an experiment in that way. There are no controls, no treatments.

I think that’s why eirais used the term “observational”. In the observational sciences (astronomy, geology, epidemiology, etc.) you can’t perform experiments or run controls. You have to work with what nature gives you.

They just picked up and changed their guidance, that's all

They changed their guidance in response to new observations. As they should.
posted by mr_roboto at 10:29 AM on May 15, 2021 [7 favorites]


Yeah, I think an economist might call a policy change like this an instrumental variable? But statistical methods are stupidly discipline specific and I might be using that term wrong. The quality of inference you can make from a before/after change like this is not great, in my not-an-economist mind. It’s also probably all we’ll get for evaluating whether this was boneheaded. Sure looks boneheaded to me. It’s possible I could be wrong, and also that I could be right but we’ll get away with it. Sometimes we are the Homer Simpson of nations. But anyway, that’s exactly what I mean. It’s really dumb for the mask-bonfire types to make strong claims about the behavioral incentive piece of this. By the same token I should temper mine, too.
posted by eirias at 10:31 AM on May 15, 2021 [1 favorite]


In the observational sciences (astronomy, geology, epidemiology, etc.) you can’t perform experiments or run controls

Not really sure what you're talking about. Epidemiologists have to run their disease studies with controls, and put patients into cohorts, as a couple instances. I don't have as much familiarity with the other two sciences you mention, but controlling for instrument or environmental noise are absolutely aspects of astronomy/experimental physics.
posted by They sucked his brains out! at 11:08 AM on May 15, 2021


My YMCA just announced that they'll only require masks for vaccinated people, in keeping with the new guidelines. We're in frickin' Michigan. And as pointed out multiple times, there's no way to make sure unvaccinated people wear masks. I haven't been to the Y since the pandemic started, but I've kept paying my dues because I want to support them. I'm seriously reconsidering that, as they clearly aren't going to support me (immunocompromised person).
posted by FencingGal at 11:40 AM on May 15, 2021 [6 favorites]


I doubt any immunocompromised person was eager to go to say, go to a movie theater even if people were wearing masks. So let movie theaters drop the mask requirement.

When a number of people in this thread are relating personal experience of what it's like to live with heightened risk, it seems especially thoughtless to suggest that certain parts of society just be closed off to them and others like them.
posted by fedward at 11:46 AM on May 15, 2021 [21 favorites]


How many of us are expected to be able to read and understand medical research papers? How many of us are expected to be able to interpret statistical data? Once upon a time, there were supposed to be experts who could interpret these sources and explain to us simple folk what is going on. Clearly, from the discussion here, there are no experts. People here are arguing the science, arguing the statistics, and unless I apply analysis to these arguments, forget the science and statistics, I can’t follow what is going on. The CDC is supposed to be experts. Their information has seemed to be both inconsistent and maybe contradictory. Add on to this, the behavior of actual human beings during this plague. No mask once meant you’re either a fool or an ass. Now it means you’re a safe, fully vaccinated individual, or you are either a fool or an ass. None of this should be so complicated that we have to argue back and forth over what might be right to do, and what might be wrong to do. Science and statistics has been overcome by politics and the human need to nitpick and argue for reasons other than finding out what is the right thing to do. Like I said above, just wear a mask.
posted by njohnson23 at 11:52 AM on May 15, 2021 [3 favorites]


it seems especially thoughtless to suggest that certain parts of society just be closed off to them and others like them.

That was certainly not what I was arguing - my point was that certain parts of society were already closed off to immunocompromised people. The new CDC ruling doesn't say, make indoor dinning dangerous after being safe - it was never safe for high-risk populations. The new CDC ruling does mean that places that were previously relatively safe (like Trader Joe's) now more high-risk (since the company has dropped their mask requirement).
posted by coffeecat at 12:18 PM on May 15, 2021 [2 favorites]


I'm no expert either, but making national level public health recommendations during a pandemic caused by a novel disease seems like it really is complicated enough in practice that there's not necessarily a single, scientifically and statistically right answer or correct date that every reasonable expert would agree with.
posted by eponym at 12:19 PM on May 15, 2021 [3 favorites]


"Then there are essential businesses and non-essential - I doubt any immunocompromised person was eager to go to say, go to a movie theater even if people were wearing masks. So let movie theaters drop the mask requirement. But grocery stores, pharmacies, etc. - these should be places kept safe for everyone, with higher-standards of mitigation." — coffeecat
Who gets to be in charge of deciding what immunocompromised people are allowed to do?

If we're going to decide which parts of society are inaccessible to the immunocompromised, what about other medical conditions?
posted by truex at 12:33 PM on May 15, 2021 [9 favorites]


The CDC have now formally confirmed the words of our prophet Chet Hanks.
posted by srboisvert at 1:26 PM on May 15, 2021 [2 favorites]


I think what I'm a little angry about is that there were ever only two states; people should wear masks and people don't need to. The state of "people should wear masks, except vaccinated people who don't need to" never existed for public spaces, because the honor system was never going to work and because we have no system of verifying vaccination status on a retail level. And you cannot tell me that the CDC, stuffed full of public health experts, did not know that. And therefore they should not be pretending that they did anything other than say masks are unnecessary indoors.
posted by tavella at 2:47 PM on May 15, 2021 [14 favorites]


Others have said it, but I agree that there are fundamentally legitimate two purposes for wearing masks. One is to serve as designed, as a barrier to prevent the virus from spreading from person to person. The other is to signal that the wearer is exerting at least a basic level of conscientious and diligent prophylaxis against spreading the virus, and therefore they might be accorded a degree of trust in social interactions in the midst of a pandemic.

That second purpose is probably not much factored into the calculus by CDC and various epidemiologists. But as a sociopolitical factor, it's absolutely important.

Saying that everyone that is vaccinated can now remove their mask, well before we've reached herd immunity and when we know there is a large contingency of anti-vaxxers/anti-maskers out there? And there are a large number of people who are unable to get vaccinated? It just seems irresponsible.

I'm vaccinated. And although I'm not an epidemiologist, I understand statistics well enough to know that I'm probably safe. But I also have COPD. And I've personally experienced enough of respiratory disease to know that even mild issues are life-threatening.

So I'll be wearing a mask in public for the foreseeable future, until we get at least a little closer to herd immunity and we have a better idea of whether the anti-mask idiots are going to cause a resurgence of Covid through variants. If Covid rates are well under control by next spring, I expect I'd stop wearing a mask then.
posted by darkstar at 3:39 PM on May 15, 2021 [8 favorites]


Not for the first time, I feel like Graham Chapman in the Argument Clinic. "Argument's an intellectual process. Conservatism is just the automatic gainsaying of anything the other person says."

ITYM Michael Palin. Chapman played the verbal abuse guy.

stupid git.
^^(sorry, couldn't resist!)
posted by Greg_Ace at 3:56 PM on May 15, 2021 [1 favorite]


Look, the immunocompromised people I know (and many of the comments in this thread) have decried how this ruling will make it hard for them to do very necessary errands (like grocery shopping). Hence, my concern/surprise that the CDC recommendation makes no effort to keep such places safe. Truly did not expect that advocating for masks to remain in grocery stores to be a controversial reaction, but I guess that's 2021 for you.
posted by coffeecat at 3:56 PM on May 15, 2021 [7 favorites]


stupid git.

*16 ton weight falls and crushes posting-too-quickly old person*
posted by delfin at 5:22 PM on May 15, 2021


No it didn't.
posted by Greg_Ace at 5:46 PM on May 15, 2021 [3 favorites]


As shown in some misinformation above about not knowing how science is actually done, scientific literacy is a very real problem, and that complicates how to get messages across about what are the best paths forward for getting all of us past the pandemic.

Some research from MIT's Crystal Lee goes even further: Viral Visualizations: How Coronavirus Skeptics Use Orthodox Data Practices to Promote Unorthodox Science Online offers an empirical analysis of how some anti-mask-wearers are using how we communicate data to corrupt messaging.
This paper investigates how these activist networks use rhetorics of scientific rigor to oppose these public health measures. Far from ignoring scientific evidence to argue for individual freedom, antimaskers often engage deeply with public datasets and make what we call “counter-visualizations”—visualizations using orthodox methods to make unorthodox arguments—to challenge mainstream narratives that the pandemic is urgent and ongoing. By asking community members to “follow the data,” these groups mobilize data visualizations to support significant local changes.
It's really quite illuminating of larger phenomenon on all kinds of social media platforms, some of whose users rate anecdote and personal opinion over professional expertise to spread misinformation:
In other words, anti-maskers value unmediated access to information and privilege personal research and direct reading over “expert” interpretations. While outside content is generally prohibited, Facebook
group moderators encourage followers to make their own graphs, which are often shared by prominent members of the group to larger audiences (e.g., on their personal timelines or on other public facing Pages).
I'm not sure how we establish a baseline of literacy, but it definitely seems like keeping an eye out for our how our community's language and processes are corrupted to other ends by gaslighters is probably more important than ever:
[O]ur paper introduces new ways of thinking about “democratizing” data analysis and visualization. Instead of treating increased adoption of data-driven storytelling as an unqualified good, we show that data visualizations are not simply tools that people use to understand the epidemiological events around them. They are a battleground that highlight the contested role of expertise in modern American life.
posted by They sucked his brains out! at 5:49 PM on May 15, 2021 [3 favorites]


Who gets to be in charge of deciding what immunocompromised people are allowed to do?

The point is that the people I know who have compromised immune systems have no intention of stepping into a movie theater at the moment, because the risk of dying when there's still limited data on how effective the vaccine is for them makes doing something that's entirely optional not worth it.

