New CDC mask guidance spurs resistance, confusion amid COVID-19 surge

WASHINGTON (SBG) — Federal health officials acknowledge their reversal on masking guidance for those who are vaccinated against COVID-19 is unwelcome, but they maintain new scientific data supports recommending additional precautions, even for those who are ostensibly immunized.

“I know that this is not a message America wants to hear,” Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said on CNN’s “New Day” Wednesday.

The CDC announced Tuesday that vaccinated Americans in areas with “high” or “substantial” virus transmission should wear masks indoors, and all children and adults in K-12 schools cover their faces, regardless of vaccination status. The shift comes as COVID-19 cases rise across the country and the more contagious delta variant becomes the dominant strain, overwhelming hospitals in some areas.

Although all available data indicates the vaccines protect most who experience breakthrough infections against serious symptoms, officials said new research—which has not yet been made public—suggests people who are vaccinated can transmit the delta variant to others. If they interact with children, the immunocompromised, or others who have not been vaccinated, they might infect them.

“The science that prompted this guidance is just days old...,” Walensky said. “We wanted people who are vaccinated to understand they could potentially pass this virus.”

Many politicians and social media users have made clear the new guidance is, in fact, a message they do not want to hear, and it is one they have no intention of following. Several Republican governors whose states have low vaccination rates and high infection rates dismissed the advice as baseless federal overreach.

“The Biden administration’s new COVID-19 guidance telling fully vaccinated Iowans to now wear masks is not only counterproductive to our vaccination efforts but also not grounded in reality or common sense,” said Iowa Gov. Kim Reynolds.

Sen. Rick Scott, R-Fla., told Fox Business the guidance represented an effort to “use fear to control us.” Florida accounted for 20% of new infections in the U.S. in the last week, and cases reported in the state have risen by 400% since the start of this month.

“We've got to step up and say, enough's enough, CDC,” Scott said. “You need to put out information, give us better information. You know, we're smart. We can make good decisions for ourselves. We don't need you to tell us to wear a mask.”

Republicans tried to force the House of Representatives to adjourn Wednesday after a mask mandate was revived at the behest of the House physician. Rep. Chip Roy, R-Texas, raged against the requirement in a floor speech, claiming it would “breed resentment.”

“Consider resentment being magnified right here on the floor of the House of Representatives,” Roy said. “We are absolutely sick and tired of it. So are the American people.”

Democrats have been more receptive to the masking recommendations, and some liberal-leaning communities had already reimposed mask mandates on their own. House Speaker Nancy Pelosi, D-Calif., reportedly called Minority Leader Kevin McCarthy, R-Calif., a “moron” Wednesday after he asserted the mask rules were not based in science.

“We cannot ignore the rapid spread of the COVID-19 delta variant in Missouri — outpacing much of the country,” Democratic Kansas City Mayor Quentin Lucas said as he prepared to announce a new indoor mask mandate. “We will do all we can to ensure our corner of this state is safe.”

Reactions from epidemiologists and public health experts have been more mixed. Some felt lifting the masking guidance in May was premature and reinstating it now is justified, but others have questioned the rationale for the change offered by the CDC.

According to Dr. Timothy Murphy, an infectious disease expert at the University at Buffalo, the guidance appears to be an appropriate response to evidence that vaccinated people might be able to spread the virus. Given the confusion and frustration that greeted the announcement, he suggested the CDC could have communicated it better, but the policy reflects the science.

“It’s the reality of the pandemic,” Murphy said. “The pandemic keeps changing.”

Dr. David Holtgrave, dean of the University at Albany School of Public Health, said the data supporting the new recommendation should be published promptly to address lingering questions about the decision, but masks are a relatively easy and inexpensive way to combat the recent surge of infections. Expanding vaccination would have more impact, but it will also take much longer.

“I think two things can be true at once: the currently available COVID vaccines are highly effective, but in an era of the Delta variant, mask use, even among the fully vaccinated, may help to disrupt the transmission of the virus,” Holtgrave said.

Dr. Anthony Fauci, the federal government’s top infectious disease expert, defended the updated guidance in a CNN interview Tuesday night, insisting it was driven by the virus mutating and becoming more infectious. He also rejected the premise that masking restrictions amount to an unfair punishment for the vaccinated.

“Nobody's going after the vaccinated people,” Fauci said. “What the CDC is saying is that, given the small chance that you could get infected and transmit that infection to someone else, wear a mask prudently.”

The hardening resistance to mitigation measures in areas where vaccination rates are lowest presents a challenge for public health officials. Those who are most at risk of severe infection also appear to be least likely to comply with guidance intended to protect them from it.

