POST 161. May 15, 2021. CORONAVIRUS. “Even if the spread of Covid-19 decreases enough to allow a return of most activities, there are some aspects of pandemic life that epidemiologists say will persist much longer. In particular, they say that masks are a norm that should continue, even if that view puts them at odds with the new C.D.C. guidance. More than 80 percent of them say people should continue to wear masks when indoors with strangers for at least another year, and outdoors in crowds.”

 “New Jersey’s mask mandate requiring residents to wear face coverings indoors won’t be relaxed yet, Gov. Phil Murphy said Friday….”I would guess in a matter of weeks we’ll get to the point where we can comfortably say inside, no matter what, you’re OK,”

for links to POST 1-161 in chronological order, highlight and click on

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“Eight members of the New York Yankees have tested positive for coronavirus this week despite being inoculated with the Johnson & Johnson vaccine, the baseball team said Thursday.” “The Yankees have called all eight instances “breakthrough positives.”

PREQUEL

POST 160. May 13, 2021.CORONAVIRUS. “The CDC acknowledged Friday that airborne spread of COVID-19 among people more than 6 feet apart “has been repeatedly documented.”” Meanwhile states relax or eliminate indoor dining restrictions. HUH?

http://doctordidyouwashyourhands.com/2021/05/post-160-may-13-2021-coronavirus-the-cdc-acknowledged-friday-that-airborne-spread-of-covid-19-among-people-more-than-6-feet-apart-has-been-repeatedly-documented-meanwhile-sta/

“Americans who are fully vaccinated can go without masks or physical distancing in many cases, even when they are indoors or in large groups, federal officials said Thursday, paving the way for a full reopening of society.

The change represents a huge shift symbolically and practically for pandemic-weary Americans, millions of whom have lived with the restrictions for more than a year. A growing number have complained they cannot do more even after being fully vaccinated and criticized the Centers for Disease Control and Prevention for being overly cautious. More than 154 million Americans have had at least one shot and 117 million are fully vaccinated, about 35 percent of the population.

“We have all longed for this moment when we can get back to some sense of normalcy,” CDC Director Rochelle Walensky said at a briefing. “Based on the continuing downward trajectory of cases, the scientific data on the performance of our vaccines and our understanding of how the virus spreads, that moment has come for those who are fully vaccinated.”

Walensky cited a growing body of real-world evidence demonstrating the efficacy of the coronavirus vaccines and noted the shots offer protection even against more contagious variants circulating in the United States. She also noted the rarity of breakthrough infections in those who are fully vaccinated and the lesser severity of the relatively few infections that have occurred.

She did leave open the possibility that the restrictions could return should the pandemic worsen. “This past year has shown us that this virus can be unpredictable,” she said.

The relaxation of masking does not apply to airplanes, buses, trains and other public transportation, to health-care settings, or where state or local restrictions still require them, Walensky said. Officials also noted that some business settings may require masks, especially since some workers may remain unvaccinated.

Masks are still required in planes, trains and buses despite the loosened CDC guidelines

The CDC director urged those who are immune-compromised to speak with their doctors before giving up their masks, and said that those who are not vaccinated remain at risk for mild or severe illness and death and should still wear masks.

“The science is … very clear about unvaccinated people,” she said. “You remain at risk of mild or severe illness or death or spreading the disease to others. You should still mask and you should get vaccinated right away.”..

“This is a day that I think will be marked as a true turning point in the pandemic in the United States,” said Richard Besser, former acting director of the CDC and president and chief executive of the Robert Wood Johnson Foundation. “The idea that people who are fully vaccinated can take off their masks, can go outside, can go inside, be around people and not have to worry about covid anymore, that’s absolutely huge.”” (A)

NPR’s Ailsa Chang talks with CDC Director Dr. Rochelle Walensky about the new guidance that fully vaccinated people don’t need masks indoors and how the Pfizer vaccine is now available to kids 12-15…

WALENSKY: So I think that there are several things that we have been following as we think about updating our guidance. The first is in the last two weeks, our cases are down in this country by about a third. The second is we now really do have an opportunity across this country for anyone who wants a vaccine to get it. We expanded that opportunity yesterday for 12- to 15-year-olds, which made 17 million more people eligible for a vaccine. We don’t have vaccine shortages. We have opportunities for people to find where they can get vaccinated. And really, everybody who wants a vaccine at this point has access to one…

But then thirdly is there has been evolving science. So really, over the last several weeks and even some studies released in the last week or so have demonstrated important things related to vaccination. One is that the vaccine is working in the public in the same way it worked in the clinical trials, that the effectiveness in real-world studies is very similar, over 90%, as it was in the clinical trials. And so that’s really terrific news.