Whereas they have to go shopping from time to time (at least one example in my friend circle lives in a small town - there is no Postmates/Instacart, there is no curbside pickup, etc. If she can't get a friend to go shopping for her, she has to go in and do it). She can watch movies at home without a problem, but this announcement by the CDC has made her life significantly worse.
posted by Candleman at 6:45 PM on May 15, 2021 [6 favorites]


One thing I find extremely disturbing in the public conversation about all this is that most people are acting as if a huge chunk of the vaccines were not J&J. Like J&J has just vanished from all the talk about how safe people are. I can't find numbers for how many people got the J&J. I mean cool that you all got shots with 95% efficacy but I got one with only just 70% efficacy (albeit during trials with higher baseline risk). I've seen no studies mentioning the real world effectiveness of J&J yet.
posted by srboisvert at 8:14 PM on May 15, 2021 [10 favorites]


I can't find much at all about J&J in some respects, usually stuff like "because they're later in the process and the variants were coming about, it's a different situation." This is about the sort of thing I've seen, if that helps any.
posted by jenfullmoon at 8:39 PM on May 15, 2021


srboisvert, the CDC document about vaccine efficacy discusses the Johnson & Johnson vaccine extensively. The bottom line: “All authorized COVID-19 vaccines demonstrated high efficacy (≥89%) against COVID-19 severe enough to require hospitalization. All authorized COVID-19 vaccines demonstrated high efficacy against COVID-19 associated death.”
posted by chrchr at 9:00 PM on May 15, 2021 [3 favorites]


Saying that everyone that is vaccinated can now remove their mask, well before we've reached herd immunity and when we know there is a large contingency of anti-vaxxers/anti-maskers out there? And there are a large number of people who are unable to get vaccinated? It just seems irresponsible.

Serious question. Not intended as a rhetorical flourish.

When do you think this situation is going to change?

We are not going to achieve herd immunity, at least as it is presently understood.

Some anti-vaxxers will probably eventually give in sooner or later, but I would expect a hard-core minority to continue to refuse the vaccine. Like 20%. More concentrated in some places.

If I'm not wrong about that (and I think these are pretty conventional assumptions, but I'd be very very glad if I were wrong about, e.g., vaccine uptake), what is the exit strategy here? We are literally never going to reach a scenario where there isn't a population of real size blithely carrying risk around. If you think that requires everyone to mask to avoid that group using the rest as camouflage, how does that not equal wearing masks forever?
posted by praemunire at 9:01 PM on May 15, 2021 [7 favorites]


praemunire: what is the exit strategy here?

According to Canadian modelling, it makes sense to lift restrictions once about 75% of adults are at least partially vaccinated. If you start lifting restrictions when only 55% of adults are at least partially vaccinated, you risk a fourth wave of hospitalizations in the fall of 2021. Graph.
posted by russilwvong at 9:20 PM on May 15, 2021 [11 favorites]


According to Canadian modelling, it makes sense to lift restrictions once about 75% of adults are at least partially vaccinated.

And I think that is a basically reasonable approach (unless the data changes). If I were dictating policy, I'd probably do something along those lines. But...

(a) We may not get to 75%. In certain states, I really don't think we will. But, saying we do...

(b) The CDC didn't say, "Hey, lift restrictions before reaching [x]." (I don't know if people didn't read the statement, or what?) It said "people who are vaccinated no longer pose an appreciable risk to others." Which seems to be true. The problem is not that I, a vaccinated person, am at appreciable risk of getting sick or of passing it on to others. The problem is what the unvaccinated will do, in defiance of the science. It seems like both of these factors need to be balanced by governors in determining how long to maintain mandates, but that's a separate question from whether the CDC should maintain a position its scientists don't believe on whether it's safe for vaccinated people to go to public indoors spaces unmasked.

(c) Many of the objections here are because people feel that they can't endure the increased risk of encountering an unmasked, unvaccinated person. I'm not going to make calls for those people; it's not my lungs or my grandmother with cancer. I think these people are in an awful situation. But the unmasked unvaccinated are not going away, or diminishing in numbers to the point that you're unlikely to encounter them in public. If you are saying "you can't do anything that might lead to states relaxing indoor masking mandates because the unmasked unvaccinated create too much risk for me," you are saying never end the mandates, or admit anything that might prompt the states to do so (unless, I suppose, we miraculously develop a treatment that works very well against COVID; may that day soon come). A substantial chunk of these people are just not changing their minds. And if your concern is an immediate personal risk, you'll take little comfort in a model that shows that 75% vaccination means society won't be overwhelmed.
posted by praemunire at 9:49 PM on May 15, 2021 [10 favorites]


Serious question. Not intended as a rhetorical flourish.

When do you think this situation is going to change?



Unfortunately, the end-point for me isn't one that will be easy to define.

What it means in practicality is that I wear the mask a bit longer, so that the vaccination rate for those who want to and can get vaccinated has a chance to approach 100%.

And during that time, probably a sizeable portion of the anti-maskers themselves have the opportunity to actually get Covid, and either survive (hopefully) or not.

I'll be happy to see infection rates diminish by at least an order of magnitude, and hope that can happen by next spring.
posted by darkstar at 9:59 PM on May 15, 2021 [1 favorite]


What it means in practicality is that I wear the mask a bit longer, so that the vaccination rate for those who want to and can get vaccinated has a chance to approach 100%.

Please understand that I am completely in favor of your wearing a mask as long as you wish or think it appropriate. (For the record, you can even see it on this site--after some initial doubts, I converted over to supporting mask-wearing quite early. I have a journal entry for March 25, 2020, where I mention giving the double-barreled finger to someone who was trying to unobtrusively take a picture of me wearing a mask to the grocery store.) But how does A lead to B? If you're vaccinated, you're not at appreciable risk of spreading to the unvaccinated; you are not affecting the chance for someone else to get vaccinated that way. And there's at least as good an argument that letting the vaccinated go unmasked will encourage vaccination, or will have no meaningful effect on rates, as that it will discourage it. (Maybe we'll have better data on this later.)

And how does your personal choice scale up to a public health policy? It doesn't seem to address at all the intransigent issues of the people who won't be able to avail themselves of the vaccine's protection even though they desperately want to, and those who refuse to even though any decent person should.

At any rate, more than a year in, "this is just going to sort itself out...at some point" is not a workable approach.
posted by praemunire at 10:14 PM on May 15, 2021 [3 favorites]


srboisvert, the CDC document about vaccine efficacy discusses the Johnson & Johnson vaccine extensively. The bottom line: “All authorized COVID-19 vaccines demonstrated high efficacy (≥89%) against COVID-19 severe enough to require hospitalization. All authorized COVID-19 vaccines demonstrated high efficacy against COVID-19 associated death.”

Which you will notice is a rather significant goal post move from the mRNA vaccines prevention of illness altogether. I was never that concerned about death or hospitalization for myself because my age and fitness already made it fairly unlikely. What I personally was, and still am, terrified of is long covid.

NPR has an extremely disturbing look at how long to reach 75% vaxed in the United States. In some of the laggard states it will not be until late spring 2022 assuming a linear trend (which is likely a wildly overoptimistic projection).
posted by srboisvert at 2:58 AM on May 16, 2021 [5 favorites]


Herd immunity is local, though. You don't only reach herd immunity in, say, San Francisco once Mississippi and Alabama get to 75%, or when the nation as a whole gets to 75%. You get there once SF and environs reach 75% (if 75% is indeed the magic number. Estimates of r0 vary, and the herd immunity threshold is a function of r0).

We want everyone to get vaccinated and we want the entire planet to reach herd immunity. But the most likely result in the United States is pockets of herd immunity in heavily blue areas amongst big swaths of bubbling petri dish red zones.
posted by Justinian at 3:21 AM on May 16, 2021 [8 favorites]


I would actually happily wear a mask for as long as it takes to defang this threat. I would rather have another year+ of masking than several more years of the threat simmering under the surface. Even though I am fully vaccinated and presumably quite protected. This isn’t for me. This is for my child, and for my friends’ children. This is for maintaining a norm that allows at-risk people to function by reducing the need for trust in public spaces.

But it’s true that my personal choices don’t scale. I think that’s part of why this has me feeling down. I can continue to wear a mask to make a point, or to model it for my child, and I probably will, at least for now, but it’s a bit quixotic and I know it.

On some level I just can’t understand how “but we might still have to do this in a year” is an argument when we are talking about a norm of dress in public spaces. I mean, okay? It is such a small concession to others’ comfort. I think there’s actually a better case for mask mandates than there is for city ordinances saying that I can’t go outside topless. And yet I’ll presumably still be wearing shirts in a year. To me it seems incredibly entitled to expect that a world-shaking calamity like a pandemic should leave no trace on your life or your culture when it’s gone.
posted by eirias at 4:38 AM on May 16, 2021 [22 favorites]


To me it seems incredibly entitled to expect that a world-shaking calamity like a pandemic should leave no trace on your life or your culture when it’s gone.

eirias, I agree with you, but "return to normalcy" is a powerful slogan. It's almost impossible to find contemporary writing from the 1918 flu pandemic, for instance. 1939's Pale Horse, Pale Rider aside, it took nearly a century for the flu to start showing up in fiction and film. It's not just about turning away from trauma -- artists were perfectly able to grapple with the legacy of the Great War. Something specific about illness; my theory is that it's because the true enemy (virus) is invisible, and so it becomes easier to transfer anger and enmity onto the things you can see -- the people around you, and their masks (or lack thereof).