“COVID is surging among the unvaccinated,” said Peter Loge, a former Food and Drug Administration communication adviser who heads the Project on Ethics in Political Communication at George Washington University. “People who refuse to get vaccinated will probably also refuse to wear masks. But that doesn't mean the CDC and others shouldn't encourage them to.”

Experts say the polarization surrounding the pandemic is an unfortunate impediment to saving lives, and they have recently applauded some Republicans for vocally endorsing vaccination. The partisan backlash against the prospect of renewed mask mandates is already fierce, though, and some vaccinated progressives have bristled at the suggestion of masking up to protect unvaccinated conservatives.

“I think it is important for everyone to set politics aside and focus on what we can do together as a nation to prevent the spread of COVID-19,” Holtgrave said. “It would be bad for public health to just let COVID be transmitted without doing everything we can to stop it.”

President Joe Biden said Tuesday the return of masking recommendations for the vaccinated is “another step on our journey to defeating this virus.” He emphasized such precautions can help slow the spread of COVID-19 and prevent a return to more restrictive lockdowns until more of the population is vaccinated.

“Today’s announcement also makes clear that the most important protection we have against the delta variant is to get vaccinated,” Biden said. “Although most U.S. adults are vaccinated, too many are not.”

Biden is set to outline new steps to encourage vaccination Thursday, and local mandates and other policies intended to pressure the unvaccinated are becoming more common. Again, though, elected officials who oversee areas where transmission is highest have adamantly opposed requiring inoculation.

“Vaccines are the most effective defense against contracting COVID and becoming seriously ill, and we continue to urge all eligible Texans to get the vaccine,” Texas Gov. Greg Abbott’s office said in a statement. “The COVID vaccine will always remain voluntary and never forced in Texas.”

The new guidance could prove to be temporary if infection rates begin to slow. Some experts believe delta-driven transmission in the United Kingdom has already peaked, and a similar pattern in the U.S. would mean the current surge could ease in the next few weeks.

“If the U.K. is turning the corner, it’s a pretty good indication that maybe we’re further into this than we think and maybe we’re two or three weeks away from starting to see our own plateau here in the United States,” Dr. Scott Gottlieb, who served as commissioner of the Food and Drug Administration from 2017 to 2019, told CNBC Monday.

Some of the data that spurred the CDC announcement has not been released, but what has been reported about breakthrough infections among the vaccinated suggests it is an extremely rare phenomenon. Internal CDC documents obtained by ABC News this week estimated 0.1% of the fully vaccinated had experienced symptomatic COVID-19 infections.

Studies conducted in other countries where the delta variant has been circulating longer than in the U.S. have found vaccines might not be quite as effective in preventing infection with the delta variant. They still appear to prevent hospitalization or death at extremely high rates, though.

“CDC focused a great deal on data that they say shows fully vaccinated persons may still transmit COVID-19,” Holtgrave said. “This takes the view of trying to protect a whole population at the same time, and finding every way possible to disrupt transmission of COVID is important.”

The risk of a breakthrough infection might be low, but with 163 million people fully vaccinated, Murphy stressed even a very small percentage of them getting sick and infecting others would have a substantial negative impact. Until herd immunity is achieved through vaccination, masking could help protect those who cannot get immunized.

“You look at 0.1% of 610,000 deaths, that’s thousands of people,” he said. “Those are preventable deaths.”

The CDC has changed its guidance many times before as its understanding of COVID-19 evolved and the virus mutated. Fauci and other officials had also admitted not being entirely candid with the public about their reasoning, such as when they discouraged masking last spring partly out of concern about shortages.

That track record has left some skeptical of the sudden change of course just days after officials said they had no intention of altering mask guidance. Loge said the CDC could do a better job of explaining itself as it grapples with the shifting science of a novel virus, but that is not necessarily a reason to ignore its current advice.

“People need to behave responsibly, even if they don't like how they're being told what to do or the people telling them to do it...,” he said. “COVID is like weather or a wildfire. It's moving and changing, and we have to move and change with it.”

The new recommendation does not alter the CDC’s core stance that more vaccination is the key to ending the pandemic, and new daily vaccinations hit their highest level in four weeks Wednesday. In the meantime, Loge likened asking the vaccinated to wear masks in high transmission areas to wearing a seat belt in a car: a simple but somewhat uncomfortable safeguard against an unlikely occurrence.

“Everyone who can should get vaccinated. Until they are, people who live around a lot of unvaccinated people should wear a mask when they're indoors,” he said. “Wearing a mask indoors is a drag, but so is getting sick and dying. On balance, it seems like a better idea to wear a mask.”