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Monday, August 22, 2022

NPR vs CDC on the new COVID-19 guidelines

NPR tweeted out a summary of the new CDC (United States) guidelines on COVID-19. The figure was posted under the name of Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials. I've posted a screenshot of the figure on the right.

Before discussing the four bullet points, I want to emphasize that Marcus Plescia issued a press release on August 11, 2022 when the new guidelines came out and it did not mention the points in the NPR figure. In fact, it seems to me that he would not agree with the NPR sumary.

Let's compare the NPR summary with the actual CDC guidelines at: Summary of Guidance for Minimizing the Impact of COVID-19 on Individual Persons, Communities, and Health Care Systems — United States, August 2022.

In each case, I'll quote the NPR statement in boldface and the corresponding CDC quideline below it in italics and you can judge for yourself which one is accurate. Why is this important? It's imprtant because the antivaxxers are seizing on the NPR guidelines to justify their opposition to vaccinations. They claim that the new CDC guidelines are a tacit admission that vaccinations were useless.

Those exposed to the virus are no longer required to quarantine.

Symptomatic or infected persons should isolate promptly, and infected persons should remain in isolation for ≥5 days and wear a well-fitting and high-quality mask or respirator if they must be around others. Infected persons may end isolation after 5 days, only when they are without a fever for ≥24 hours without the use of medication and all other symptoms have improved, and they should continue to wear a mask or respirator around others at home and in public through day 10.

Unvaccinated people now have the same guidance as vaccinated people.

Implementation of multiple prevention strategies helps protect individual persons and communities from SARS-CoV-2 exposure and reduce risk for medically significant illness and death by reducing risk for infection (Table). Implementation of multiple nonpharmaceutical preventive interventions can complement use of vaccines and therapeutics, especially as COVID-19 Community Levels increase and among persons at high risk for severe illness. CDC’s COVID-19 prevention recommendations no longer differentiate based on a person’s vaccination status because breakthrough infections occur, though they are generally mild (16), and persons who have had COVID-19 but are not vaccinated have some degree of protection against severe illness from their previous infection (17). In addition to strategies recommended at all COVID-19 Community Levels, education and messaging to help individual persons understand their risk for medically significant illness complements recommendations for prevention strategies based on risk.

Students can stay in class after being exposed to the virus.

Persons who have had recent confirmed or suspected exposure to an infected person should wear a mask for 10 days around others when indoors in public and should receive testing ≥5 days after exposure (or sooner, if they are symptomatic), irrespective of their vaccination status. In light of high population levels of anti–SARS-CoV-2 seroprevalence, and to limit social and economic impacts, quarantine of exposed persons is no longer recommended, regardless of vaccination status.

It is no longer recommended to screen those without symptoms.

Prevention recommendations based on COVID-19 Community Levels have the explicit goals of reducing medically significant illness and limiting strain on the health care system. At all COVID-19 Community Levels (low, medium, and high), recommendations emphasize staying up to date with vaccination, improving ventilation, testing persons who are symptomatic and those who have been exposed, and isolating infected persons.

The first point on the NPR list is technically correct as long as it refers to people who are exposed but have no symptoms. I think it's pretty stupid of CDC to say that. They should have said to be cautious and get tested if you have been exposed but have no symptoms and wear a mask if you are around peole who are at high risk. I would highly recommend not visiting people in the hospital or your elderly grandparents for several days until you're sure you don't have COVID-19.

The second point is being interpreted to mean that you can no longer ban unvaccinated people from your restaurant or from flying. The anti-vaxers are saying that unvaccinated people can now visit the elderly in a long-term care home.

Good luck with that.

There's nothing in the guideline summary about students but I'm sure there are many school districts who will allow students to stay in class even if several other students come down with COVID-19. If you are a parent of one of those students, I suggest you keep your child home for a few days and test them.

PCR screening of people who don't have symptoms was abandoned a long time ago. It's still a good idea to use rapid antigen tests to screen people if they have been exposed.

I really don't think the CDC is doing a good job of communicating and I don't think their guidelines are the best way to fight the pandemic, especially in an environment where any ambiguity will be exploited by anti-vaxers.


Paul Hutch said...

The CDC's recommendations have been almost totally ignored by businesses, local governments and individuals in the USA for more than a year now. Masks are not even required at most dentist's offices and some other doctors offices.
Outside of my periodontist who has mostly elderly patients and some immune-compromised staff, I have not been asked to wear a mask in any situation for nearly a year.

During this time USA hospitals have not been overwhelmed and the death toll has been in a range that the majority of US citizens finds acceptable. Antivaxxers and most Republicans have been slamming the CDC for it's regulations pointing to these facts as alleged proof that the guidelines are just plain wrong. This is further eroding public trust in the CDC and all other federal level medical and science guidance. My general impression is that at the start of the pandemic the majority of us trusted the CDC, and now it is far less getting dangerously close to a minority position.

My general impression is that they felt that if they did not change their guidelines the erosion of public trust would spread further becoming a majority of US citizens. From people I've spoken with it does appear that loosening the restrictions is lowering the distrust level which is essential for when the next major pandemic wave hits.

A final problem is that some USA courts have been striking down mask and vaccine mandates for violating state constitutions and laws for almost two years.

I'm confident that your recommendations are far superior from a scientific standpoint and I use them myself. However the political climate in the USA has gotten so much worse over the past few decades that straight science has to be heavily modified for sociological reasons. :-(

Jonathan Badger said...

I think the mask situation in the US is very locale based (maybe red vs blue state). Certainly in the Washington DC area where I live my dentists and doctors still require masks and my barber requests (but doesn't insist) that I mask.

Paul Hutch said...

Yes it likely varies regionally, I only travel extensively around southern New England so my experience is restricted to Massachusetts, Rhode Island & Connecticut. Friends in New Hampshire and Maine have told me masks were dropped earlier than in southern New England.