There was a brief moment in mid-late 2020 when I started to think that maybe the ways the pandemic had unmasked (sorry) disparities across our society would lead us to revamp as we moved toward a new normal. The Biden-Harris slogan, "Build Back Better" seemed to capture some of that optimism. But increasingly I think that nothing fundamentally is going to change -- everyone seems in such a rush to "get back to normal" that we're again trampling on each other.

I will say, though, that I've had more people ask me if they should get the vaccine in the last week than ever before. (My answer is and has always been a resounding yes.) So I think that the CDC announcement is nudging some of the vaccine-hesitant. I just don't think that's enough to make up for the substantial number who lie about their testing status/vaccine status.
posted by basalganglia at 9:13 AM on May 16, 2021 [12 favorites]


Rochelle Walensky seems to want it both ways in this interview. One the one hand, she says that the new guidance isn't "granting permission" for the unvaccinated to take off their masks, the clear implication of which is that they have power to withhold that permission, at least in an advisory capacity. On the other hand, she's passing the buck to state and local governments, ignoring the impact the new guidance will have on any governments that may want to require more stringent mask requirements.

CDC isn't just there to issue rulings on scientific questions -- they must offer guidance in a way that understands that Americans aren't participants in a carefully-controlled study. Saying they think this guidance will incentivize vaccination is an admission that they believe that their actions can matter, at least at the margins. You can't then throw up your hands and hide behind the science when someone suggests that you're putting retail workers, young children, and the immunocompromised in a vulnerable position. This is bad policy and bad politics.
posted by tonycpsu at 10:26 AM on May 16, 2021 [9 favorites]


I wonder how this will impacts the various private businesses that currently allow employees to work from home because of the risks. People, esp those with unvaccinated/immunocompromised family members, who rely on public transport might have some tough decisions ahead of them if they are forced to commute. Not everyone can read advanced charts and make informed decisions based on statistics or even meaningfully know what kind of risks they are taking either way.
posted by asra at 10:36 AM on May 16, 2021 [5 favorites]


tonycpsu: CDC isn't just there to issue rulings on scientific questions -- they must offer guidance in a way that understands that Americans aren't participants in a carefully-controlled study. Saying they think this guidance will incentivize vaccination is an admission that they believe that their actions can matter, at least at the margins.

Agreed. It seems that both the CDC and their critics agree on the goal - encouraging people to get vaccinated. The disagreement is over whether setting a regional benchmark (e.g. mandates can be relaxed after 75% of adults are partially vaccinated) or individual guidance (after you get vaccinated you no longer need to wear a mask and physically distance) is the most effective way to do it.
posted by russilwvong at 10:48 AM on May 16, 2021 [2 favorites]


This guidance has affected behavior in my very liberal, highly vaccinated town pretty quickly, I think. I went to two outdoor gatherings this weekend — my first since New Years 2020. In both cases, those of us who brought young children were masked for the sake of modeling an easy to follow rule, but everyone else was barefaced. It felt extremely awkward to be the only ones and it was clear my friends felt awkward about it also — I felt compelled to explain myself. It’s difficult to envision a mask mandate anywhere lasting the week, and I think most voluntary masking behavior will decline in short order, too.
posted by eirias at 3:57 PM on May 16, 2021 [8 favorites]


On some level I just can’t understand how “but we might still have to do this in a year” is an argument when we are talking about a norm of dress in public spaces. I mean, okay? It is such a small concession to others’ comfort

I know what you mean, but if we are worried about Covid I do think the mask mandate (especially for vaccinated people) is far less important than the other restrictions. And keeping a general lockdown, or even lockdown-lite, in place for a year is a bit harder to pitch as a small ask.

I admit I have no clue what's going to happen. I'm on the optimistic side--especially compared to the median poster on this thread--but for sure I'm going to be paying a lot of attention to local numbers over the next couple months, and then again when the whether gets cold.
posted by mark k at 4:50 PM on May 16, 2021 [2 favorites]


My state is 70% unvaccinated and my employer will not require vaccinations, but is rescinding its face covering requirement based on this guidance. Setting aside our disdain for those who for whatever reason choose not to get vaccinated, how is this a good decision from a public health standpoint? Are the 70% not the public?
posted by HotToddy at 5:19 PM on May 16, 2021 [10 favorites]


This guidance has affected behavior in my very liberal, highly vaccinated town pretty quickly, I think.

Same here (at more medium levels of liberalism and vaccination), though it isn't uniform. I went to Costco this morning and at least 80% or 90% of the customers were wearing masks, and restaurants seem to still be insisting on masks for when you are not at your table. In other settings, just like you describe, I am seeing virtually no masks.
posted by Dip Flash at 5:49 PM on May 16, 2021 [1 favorite]


Slightly tangential, but we took our son for his first Pfizer shot today, and I was pleasantly surprised to see a lot of other families there getting their of-age children vaccinated. This, in a red county of a blue state. I don’t know; it was heartening.

Mask wearing has dropped off a bit in general around here, but not as much as I expected.
posted by Don.Kinsayder at 6:18 PM on May 16, 2021 [1 favorite]


I wasn't sure what to expect when our city stopped their mandate in city buildings following the changed CDC guidance, but I was pleasantly surprised that people were still mostly staying away or staying masked during my first full day post-mandate on desk at the library.

I will say it was nice to not have to deal with the regulars who made a big loud antagonistic point of flaunting the mask mandate, time will tell but maybe it's just not fun for them without the attention, or maybe they realize their safety net of other people being responsible for them is gone.
posted by jason_steakums at 8:54 PM on May 16, 2021 [2 favorites]


> I went to Costco this morning and at least 80% or 90% of the customers were wearing masks

100% at the Costco I was at just now. I wish I'd thought to check for signs; is it required, or are we all just in the habit?
posted by The corpse in the library at 1:01 PM on May 17, 2021 [1 favorite]


Just received word that my office is no longer requiring a mask for those who are vaccinated, and of course mentioned in the same email that, per our legal department, we were prohibited from inquiring about any employees vaccination status. I generally trust my co-workers but we work in a massive cube farm - very high density, no offices, and there's probably 200+ desks on our floor. Thankfully they aren't forcing us back to the office (yet).

Also went out for brunch yesterday with my wife (outside, nobody else nearby) and happen to look inside - every table plus the bar was full, not a single mask in sight except for the waitstaff. It was weird and more than a little unsettling to see so many people packed in like that. This is in a very blue, very liberal area that's had extremely high mask compliance throughout the pandemic. If people are already over it here, I can only imagine what it's like in the rest of the country.
posted by photo guy at 1:49 PM on May 17, 2021 [1 favorite]


100% at the Costco I was at just now. I wish I'd thought to check for signs; is it required, or are we all just in the habit?

Costco now only requires them where local regulations still have the mandates. The store I was at had signs up at the entrance announcing the new policy, but only a few people (all men) were not wearing them.
posted by Dip Flash at 2:50 PM on May 17, 2021


Going down to see me son in Santa Clara this weekend. Fully vaxxed. Driving, not flying. Haven't seen him in two years. Still going to wear a mask like, everywhere. Glad California is waiting to turn off their mask mandates for another month...
posted by Windopaene at 3:54 PM on May 17, 2021 [2 favorites]


We've spent the last 14 months imploring people to listen to the CDC; I'm all for doing that now. If you feel better wearing a mask, do that. If you are fully vaccinated and prefer to not wear the mask outdoors, that's fine. I'm okay with not using the mask as a symbol. I like the idea of wearing one in flu season. If someone is immuno-compromised or otherwise at great risk, and asks me to wear a mask, I will, of course.

I drove to an event (all attendees vaxxed, people I trust) with friends. 3 of us! in a car! unmasked! It felt so weird. The event was indoors, we all wore masks. Being with people felt great.
posted by theora55 at 7:46 PM on May 17, 2021 [6 favorites]


I went to the grocery store yesterday and our plans changed so I went again today. This is in a purple part of a red state. The grocery store has already changed their signs from "masks required" to "masks recommended." Yesterday everyone was wearing a mask, though as usual there were a couple people with uncovered noses. Today I saw a single person completely unmasked. Seeing them unmasked felt jarring and like a jerk move, but at the same time I feel appreciative of the 14 or so others who were masked up. So at least around here unmaskpocalypse has not happened yet, but this guidance is still pretty new so we will see.
posted by Tehhund at 6:29 AM on May 18, 2021 [1 favorite]


Seems like everyone around here (blue Ohio) has kept wearing masks. And I was at Mid-Ohio Sunday for a race, and inside areas had a very high rate of mask wear. Which I would not expect from that crowd. So overall on limited data people are not just shedding masks.
posted by glaucon at 7:25 AM on May 18, 2021 [2 favorites]


My second shot is six days away, so I will continue masking at every opportunity until its symptoms have passed at a bare minimum.

After that... The CDC appears to believe that relative normality is possible if (a) you are vaccinated and (b) non-vaccinated people around you remain masked and distanced.

The former, I can control. The latter, I cannot... and I have no way of telling whether any maskless person I encounter is vulnerable or not. I have little reason to believe that some of them would tell me the truth, even if I asked them politely.

So this is kind of like the Second Amendment for me. The CHUDs read only the part of it that they care to (the words "resume normal activities without masks or distancing") and act accordingly. I read both parts of it and try to behave in ways that minimize the potential threat, even if others won't.
posted by delfin at 12:50 PM on May 18, 2021 [3 favorites]


Went for my weekly shopping trip this morning here in Seattle. Walked into the Trader Joe's, first person I saw was an older woman, not wearing a mask. Second person, young-ish dude, also not wearing a mask. Yikes! Then went to the Ballard Market, saw their new sign that said masks not required for vaxxed people...