The second is that it’s working against the variants that we have circulating in this country. So we saw that in the lab, but we have also seen it in now studies that were published just this past week in the New England Journal, that the vaccines are working against the B.1.1.7 variant, the B.1.351 variant. And then thirdly, there’s emerging data that has demonstrated that if you are vaccinated, you generally don’t get asymptomatic infection and generally cannot transmit to other people. Certainly, there are exceptions for all of these. But for the most part, the vaccine is – once you’re vaccinated, you can’t transmit to others.” (B)

“At the very beginning of the pandemic, the C.D.C.’s position was that most ordinary people did not need to wear masks unless they were sick and coughing. At the time, there was limited understanding that the virus was airborne and could be transmitted by people who were asymptomatic, and there was also a concern that recommending masks would worsen an N95 mask shortage for health care workers.

But the C.D.C.’s position quickly shifted.

By April 2020, the C.D.C. urged all Americans to wear a mask when they left their homes.

The guidance kept changing throughout the pandemic. For example, the agency first said that wearing masks protected others, not the wearer. By November, officials went a step further, saying masks benefited the people who wear them, in addition to those around them.

With vaccinations ramping up, the C.D.C. began to loosen its guidance last month, advising that fully vaccinated people could remove their masks in many situations outdoors, where the virus spreads less easily.

Then on Thursday, the C.D.C. announced that the relaxed rules also applied indoors.” (H)

“The trends are all going down because vaccines are making a big difference,” said Dr. Isaac Weisfuse, a medical epidemiologist at Cornell University and former New York City deputy health commissioner. “The fewer people you have who are susceptible, the more likely the trends will keep going down.”

In the U.S., the number of newly reported Covid-19 cases, hospitalizations and deaths are all decreasing. The most recent seven-day average for new cases fell about 23 percent over the previous week, Walensky said. The seven-day average for daily deaths also declined to 587 per day, according to the CDC.

“Today, Covid-19 deaths are at the lowest point since April 2020,” Andy Slavitt, the White House Covid-19 adviser, said Thursday in a news briefing.

These statistics help reinforce that the vaccines are working — and working well, said Dr. Monica Gandhi, an infectious disease physician and professor of medicine at the University of California, San Francisco.

“It’s like we reached a tipping point in terms of the weight of the evidence showing that these are profoundly effective vaccines, beyond our wildest dreams, and they’re really good at blocking transmission,” Gandhi said.

The change in recommendations was overdue, according to Dr. David Dowdy, an associate professor of infectious disease epidemiology at the Johns Hopkins Bloomberg School of Public Health.

“I think part of the problem before this was that there was something of a mixed message: The vaccines are very effective, but you still have to wear a mask,” Dowdy said. “This is now a strong statement that we know these vaccines work, and for those who are fully vaccinated, it’s appropriate to take some steps toward living life a bit more normally.” (C)

“Covid-19 cases are decreasing in the United States, and masks are no longer required everywhere, but the pandemic is not over — and won’t be until younger children can also be vaccinated, epidemiologists said in a new survey by The New York Times.

The true end of the pandemic — when it becomes safer to return to most activities without precautions — will arrive once at least 70 percent of Americans of all ages are vaccinated, they said. Adolescents just began receiving vaccines this week, and those for children younger than 12 are not yet approved.

“Children are key to ending the pandemic,” said David Celentano, the chair of epidemiology at Johns Hopkins University and one of the 723 epidemiologists who participated in the survey this month.

They are optimistic this will happen, even if not as quickly as many Americans hope. In five years, they expect Covid-19 will be more like the flu, circulating at a lower rate and with some deaths every year — but no longer a public health crisis necessitating lockdowns…

Still, the campaign to vaccinate more Americans cannot let up until children are protected, they said. Half of respondents said at least 80 percent of Americans, including children, would need to be vaccinated before it would be safe to do most activities without precautions. Though children are less likely than adults to develop severe cases of Covid-19, the scientists said their immunity was important because they could be hosts for the virus and a way for it to continue to circulate or develop new variants.

