CDC Reverses Indoor Mask Policy - Are We Getting the Whole Truth?

Depending upon your politics, the Center for Disease Control and Prevention (CDC) has either shamelessly reversed course or simply issued a new guideline in response to new medical evidence. Indeed, many are hostile to the agency’s recent 'new & improved' recommendation that those who have been vaccinated against COVID-19 mask up when indoors in regions where the Delta variant is highly prevalent. The dissenters point out that this directly contradicts very recent CDC and public health expert advice that clearly stated that those vaccinated could be safely liberated from their face masks.  In fact, this demasking was offered as a direct incentive to those who remained hesitant to roll up their sleeves.  The CDC and its supporters maintain that their new policy on masking the vaccinated is based on a sound review of recent data, which they tarried in releasing. 

I am a rationalist who practices gastroenterology guided by medical evidence.  Despite some missteps, I have largely supported the CDC and have heeded and disseminated their advice.  But, in this instance, I don’t think they are being straight with us.

Making a comeback!

Here are some facts. The vaccines are performing very well including protecting against the Delta variant.  The overwhelming majority of COVID-19 cases, hospitalizations and deaths are occurring in those who have not been vaccinated.  It is within this population – not among the vaccinated – where the pandemic now lives.

We also know that ‘breakthrough infections’ in vaccinated individual is extremely rare, a fact that the CDC admits.  For example, breakthrough rate is estimated to be 0.098% for symptomatic infections, in other words, very close to zero.  The CDC now argues for vaccinated folks to mask up to prevent them from transmitting the virus if they become infected, although this seems like overkill considering that the breakthrough rate is about zero.  What is the quality of evidence that suggests that the few infected vaccinated individuals can transmit the infection?  What does make sense, of course, is for unvaccinated folks to don a mask since this is how the disease is being perpetuated. 

Since there is no way to enforce the more rational strategy that unvaccinated people wear a mask indoors, the CDC is asking all of us to do so in order to capture the unvaccinated within the new policy.  Otherwise, how could a retail store, for example, know that some unmasked customers were vaccinated or not?  They couldn’t.  In my view, the CDC has unnecessarily rolled the vaccinated into the new mask group to eliminate this conundrum.  If all of us are masked, then we know that the unvaccinated are also masked.  If I am correct about the CDC’s motives and strategy, shouldn’t they have told us the truth rather than exaggerate and mislead us about how dangerous vaccinated individuals might be?  It’s the CDC’s explanation that needs to be unmasked.

And masks won’t end the pandemic anyway.  This is a half measure at best.  The right approach is to increase vaccination rates and I anticipate that the government, employers, schools and others will be leaning hard in this direction in the near term.