Was shopping, and saw a woman, who saw me, and she recognized me, (my long hair makes me fairly identifiable, even with a mask on), and she wasn't wearing a mask. I haven't seen this person in like 8 years or so, and she used to have long hair, and now has very short hair. Took me a long time to figure out who she was. If she had had a mask on, I never would have figured it out. She said she saw the new sign, and being fully vaxxed, took off her mask...

It was a weird experience. Still keeping my mask on for the foreseeable future...
posted by Windopaene at 1:03 PM on May 18, 2021


On the one hand, I get the fear...on the other, unmasking isn't a risk for me, as I am fully vaccinated. So definitely going to unmask next Target or Trader Joe's trip. No reason to leave it on. Gotta let go sometime. If the guidance changes, then I'll pop it on. Chicago is keeping some restrictions despite IL lifting them so. It will be uneven for a while.
posted by tiny frying pan at 2:15 PM on May 18, 2021


Sucks when you are in the outlier 5% though...

And I too am "fully vaxxed"
posted by Windopaene at 3:27 PM on May 18, 2021 [1 favorite]


You know, in the beginning, they said that masks weren't to protect the wearer, but people around the wearer. As I recall, people were initially asked to wear masks to protect others. With telling vaccinated people not to wear masks, that seems to have gone totally out the window.
posted by FencingGal at 4:16 PM on May 18, 2021 [1 favorite]


Too much for some folks I guess. I don't get it. I hate the mask but... Death?
posted by Windopaene at 4:26 PM on May 18, 2021


Unfortunately I don't think "wear a mask to protect others" ever "caught on," as it were. People only cared about protecting themselves.
posted by jenfullmoon at 5:17 PM on May 18, 2021 [2 favorites]


Some say "Well, we have to return to 'normal' sometime soon." ...Why? The world around us has changed. The virus is not going to magically disappear or be capable of eradication. Whether we are vaccinated or not, many people around us are still vulnerable. Many are explicitly choosing to remain as vulnerable as possible, and don't care what impact that may have on anyone else. We can continue to adapt to our new reality... or we can hang up a big MISSION ACCOMPLISHED banner and act like the war's been won already.


Exactly this. We have to stop pretending that there is some idealised “normal” to return to. For all of the damage caused by this pandemic, needing to wear a mask is not even on the list for me. It seems to me that continued masking could be a part of the way forward for humanity, so why perpetuate the narrative that it is some huge burden to be dispensed with as soon as possible?
posted by clark at 6:17 PM on May 18, 2021 [4 favorites]


Because most people who are vaccinated and statistically incredibly safe from this awful disease won't agree to wear masks indefinitely when they aren't at personal risk?
posted by PhineasGage at 7:42 PM on May 18, 2021


Because we should focus mitigation efforts on things that are effective and not spend a bunch of energy on ineffective policies. It doesn’t matter if vaccinated people wear masks. We can spend that effort on something else, like trying to get more people vaccinated.
posted by chrchr at 8:02 PM on May 18, 2021 [3 favorites]


So variants come up and they are a legitimate concern. A few threads though on some of the issues with early arguments like "60% more infectious" and what that actually means.

John Burn-Murdoch
Meaghan Kall
Gro-Tsen

The last thread makes several mistakes, and claims that public health people aren't thinking about some of this stuff is belied by the other two threads. So I was on the fence about including it, but it makes the tl;dr; point most explicitly: Early reports of "increased infectivity" are not necessarily reporting something inherent to the virus, as opposed to local conditions, and real world results has been consistently better than the early models (based on that number) would have predicted.

The scary thought for me is not these variants, but the ones that actually evolve to escape the vaccine. But we're not there yet. For me it's actually part of the argument for re-opening: If things *are* bad by winter it'll be easier to go into a lockdown if we weren't trying to maintain it all year.

It seems to me that continued masking could be a part of the way forward for humanity, so why perpetuate the narrative that it is some huge burden to be dispensed with as soon as possible?

It's unfortunate masks became so totemic, mostly because a lot of people died because assholes wouldn't wear masks at all.

But as we're recovering--and I'm not arguing the timing is quite right--but as we're recovering and thinking about some new normal, I believe if you were to write guidelines in which vaccinated people wearing masks made scientific sense, you would also need to do things like limit gatherings and keep retail space at 50% capacity. Any vaccinated world where masks make sense is a world where you are asking people to give up a whole lot more, too.

Many poster have been quite explicit here that they really like the value of masks as a signal. But once masks stop making sense scientifically wearing them signals nothing, or at least nothing valuable. It shouldn't be part of the long term argument.
posted by mark k at 8:21 PM on May 18, 2021 [2 favorites]


There are two groups of unvaccinated

Another category to add to the growing list: the severely needle-phobic, who just can't. An already reclusive septuagenarian I care deeply about is in this category, and nothing I or anyone else can say or do will help them fight that particular demon.
posted by ManyLeggedCreature at 3:52 AM on May 19, 2021 [1 favorite]


But how am I a risk to others unmasked and fully vaxxed? Can someone explain?

Because yeah, they did think you could be asymptomatic and spread it, which did happen. But now they know fully vaxxed people do not do that. So why wear a mask in Target when I can't hurt anyone maskless?

If I'm missing something I want to know, but I don't understand this from the actual safety perspective and not a social one, "keep masking right now even if you're fully vaxxed."
posted by tiny frying pan at 4:42 AM on May 19, 2021 [1 favorite]


It's just ... there's no difference between virology science and behavioural science. It's all science. You can't say that there's "no" scientific basis in continuing to wear a mask when you're vaxxed if it's a strong social signal that masking is still a thing that wise and thoughtful people do to protect their neighbours. That is science.

That's what the CDC fucked up. That's what scientists everywhere fuck up. In thinking their own branch of science is the only important one. When the truth is that everything is interconnected and "soft" science and "hard" science is still fucking science, and that "science," especially science that affects millions of people, doesn't mean a fucking thing until it's integrated with intelligent, thoughtful policy.
posted by seanmpuckett at 4:55 AM on May 19, 2021 [12 favorites]


. . . And boom goes the dynamite. Thanks for articulating that. I couldn’t put the words together myself.
posted by Don.Kinsayder at 5:24 AM on May 19, 2021


Ok....but the actual transmission science. Not the social aspect. As I am clearly asking about. We can go round and round about where and when to mask...I am not against masks. I don't understand for that aspect why I need to wear one in a store, etc., which seems to be what many are saying here we need to keep doing.
posted by tiny frying pan at 5:30 AM on May 19, 2021


From the purely "spherical cow" aspect of considering a thing in total isolation from real world context, I think the CDC has said from a virology perspective it's okay for vaxxed people to eschew masks?

But from an epidemeological perspective (which considers social aspects as well).... we're not spherical cows.

I really wish the CDC had just told Biden privately and let him make some kind of informed policy decision. This is like a bridge engineer saying "yay the new pedestrian bridge to get onto the holiday island is installed and it's ready" and then ten thousand people try to get onto the bridge all at once and a bunch of them die in a trample situation. I mean... you gotta manage everything holistically. The bridge the masking, it's all just part of our approach to managing the pandemic.
posted by seanmpuckett at 5:57 AM on May 19, 2021 [1 favorite]


So same answer again. Got it.
posted by tiny frying pan at 6:01 AM on May 19, 2021


I'm sorry we're talking in circles.
posted by seanmpuckett at 6:02 AM on May 19, 2021


I went to the grocery store for the third time in 3 days because I'm bad at planning. Masking is down to 60-70%. It seems Unmaskpocalypse is here.
posted by Tehhund at 6:22 AM on May 19, 2021


I’ve been thinking about a loose analogy. In the US we set a drinking age of 21 for public health purposes having to do mostly I think with automobile accidents. To support this, we have an infrastructure in place that requires people to prove that they’re over 21 to buy booze, a social schema in which a worker asks to see your license and you’re expected to produce it. In practice this infrastructure is only really used in low trust settings. That’s the equivalent of grocery store masking here. Yeah, people who are over 21 pay some cost in needing to have a state ID on them to buy a drink. We’re applying the limitation to a bunch of people who pose no threat from the standpoint of this public health policy because in fact they are over 21. People who legitimately have the right to buy alcohol are almost certainly inconvenienced sometimes. We do it anyway because it lets us relax the need to lean on trust in a situation where we know lots of people are motivated to lie.

It’s an imperfect analogy for lots of reasons. But that’s what I’m thinking about, as I watch my own city’s mask mandates expire. If we had a carding system here for vaccines that was practical/not overly-burdensome to public accommodations and was also resistant to forgery, I would not really be worried about this at all. In the absence of such, the mask was the card.
posted by eirias at 6:34 AM on May 19, 2021 [7 favorites]


If you are vaccinated then you, personally, are not at risk of catching the virus, and are not at any major risk of transmitting the virus. Hooray!

The problem is that if the unvaccinated see a bunch of people stop wearing masks many of them are going to feel social pressure to go unmasked despite the CDC saying unvaccinated people should wear masks. This is because we are social creatures and what the people around us do is often weighted more than some below the fold warning from the CDC to unvaccinated people.

If we could continue masking until we got to, I dunno, 75% fully vaccinated in your locale, it would help encourage the people who are unvaccinated to continue wearing masks until (and if) they can get vaccinated.

So yes, you personally are not hurting anybody with virus particles, but by dropping masking now, you are one more particle eroding away the social norm before vaccination rates are high enough.