“Children cannot be left out of the equation as we reopen,” said Corinne McDaniels-Davidson, the director of the San Diego State University Institute for Public Health. “The ideas that they cannot transmit Covid or are immune from disease are pervasive among the lay public. We need education here.”

In assessing when the acute phase of the Covid pandemic could be considered over, they said vaccinations were more relevant than other metrics like new cases, hospitalizations or deaths (because an effective vaccination campaign would lower those rates, they said).

The country is not there yet. Nationwide, 36 percent of Americans are fully vaccinated, and the pace of vaccinations has slowed….

Even if the spread of Covid-19 decreases enough to allow a return of most activities, there are some aspects of pandemic life that epidemiologists say will persist much longer.

In particular, they say that masks are a norm that should continue, even if that view puts them at odds with the new C.D.C. guidance. More than 80 percent of them say people should continue to wear masks when indoors with strangers for at least another year, and outdoors in crowds.”  (D)

“The agency, however, came under sharp criticism for its quick turnabout. Just six weeks ago, CDC Director Dr. Rochelle Walensky was warning of “impending doom” as daily Covid-19 cases in the U.S. began to rise again. And many health and business leaders say the new recommendations were too ambiguous. It requires essential workers to police vaccination records and will be difficult to enforce.

“Under current plans, it will be impossible to enforce in most settings,” Dr. Peter Chin-Hong, an infectious disease physician at the University of California San Francisco, told CNBC. “Businesses, schools and event organizers may still have purview in requiring evidence of vaccination prior to inclusion in specific communities or events, but for other everyday events there will be no enforcement in the way of vaccine passports or QR codes as done in other countries.”

There are some instances where fully vaccinated people still need to wear masks: traveling by plane, bus or train as well as in certain places such as hospitals, nursing homes, prisons or at establishments that require them, the agency said. The CDC’s guidance also isn’t mandatory. States, municipalities and businesses can decide whether or not they want to follow it, increasing confusion for many business owners and employees.

Some health and law experts told CNBC it would further complicate public health efforts to end the pandemic, adding it is “nearly impossible” to police the use of face masks because there is no way to know who is vaccinated and who isn’t. More than half of the population still haven’t gotten the shots, they said, risking more outbreaks from unmasked, unvaccinated individuals.” (E)

“CNN: What do you think of the CDC’s Thursday decision on masking?

Dr. Leana Wen: Frankly, I was shocked. For months, I’ve been pushing for the CDC to give clearer, more practical guidance on what fully vaccinated people could do. They’ve been moving so slowly and cautiously, and I expected for them to say something like, fully vaccinated people can now get together with other fully vaccinated people, not just in informal settings like small dinners at home but formal settings like workplaces — I was thinking a conference room where fully vaccinated colleagues can all take off their masks.

Instead, the CDC removed virtually all restrictions on fully vaccinated people. On the one hand, this is a great affirmation of just how effective the vaccines are. I do think there is a great story to tell, that the vaccines are so powerful at protecting against illness and preventing vaccinated people from spreading coronavirus. On the other hand, this is such a sudden reversal. I don’t think people fully understand why the change was made — it feels like we went from zero to 100 overnight.

My concern is not for those who are fully vaccinated. Those people are well protected (with the exception of individuals who are immunocompromised). My concern is for those who are not yet able to be vaccinated, who are now potentially exposed to a higher level of risk because they will be around unvaccinated people who choose not to wear masks.

That’s because we can’t possibly know who’s vaccinated and who’s not. If you’re in a grocery store, and most people aren’t wearing masks anymore, what if some people aren’t vaccinated? If you yourself are vaccinated and pretty healthy, this is not a problem for you. But what if you’re not vaccinated — not because you don’t want to, but because you can’t?