All that said, while I find this argument correct, I also feel like it's too late. Trying to protect people by keeping up the social norm only works if enough people do it, but the cat is basically out of the bag at this point thanks to the CDC announcement. I can already see mask usage eroding in public, and so trying keep this going now is an uphill battle. So I'm left hoping that our reasonably high local vaccination rates will be enough once all the mandates drop and that the unvaccinated do continue to mask. I guess we're going to find out in a concrete way soon.
posted by delicious-luncheon at 6:34 AM on May 19, 2021 [3 favorites]


Because yeah, they did think you could be asymptomatic and spread it, which did happen. But now they know fully vaxxed people do not do that.

Tiny frying pan, can you link to where you found that info? I've been looking for information about that.
posted by ishmael at 6:37 AM on May 19, 2021




So why wear a mask in Target when I can't hurt anyone maskless?

Because we don't know that you can't.

See the comment immediately above, where the CDC isn't sure what fully vaxxed people can spread and what they can't. Vaccines "help" prevent the spread, but by how much? Most people around you in these stores will be masked, vaccinated or both, but can we know for sure how vulnerable they actually are? Or what they might be unknowingly carrying? New mutations and variants are emerging, as would happen with any virus. Do we know whether one or more of them will do SERIOUS damage if people let their guard down and fail to follow smart, preventative practices habitually, and they manage to gain a more significant foothold in the population?

The CDC is making this shit up as they go along, based on their best evidence available. In and of itself, that's not wrong; that IS the scientific method, isn't it? Hypothesize, test, examine results, rethink, repeat. CHUDs make fun of we defensive types because the message to the public keeps changing: Don't wear masks. Okay, wear them. Everyone should wear them. Some people don't need them. Wear TWO. Now don't wear any, if you've been vaxxed. Well, the message keeps changing because the evidence and the best hypotheses based on that evidence keep changing, too.

So the CDC's current guidance is that, based on what they know now, vaxxed people are largely safe. I hope that they're correct in that! I have some faith that, right now, they are correct in that. If I refused to even consider that they may be, hiding under my bed and spraying Lysol at anyone who approaches, I would be Chicken Little-ing in a big way. But to drop my guard entirely, to cast my masks aside and start hugging strangers at the bus stop, would be to assume that the CDC and other disease experts now know everything that they need to know about the present and future of the virus. What the threat level is now, what it'll be next month, the month after that, by Christmas. What potential complications are out there, when they might arrive here, and who might be carrying them. How many people are out there who are and will remain vulnerable -- either because they won't get the shot, or because they can't -- and what can be done on their behalf.

Are we on the right track? Probably. Are we where we need to be yet for our society to let its guard down, even partially?

*stares at mandates and store policies dropping (in my view) prematurely, vaccination rates well below where they could be, explosions of cases in India and elsewhere, and other signifiers*

I don't have THAT much faith. I'm not going to uproot my entire life to ward off even the slightest potential threat, but I am going to take what I view as sensible, simple precautions. And putting a mask on my face even after I get my second shot next week... that's not uprooting my life in any way. That's clearing a bar this high, I say, pointing to a bar an inch off the ground. And I don't find that expectation unreasonable at all.
posted by delfin at 7:24 AM on May 19, 2021 [6 favorites]


We know that an unvaccinated person with symptoms can spread the virus for 5 to 10 days, we also know the vaccine will usually kill off the virus in 1 to 2 days. That means the worst case would be an 80% reduction in transmissibility. However that still isn't zero and with vaccinated people rarely showing any symptoms, there is little chance they will isolate themselves the way that an obviously ill person would.
posted by Lanark at 7:26 AM on May 19, 2021


This piece has a good overview of some of the studies:

Mounting evidence suggests COVID vaccines do reduce transmission:
Evidence is increasing that, not only do COVID-19 vaccines either stop you getting sick or substantially reduce the severity of your symptoms, they’re also likely to substantially reduce the chance of transmitting the virus to others.
Also
COVID-19 transmission very unlikely in vaccinated people
:
At the beginning of vaccination drives around the world, the question of whether fully vaccinated people could transmit the disease has always been asked. But with the series of studies and real-world data, this is finally answered.
posted by chrchr at 7:27 AM on May 19, 2021 [4 favorites]


Chud isn't an acronym.

(my head-canon is that it's a portmanteau of "churl" and "dud," with a whiff of "schmuck." Runner up is a contraction of 'chucklefuck' and 'dipshit.')
posted by snuffleupagus at 8:27 AM on May 19, 2021


Chud isn't an acronym.

CHUD is absolutely an acronym, from the movie CHUD.

It starts off standing for Cannibalistic Humanoid Underground Dwellers, but later in the movie it turns out to REALLY stand for Contamination Hazard Urban Disposal.
posted by GCU Sweet and Full of Grace at 8:52 AM on May 19, 2021 [14 favorites]


Wait...what?!?

I'm floored, off to read.
posted by snuffleupagus at 8:54 AM on May 19, 2021 [1 favorite]


It's on prime video if you gots that and are in 'Merka. Solid mid-80s horror.
posted by GCU Sweet and Full of Grace at 8:57 AM on May 19, 2021 [2 favorites]




The other thing about the CDC’s early guidance for the vaccinated is that they weren’t sure how prevalent asymptomatic infection would be. When the vaccines were first rolled out, it was well understood that they were effective at preventing death and serious illness, but there was a question about whether or not they truly prevented infection or just reduced the symptoms.

Now, millions of vaccine doses have been administered and now we know that the vaccines are as effective against asymptomatic infections as we could have hoped. Asymptomatic infections among vaccinated people are extremely rare. In real world studies, you see numbers like 0.04 per 1000 people. That’s a big part of why the CDC changed their guidance on masks for the vaccinated.
posted by chrchr at 9:23 AM on May 19, 2021 [3 favorites]


But from an epidemeological perspective (which considers social aspects as well).... we're not spherical cows.
[ . . . ]
You can't say that there's "no" scientific basis in continuing to wear a mask when you're vaxxed if it's a strong social signal that masking is still a thing that wise and thoughtful people do to protect their neighbours. That is science.


It's a scientific claim, in that it's a hypothesis you can study. But the conclusion isn't something we have data about.

The CDC is clearly hoping the equally scientific argument that these guidelines send a strong signal that vaccines are safe and advantage and it is in your individual interest to get one. They may also worry that requiring masks when there is no longer a direct benefit will erode trust in their other statements.

A lot of the social arguments here are based on how people should respond to masks requests, but the point that we're not spherical cows applies to our behavior, too.
posted by mark k at 9:39 AM on May 19, 2021 [2 favorites]


The CDC has great data on vaccinated people who tested positive.

In the wild, out of over 95 million fully vaccinated people, 9,245 have had positive COVID-19 tests. That’s like 1 in 95,000. No doubt that’s a gross under report because most asymptomatic people aren’t getting tested, but it gives me the sense that there aren’t hordes of asymptomatic COVID-19 zombies roaming the earth. Add to that the emerging data about transmission and its clear why the CDC concluded that vaccinated people don’t need to wear masks.

Also also, you might conclude from my contributions to this thread that I’m an anti-mask zealot. However, I am wearing a mask as I type this. I’m on public transit. I’m going to continue to wear a mask on public transit and anywhere else I’m required to, and so far, that’s everywhere. My locality is requiring that businesses actually check vaccination status and there’s no feasible way to do that and so far every business near me still requires masks for all patrons.
posted by chrchr at 9:41 AM on May 19, 2021 [7 favorites]


The tally of breakthroughs is also certainly an undercount because many asymptomatic cases go undetected — unless, of course, they occur in a setting with widespread and frequent testing, like on a professional sports team. [Or a weekly teevee show.]

Two extra points: Starting Friday, the CDC will only report breakthrough infections that lead to hospitalization or death because those have the “greatest clinical and public health importance.” The Yankees cases, of course, didn’t rise to that level. And [Gleyber] Torres, the shortstop, had Covid-19 last year, indicating that his case is both a breakthrough infection and a reinfection. [...] But considering Torres was asymptomatic, his case fit with what experts expect from most reinfections. - 5 pressing questions about the New York Yankees’ breakthrough Covid-19 infections, STAT News, May 14, 2021.; 9th vaccinated New York Yankees member tested positive for Covid-19 but feels good, manager says (CNN, May 16)
posted by Iris Gambol at 11:20 AM on May 19, 2021


Also also, you might conclude from my contributions to this thread that I’m an anti-mask zealot. However, I am wearing a mask as I type this. I’m on public transit. I’m going to continue to wear a mask on public transit and anywhere else I’m required to, and so far, that’s everywhere. My locality is requiring that businesses actually check vaccination status and there’s no feasible way to do that and so far every business near me still requires masks for all patrons.

All of which is good (and a bit relieving) to hear.

Point being, of course, that several things can be true at the same time:

1) Vaccinated people are, indeed, dramatically lower in risk for both COVID infection and passing on COVID to others.
2) Unvaccinated people remain at elevated risk.
3) America will continue to have a significant percentage of unvaccinated people indefinitely. Not everyone can be vaccinated safely, or would choose to even if they can.
4) A substantial percentage of those unvaccinated people will never wear a mask in public unless they are absolutely required to do so. They could sneeze and the words COVID POSITIVE could shoot out of their noses in big red capital letters, and they would still maintain their stance against GOVERNMENT OVERREACH and TYRANNY.
5) Therefore, ANYTHING that undercuts the idea that businesses, production lines, public transportation, restaurants, and anywhere else that an unvaccinated person is likely to turn up should uniformly require masks, distancing and similar preventative requirements regardless of vaccination status is putting more unvaxxed, potentially infected people in a position to more easily infect and be infected.

Which, to me, makes point #1 true but ALSO contributing to winning a battle but losing the war against COVID.

The CDC absolutely can, but forgot to consider whether they should, to borrow from everyone's favorite chaos theory hunk.
posted by delfin at 11:27 AM on May 19, 2021 [6 favorites]


One thing I find extremely disturbing in the public conversation about all this is that most people are acting as if a huge chunk of the vaccines were not J&J.

I’m actually not finding it that easy to pull up numbers on the percentage of J&J. Does anybody know?

Regardless, though, I want to point out that if you are thinking about a potential gap in effectiveness between vaccines, you should also be thinking about the potential gap in effectiveness between masks. If the government had ever truly been committed to masks as a primary measure to control the pandemic, they would have figured out how to get a pack of something like a KN95 in the hands of every citizen. Which is something I am outraged that they did not, by the way. But I think some folks in this thread are operating with slightly wonky priors about... which transmission control methods one ought to worry about being full of holes in a lot of real-world scenarios?
posted by atoxyl at 10:52 PM on May 19, 2021 [4 favorites]


If the government had ever truly been committed to masks as a primary measure to control the pandemic, they would have figured out how to get a pack of something like a KN95 in the hands of every citizen.

(I suppose this is a bit hand-in-hand with underplaying aerosols.)
posted by atoxyl at 10:55 PM on May 19, 2021


https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html

The New York Times has a visualization on their vaccine page--should be free to view as part of their Covid coverage.

You have to eyeball it, and remember to double the J&J (since it's only one dose) but it's maybe 10%. J&J really was delinquent in getting manufacturing going, then had the batch failures at their factory, then the clotting pause.
posted by mark k at 11:22 PM on May 19, 2021


Sorry, my post immediately above was an answer to atoxyl's question "I’m actually not finding it that easy to pull up numbers on the percentage of J&J. Does anybody know?"
posted by mark k at 12:00 AM on May 20, 2021


If the government had ever truly been committed to masks as a primary measure to control the pandemic, they would have figured out how to get a pack of something like a KN95 in the hands of every citizen.

There was actually a plan to do that. It was near implementation and then abruptly halted. I've never been able to get a good handle on why.
posted by Justinian at 3:51 AM on May 20, 2021 [1 favorite]


Are you talking about the post office's proposal to deliver masks to everyone, Justinian? It was stopped because Trump and many in the Trump administration were opposed to anything that made the pandemic seem like a major problem. If you are continually promising the pandemic will be over by Easter (2020) then purchasing everyone a month's supply of masks for delivery in May starts people asking questions.

We wouldn't even be having this discussion, at least not in this way, except for the denialism that came from the top.
posted by mark k at 6:22 AM on May 20, 2021 [14 favorites]


One indicator of the CDC's recent communication failures is the spate of first-person articles on their COVID safety beliefs from total health-and-science amateurs, like a Slate.com film critic and a San Francisco Chronicle food critic.
posted by PhineasGage at 9:19 AM on May 20, 2021


I don't get your point PhineasGage? Amateurs have been writing pieces about their reactions to Covid this since the beginning of the pandemic.

As far as the substance neither seem super objectionable to me. I don't there are 1000 words on Covid that don't include something I found very wrong--and that includes the stuff I write. But both seemed fairly straightforward.
posted by mark k at 1:13 PM on May 20, 2021 [1 favorite]


I meant the expressions of individual, amateur judgments - 'I am gonna do this because I think this is safe' - which i don't think would be written in the same way if there were clearer guidance at this stage from CDC.
posted by PhineasGage at 2:35 PM on May 20, 2021


OK thanks. FWIW when I read those and view that genre's continuation as preordained. "Individual amateur judgments you will always have with you" type of thing.
posted by mark k at 7:41 PM on May 20, 2021 [2 favorites]


Watching today's Covid press conference--J&J comes up at the 45 minute mark. 3 of 1,779 vaccinated with J&J tested positive. Effectiveness rate 76.7.
posted by jenfullmoon at 12:12 PM on May 21, 2021 [1 favorite]


I've been watching the USA's SARS-CoV-2 numbers daily and feeling relieved that the numbers are still going down, but it finally hit me today that we won't know the impact of this for several weeks due to 1) the lag between exposure and diagnosis and 2) the lag between this announcement and people increasingly not wearing masks. Maybe everybody else already realized that but it just hit me today.
posted by Tehhund at 12:52 PM on May 21, 2021 [2 favorites]


That's also why that Starting Friday, the CDC will only report breakthrough infections that lead to hospitalization or death because those have the “greatest clinical and public health importance” snippet I posted earlier is kinda concerning. It's Friday, and under-reporting cases of infection has been a problem throughout this crisis.
posted by Iris Gambol at 2:44 PM on May 21, 2021 [1 favorite]


For whatever anecdotes are worth, I had my second vaccine dose today in a purplish part of Northern Virginia and there was nobody else there. Four weeks ago it was absolutely hopping and everyone that arrived after me said they were getting their first dose (Moderna only at this location). At least four people that I was able to overhear scheduled their second appointment for today, but when I went in for my shot today the office was completely empty. The pharmacy tech who gave me the shot said their appointment book is full but people are no-showing and they're throwing out all the thawed doses that are not getting into arms.

I know vaccine hesitancy and second dose compliance are complicated, but I can't help but to think that this no-mask guidance and the media covering it as a mission accomplished moment aren't doing good things for our vaccination numbers.
posted by peeedro at 3:42 PM on May 21, 2021 [3 favorites]


Pure anecdata, but I wound up needing to reschedule my second dose by a few days and I suspect (from the way the website worked) that LA County just rescheduled me elsewhere without doing anything to alert the original site I wouldn't be back as scheduled.

I guess they could be working with larger, rounder numbers at mass vaccination sites in terms of how much they thaw and when, and it wouldn't be efficient to worry about every last dose, but it felt weird.
posted by snuffleupagus at 4:53 PM on May 21, 2021


That's also why that Starting Friday, the CDC will only report breakthrough infections that lead to hospitalization or death because those have the “greatest clinical and public health importance” snippet I posted earlier is kinda concerning. It's Friday, and under-reporting cases of infection has been a problem throughout this crisis.

The logic behind this is that in a vaccinated person, it's probable that a huge percentage of infections are the vaccine working as intended: you get exposed to the virus, get a few a cycles of replication as your primed immune system kicks into gear, then your body shuts it down long before you become infectious to others. With non-quantitative PCR, which can detect virus levels millions of times lower than would trigger individual or public health concerns, these get logged as "infections" despite that.

This is very relevant true if you're doing a frequent testing regiment, like the Yankees were. Here's a NY Mag interview where Michael Mena makes the point pretty well in the first half. I don't think the interviewer gets it, so there's some muddled presentation later. But when it comes to the Yankees note the difference between the Stat article you linked, which views this as a mystery, and Mena's point, which is this is the vaccine working in response to one breakthrough infection to stop transmission.

Obviously the correct number to report for vaccinated people would be infections that reach the transmissible state. This is far lower than all infections, but has to be more than just hospitalized/dead. So there's room to worry about the CDC decision. But it is not comparable to underdiagnosis among unvaccinated people; there is some logic to it.
posted by mark k at 7:41 PM on May 23, 2021 [5 favorites]


NY Mag: So there’s little downside to getting infected after you’ve been vaccinated?

Mina: Well, I wouldn’t say that. First and foremost, if you can transmit despite not getting sick, then such exposures pose a public health risk to those who are not yet protected, even if they are serving to boost your own immunity.

If you've been reading this thread, some of us will never be "protected." A frequent bit of advice now is to check on the virus activity in your community to judge your risk for #plannedactivity. If the CDC isn't reporting rates of infection in the vaccinated, only rates of hospitalization and death, then true circulation rates aren't public info. Moreover, "The Rockefeller University now suggest that these so-called breakthrough cases may be driven by rapid evolution of the virus, and that ongoing testing of immunized individuals will be important to help mitigate future outbreaks. [...] The observations suggest what is likely a small but ongoing risk among vaccinated individuals, and the possibility that they may continue to spread the virus."

Mina, in the article: I published on the need to interpret the PCR Ct values in a paper at the very beginning of this pandemic and suggested that many if not most PCR positive people no longer need to be in isolation—we missed the boat on those people. Most people only made it in to get the PCR test or only eventually got the results after their period of transmission was good and done. In fact, when PCR tests were taking 10 days to return [...] we were just too slow and inefficient with our testing to make most if it worthwhile.

There was also a shortage of tests in general, and we weren't testing enough. (Meanwhile, Trump associates made bank.) The US deaths due to COVID-19 are much higher than officially reported, while the global death toll is double official estimates. The United States squandered both money and lives in its response to the coronavirus pandemic, and it could have avoided nearly 400,000 deaths [out of "540,000 and rising" as of March 25 2021 pub date] with a more effective health strategy.

So there's room to worry about the CDC decision. - mark k
Yeah. It's kinda concerning.
posted by Iris Gambol at 8:25 AM on May 24, 2021 [2 favorites]


A frequent bit of advice now is to check on the virus activity in your community to judge your risk for #plannedactivity. If the CDC isn't reporting rates of infection in the vaccinated, only rates of hospitalization and death, then true circulation rates aren't public info

That's a good point point, but is that what the CDC is doing? When I went digging, the closest thing to what you're describing is on this page.

They are saying that, in the context of investigating commonalities among breakthroughs they are going to focus on the clinically significant ones--so the detailed sequence analysis or looking for commonalities among patients will be focusing on ones that manifest clinically.

But the numbers you check to figure out rates for your area (or nationwide) would absolutely include everyone if I'm reading this correctly.

Let me know if missed something.
posted by mark k at 8:38 PM on May 24, 2021 [1 favorite]


Good news for familes with children, via NPR:
"Children's Risk Of Serious Illness From COVID-19 Is As Low As It Is For The Flu."
"If you stop going into stores because you're terrified you'll run into an unmasked person, that's probably overreacting," says Gretchen Chapman, a psychology professor who studies health conundrums like this at Carnegie Mellon University.
posted by PhineasGage at 11:46 AM on May 25, 2021 [2 favorites]


mark k, I really appreciate your posts, and the person missing something may be me; I'm looking at the CDC's "As you look ahead to summer, consider how COVID-19 is spreading in your community when choosing activities"; in that sentence: "community" goes to the CDC COVID Data Tracker's COVID-19 Integrated County page for local rates (updates daily by 8 pm ET), and "activities" goes to the CDC Covid 19: Daily Activities and Going Out advice page (updated Apr. 27, 2021; some links within the page are from last summer). The CDC COVID Data Tracker Variant Proportions is a redesigned page showing the two weeks ending May 8, 2021 when “Nowcast On” is selected (producing weighted estimates that predict proportions for more recent time intervals); it's current through the two weeks ending April 24 when Nowcast is switched off.

Last week, Dr. Fauci (halo askew, I know) said that the public was misinterpreting the CDC's latest mask guidance. I feel like we're still being careless, and that we're not allowing the (exhausted) people working on vaccine boosters enough time to develop them properly. We've bungled so many things thus far domestically and for the rest of the world, what with Americans still traveling for work and for pleasure deep into the pandemic, and artificially low numbers and lack of safety protocols gifting visitors here for work or vacations souvenir infections, and planes and airports being incubators for everyone regardless. There are a lot of advances and positive news since the vaccine rollout, I know; I'm just so tired and lack faith. I'm exiting this thread, but offer a sincere thanks to all of you.
posted by Iris Gambol at 1:16 PM on May 25, 2021 [2 favorites]


How can I find the percentage of people between 18 and 65 (i.e., the people I encounter in my workplace) who are vaccinated? The data I see always gives numbers for 18+ and 65+, where 65+ is like 70% vaccinated and 18+ is only 46% vaccinated. Obviously the 65+ is pulling up the 18+, but they are mostly retired so the numbers don’t tell me anything about safety in my Wild West of a workplace (no masks or vaccines required, no asking if people are vaccinated, and bonus! no ventilation).
posted by HotToddy at 4:58 PM on May 25, 2021


How can I find the percentage of people between 18 and 65 (i.e., the people I encounter in my workplace) who are vaccinated?

The CDC provides data by age group, and other websites display that data in easier to view ways -- here is one example (scroll down to "What percentage of people in each age range received the COVID-19 vaccine?").
posted by Dip Flash at 5:29 PM on May 25, 2021 [1 favorite]


My workplace just released new guidance. Mask mandate is now limited to the vaccinated, but we are neither allowed to ask anyone’s vaccine status nor comment on anyone’s mask usage. I’m glad that rates are good where I am, but it’s really hard to imagine feeling comfortable going into the office again. I’m fully remote for now. I guess we’ll see.
posted by eirias at 6:30 PM on May 27, 2021 [1 favorite]


Covid Hope Over Fear: We look at the effects of the C.D.C.’s new mask guidance on Covid cases and vaccinations.
First, new Covid cases have continued to decline at virtually the same rate as during the month before the C.D.C. announcement ...

the vaccination trends also changed after Walensky’s announcement. For the previous month, the number of daily shots in the U.S. had been falling, as the country began to run out of adults who were eager to be vaccinated. With a few days of the mask announcement, the decline leveled off. ...

When you give the public some positive reinforcement, it really can bear fruit.
(The tone of this piece seems a little more final than appropriate given the short time period and limited data. Still, it's good that all the trends are positive after the mask policy change.)
posted by Nelson at 7:14 AM on June 2, 2021 [7 favorites]


That inference about vaccination rates is specious — this guidance happened the day after ACIP recommended the vaccine for 12-15. Looking at CDC vaccination trends by age, it looks clear to me that any increase in vaccinations was due entirely to the sudden jump in the 12-15 line from a steady zero to a decent clip. That had nothing to do with the mask guidance — there was pent up demand from a certain slice of parents. We’ll probably see another bump if/when we get approval extended to 2+.

I’m not blaming Nelson, a bunch of people have been promoting this, but I think it’s rubbish. It’s good that COVID rates are continuing to decline, though.
posted by eirias at 8:20 AM on June 2, 2021


I haven't read the full piece closely, but for what it's worth, the vaccination trend they're looking at is "among Americans 16 and up," specifically to avoid that issue.
posted by eponym at 8:52 AM on June 2, 2021 [4 favorites]


That inference about vaccination rates is specious — this guidance happened the day after ACIP recommended the vaccine for 12-15.

Yeah, but the decline in the 16-and-up group leveled off.
posted by mr_roboto at 9:06 AM on June 2, 2021 [2 favorites]


Thanks, I hadn’t noticed that this claim was more limited than the ones I’d seen elsewhere. I’m wondering why that apparent trajectory shift is not really in evidence at all in the vaccination data broken apart by age band (link). Maybe it’s down to deceleration in a cumulative plot being less visually apparent than a flat line in a daily plot... but then, looking again at the age stratified lines, I don’t actually think I’d put change points for each age group’s trajectory in the same place, and for the older groups I think I’d put it prior to mid May. My hunch is that a stratified analysis will be less misleading than the overall one that Leonhardt provides because of the relationship between age and eligibility even within the 16+ group.

I do still think that counting the uptick in vaccines.gov hits as a win, as the Leonhardt article also does (and he isn’t the first to crow about this), is silly. As I understand it, parents of young teens were directed to that site to find a local provider that carried Pfizer. And why use a surrogate? — we don’t care about web traffic, we care about shots in arms. It gives me the uncomfortable feeling of someone crowing about a secondary outcome in a trial... you don’t do that if you hit your primary endpoint.
posted by eirias at 10:42 AM on June 2, 2021


Cases in my location are down 53% since this thread was posted. The last time we had this few new cases was last April.

Obviously our relentless negativity has the virus on the run.
posted by Huffy Puffy at 11:08 AM on June 2, 2021 [6 favorites]


140 new cases in NYC yesterday, lower than any day last summer. We're getting there. The vaccines are working.
posted by SansPoint at 7:23 AM on June 3, 2021 [4 favorites]


Thanks for posting the NYT link.

You could probably find some people here who were pessimistic enough that this is material. But three weeks is about the absolute minimum to have seen any signal at all in the worst case scenario. I'm an optimist on vaccine impacts, but I'd view this update as "no sign that the CDC was wrong" rather than evidence it was right.

The case count in July will be interesting. If it's still low and we haven't had a small increase (or worse) the argument that the CDC was just a few weeks too early will look like it doesn't hold up. If that's good I'll postpone worrying until we get to the winter. If we avoid a winter surge (perhaps fueled by variants) then I think we'll have done it.

Still need to keep manufacturing and distributing vaccine globally *for free*, do global sequence monitoring, a flu-like booster program, etc., and for gods' sakes prepare for the next pandemic seriously, but we may truly be on the path to ending this one.

It gives me the uncomfortable feeling of someone crowing about a secondary outcome in a trial... you don’t do that if you hit your primary endpoint.

We're hitting the primary endpoint (cases are continuing to go down) and the secondary endpoint (vaccination rates have stabilized.) The better analogy is the "trial" isn't over yet so they are also looking at all the other indicators they can find and making sure they are all pointing in the same direction.
posted by mark k at 12:12 PM on June 3, 2021 [1 favorite]


We're hitting the primary endpoint (cases are continuing to go down) and the secondary endpoint (vaccination rates have stabilized.) The better analogy is the "trial" isn't over yet so they are also looking at all the other indicators they can find and making sure they are all pointing in the same direction.

Huh. Maybe that’s a better way to look at it. I’ve been treating vaccinations as the goal here because a drop in cases can otherwise be fleeting, as we’ve all seen numerous times. It’s true though that if we could manage to lick this without vaccinations, we wouldn’t actually care about those. So my analogy doesn’t work well in that sense. Vaccination is more like a measure of treatment compliance or some such. And COVID case rates have continued to drop like a rock where I am.

With vaccinations themselves, is it good enough to maintain a steady but slow pace of uptake? I was assuming they needed to reverse, not just maintain. I imagine the answer to that is regionally dependent. I don’t think we’ll see another huge spike where I am because the current fraction of people vaccinated is quite high. I guess we might if some variant emerges that makes the vaccines useless but I don't think we’ve seen one yet (I guess maybe the jury is still out on this latest threat). Elsewhere in my state I think it’s a very different story and I imagine that speeding the uptake in such places could be more critical. It could be really interesting to see the vaccine rate time series disaggregated geographically.
posted by eirias at 5:33 PM on June 3, 2021


Here’s another point for the importance of disaggregation: rising hospitalizations in areas with low vaccination rates.

Assuming this trend is real, I don’t know that it makes sense to tie it to the CDC’s change. That happened roughly four weeks ago and this seems a bit too fast to be a result, unless the variants involved have different latency from infection to hospitalization or something. I do wonder if the CDC’s change in part reflected a degree of pandemic fatigue that already existed in the country and was already putting people in low-uptake regions at risk. I don’t know. See, this is what I meant by the agony of observational data…
posted by eirias at 7:34 AM on June 9, 2021 [1 favorite]


Anecdotally, I know an infectious disease doctor at a major hospital and he says the last time he was in the COVID ward there were only about 10 - 15 people in it, and that the demographic has shifted from largely poor minorities to rural whites.
posted by Comrade_robot at 7:39 AM on June 9, 2021 [2 favorites]


The last thing this thread needs is another post, but Ed Yong of the Atlantic just wrote an excellent article about the CDC's decision, the current state of affairs in the U.S., and why the decision was not a good one from a public health perspective:

The Fundamental Question of the Pandemic Is Shifting: We understand how this will end. But who bears the risk that remains?

It sums up for me why I felt pretty uncomfortable with the CDC's move at that time, even though I personally--and all my close family--is now vaccinated.

Both areas where my close family lives had ~30% fully vaccinated and ~40% with at least one dose--a good 10% lower than the U.S. as a whole. That is nowhere near enough for herd immunity.

And the instant the CDC made their announcement, the state & local jurisdictions here dropped their mask requirements and indeed, all other covid-related requirements.

Covid cases, hospitalizations, and deaths have gone way down since January, which is good. But all of those factors have clearly plateaued here since that time. And--they've plateaued at a higher level than we had here a year ago.

Well--plateaued. In the past week or two we've actually had a noticeable uptick in cases. Which is exactly what you would expect with 75% of the population unvaccinated and all pandemic safeguards removed.

We had a chance to actually stomp out the virus here this spring and summer.

And--as usual--we've blown it.
posted by flug at 4:26 PM on June 10, 2021 [3 favorites]


It's strange that Vitamin D supplementation has been neglected in official guidelines. This latest study below should spur the drive towards supplementation.

Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness


"those with severe or critical COVID-19 disease were more likely to have pre-infection vitamin D deficiency of less than 20 ng/mL (OR=14.30, 95%, 4.01-50.9; p < .001)"

and

"While the mortality of patients who had VitD levels ≥20 ng/mL was at 5% or lower, the mortality of VitD deficient patients <20 ng/mL was much higher, at 25.6%."
posted by daksya at 10:08 PM on June 10, 2021 [1 favorite]


daksya
"This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice."

Until it's peer reviewed, this is no more trustworthy than a YouTube video advocating for vitamin D.
posted by hydropsyche at 4:59 AM on June 11, 2021 [2 favorites]




That article is absurd. Peer review has plenty of problems but that doesn't make it meaningless, only as imperfect as any other process with humans involved. I have personally caught errors in papers while reviewing them, and have had errors in my own papers pointed out by reviewers - sure, errors can always be missed but the entire point is to have an impartial person checking for mistakes or areas where improvement is needed. It's not a perfect filter by any means, but it is an important one. I notice the author doesn't suggest an alternative means of evaluating quality and filtering out nonsense from good science.
posted by randomnity at 5:41 AM on June 11, 2021 [6 favorites]


308 new cases here in the past week (pop. ~940K), down 65% from the start of the thread and down 25% from my comment last Wednesday.

31% fully vaccinated, 39% partial, 11% have tested positive to date. Ended most mask requirements May 15, 4 weeks ago.
posted by Huffy Puffy at 6:18 AM on June 11, 2021


He not's suggesting doing away with peer review but that its presence is treated as some sort of holy gateway.

This is the key point:
This then is why I was so bothered about how Covid-19 research is reported: peer review is no guard, is no gold standard, has little role beyond gate-keeping. It is noisy, biased, fickle. So pointing out that some piece of research has not been peer reviewed is meaningless: peer review has played no role in deciding what research was meaningful in the deep history of science; and played little role in deciding what research was meaningful in the ongoing story of Covid-19.
posted by daksya at 6:18 AM on June 11, 2021 [1 favorite]


Yes, the key point was actually quite clear, and I disagree with it.
posted by randomnity at 6:30 AM on June 11, 2021 [5 favorites]


Does anyone know why the paper is mostly by otolaryngologists? It seems like a weird field for what the paper is about, but I'm by no means an expert on, well, anything.

Also, daksya, the part you quoted basically does say that peer review should be done away with? At the very least, I can't figure out any other implication there. Hell, even the author is retweeting replies saying that he overstated his case.
posted by sagc at 8:22 AM on June 11, 2021 [1 favorite]


That is a really weird paper, daksya. For anyone else following along at home, the authors looked at disease severity among hospitalized patients, and compared it to historical vitamin D levels that were drawn anywhere from 2 weeks to 2 years (TWO YEARS) before hospitalization. They don't present how many were measured at what time interval -- are we talking 252 people at 2 weeks and 1 at two years, or the other way around? They also did not collect any information about whether any of the vitD deficient folks had received supplementation before contracting covid, and they certainly didn't look at supplementation during the acute phase of the illness.

They did control for important comorbidities, so that's good, I guess. On the downside, they don't seem to have applied a correction for multiple comparisons. You can maaaaybe get away with that on a descriptive/exploratory analysis, but for a hypothesis-driven paper, that's a major red flag.

A better study would have looked at whether vitD level at the time of hospitalization (not some unspecified prior interval) was in any way predictive of covid outcomes, and an even better study would have looked at randomizing hospitalized patients to vitD supplementation vs placebo. That study's not been done, to my knowledge, and in fact a BMJ Open meta-analysis of vit D and covid found that not only was there no evidence of association, there were only four studies worth analyzing of a potential 449, and even those four are rated at high/unclear risk of bias.
posted by basalganglia at 9:04 AM on June 11, 2021 [7 favorites]


It is not strange at all that official guidelines have not included Vitamin D supplementation. So far the evidence is mixed, at best.
posted by PhineasGage at 11:59 AM on June 11, 2021 [1 favorite]


basalganglia: A better study would have looked at whether vitD level at the time of hospitalization (not some unspecified prior interval) was in any way predictive of covid outcomes, and an even better study would have looked at randomizing hospitalized patients to vitD supplementation vs placebo.

This wasn't meant to be an experimental study. The intro says,
However, serum VitD levels are often measured during hospitalization for COVID-19. When this is the case, determining the direction and temporality of the association between acute COVID-19 disease and low VitD serum levels is a challenge. In other words, it is difficult to ascertain a definitive causative effect of baseline VitD level on a clinical presentation during active COVID-19 infection
The reason why this is so is obvious. Patients won't be hospitalized immediately after infection but only some time after symptom onset, at which point one can't be sure if the disease-induced inflammation didn't reduce vit D levels down.

So this was a retrospective look to try to tease out directionality in the already established link between low vit D and COVID outcomes. See https://www.nature.com/articles/s41598-020-77093-z ("The fatality rate was high in vitamin D deficient (21% vs 3.1%).")

The lack of statistical data on age of measurement is a shortcoming but the relationship between the median measured level and grade of disease is monotonic i.e mild patients had 34 ng/ml, moderate 19, severe 11, and critical 10 ng/ml, which to me suggests the relationship is causal and not spurious.


PhineasGage: That article mainly relies on the Mendelian randomization study in the no-effect group. That study did not actually measure any actual vit D levels (current or historic) but relied on genetic markers as a proxy. As the paper says,
But further investigation was needed because observational studies couldn’t establish a causal link between blood vitamin D levels and COVID-19. The challenge in establishing a causal link arises because blood vitamin D levels are influenced by multiple factors including genetics, exposure to sunlight, diet and supplements, and are associated with other risk factors for COVID-19, the researchers said.

We were trying to get at the part of the variation in vitamin D that’s genetic and leave aside the rest to see whether or not there’s an association with the risk of getting COVID-19,” Cassano said. “And when we do it that way, we find no association, and that’s telling.”
However note that "estimate of heritability of 25-hydroxyvitamin D serum concentrations attributable to GWAS common SNPs is 7.5%". An estimate close to 0% indicates most of the variance is due to non-genetic factors.

Towards the end, it says,
This study was not designed to evaluate the effect of acute changes in vitamin D status (ie, from supplementation) on prevention or treatment of COVID-19. One randomised trial and one quasi-experimental trial have provided evidence for a positive effect of vitamin D supplementation around time of diagnosis on COVID-19 prognosis in infected individuals. The doses of vitamin D administered in these studies could result in an acute change in the availability of vitamin D, which may support the immune system’s response to the virus, mitigate acute lung injury and contribute to improved prognosis. Our results, which pertain to long-term vitamin D status, do not preclude the possibility that therapeutic doses of vitamin D may be effective in preventing or treating COVID-19 infection. Larger randomised trials using diverse sample populations are needed to investigate the potential use of therapeutic doses of vitamin D supplementation for COVID-19 prevention and treatment.
posted by daksya at 12:27 PM on June 11, 2021


Daskya in critiquing these other references, you're trying to prove a negative. So far there is not a lot of peer reviewed or otherwise widely accepted evidence that Vitamin D makes a difference in treating COVID-19. It may turn out to be the right approach, but the evidence is thin and preliminary so far. Your comment "It's strange that Vitamin D supplementation has been neglected in official guidelines. This latest study below should spur the drive towards supplementation." (emphasis mine) seems overstated, that's all.
posted by PhineasGage at 12:52 PM on June 11, 2021 [5 favorites]


> It may turn out to be the right approach, but the evidence is thin and preliminary so far.

I disagree, there have been multiple prospective studies documenting "serum concentrations of 25 hydroxyvitamin D are inversely correlated with the incidence or severity of COVID-19".

Just a final set of parting words: The activity of Vitamin D "generally meets Hill's causality criteria in a biological system". A 2017 meta-analysis of 25 supplementation RCTs "to prevent acute respiratory tract infections" established "Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit". The preponderance of evidence indicates there's a causal effect.
posted by daksya at 1:43 PM on June 11, 2021


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