I have two little children, ages 1 and 3, who can’t yet be vaccinated. Or what if you’re immunocompromised and the vaccines may not protect you as well, so you still have to be careful, even if you keep your mask on? I’m worried that the new CDC guidelines make it less safe for those who are already more vulnerable…

We need to have a bit more nuance than this. I’d encourage people to consider their own medical risks. If they are being treated for cancer and are on chemotherapy, or an organ transplant patient on immunosuppresants, I agree with the CDC that these people really need to keep masking in public settings if they are around potentially unvaccinated people. The chance of your carrying Covid-19 and transmitting it to others is also much decreased if you’re vaccinated, but that risk is still there. If you live at home with someone who is vulnerable, you may also want to use some additional caution.

In my case, I’m healthy but I live with two unvaccinated children — they can’t be vaccinated yet. I’d probably still be a bit cautious. I certainly wouldn’t need to wear a mask outdoors, but if I’m in a full-capacity, indoor church service where everyone is singing, and I’m not sure that people around me are vaccinated, I’d probably still wear a mask. Others may make a different choice, and that’s OK…

Unvaccinated people must still wear masks whenever they are spending time around someone who is unvaccinated or people of unknown vaccination status. If they are around someone who is definitely vaccinated, they don’t need to mask. But if they are in public, and it’s not clear if people around them are vaccinated, they should wear a mask.

The key is that vaccinated people are well protected, but the unvaccinated are not. The danger to them is not from the vaccinated, but from others who are not yet vaccinated. My concern with the CDC guidelines is that they don’t distinguish between who’s vaccinated and who’s not.

The unvaccinated are now at higher risk, because previously people around them were masked, and now some others who are unvaccinated may be unmasked and not keeping up with distancing.” (F)

“What about kids under 12?

There aren’t any vaccines currently approved for their use in the U.S. – which means the younger set needs to keep masking for the time being.

The CDC says all unvaccinated people age 2 and older “should wear masks in public settings and when around people who don’t live in their household.”

Experts at the American Academy of Pediatrics recommend unvaccinated children 2 and older continue to wear masks around others when indoors, especially when they are among at-risk adults such as those who are immunocompromised or over 65.

“We know children over age 2 can safely wear masks to protect themselves and others from transmitting the COVID-19 virus. We’ve already seen how the masks have helped prevent the spread of respiratory infections within schools, camps and other community settings, particularly when everyone wears them, washes hands and follows other infection control guidance,” Dr. Yvonne Maldonado, chair of the AAP Committee on Infectious Diseases, said in a statement.

All three manufacturers of U.S.-authorized vaccines are studying the safety and effectiveness of their vaccines in children, including as young as 6 months.

But it will likely be at least a few more months until there’s a vaccine approved for those under 12. Pfizer says it won’t be ready to ask for FDA approval for its COVID-19 vaccine in younger kids until September.” (G)

“As for the CDC’s revision of its masking rules, it is unclear what impact this will have on teachers, staff and students in the near term. Though the CDC has not yet revised its K-12 schools safety guidance, at least one district did move quickly Thursday to announce changes to its own in-school safety policies.

“In accordance with the new [CDC] guidance, Cobb Schools will no longer require fully vaccinated individuals to wear a mask,” wrote Chris Ragsdale, the superintendent of schools in Cobb County, Ga. “I would also like to make clear that any individual wishing to continue wearing a mask while attending school and/or school events should feel free to do so.”

But Becky Pringle, the president of the nation’s largest teachers union, the NEA, urged state and district leaders not to scrap in-school masking mandates.

“We know at this point that only a third of adults are vaccinated and no students younger than 16 are vaccinated,” Pringle said in a statement. “CDC’s key mitigation measures for safe in-person instruction, including wearing masks, should remain in place in schools and institutions of higher education to protect all students and others who are not vaccinated.”

In many places where mask-wearing has become unpopular, families and political leaders want children to be able to learn mask-less — regardless of whether they’ve been vaccinated. In Florida, Gov. Ron DeSantis said at a news conference Tuesday that he believes children should not be masked in classrooms, vaccinated or not.

“These kids do not need to be wearing these masks,” DeSantis said, though the CDC has said masking is a key strategy to prevent the spread of COVID-19 in schools. On Thursday, Palm Beach County Schools told families masks will be optional when the next school year begins.

In some states, masks in schools are already optional.

“Whether a child wears a mask in school is a decision that should be left only to a student’s parents,” said South Carolina Gov. Henry McMaster earlier this week as he issued an executive order allowing parents to opt their children out of school-based mask requirements.

The move was excoriated by the Palmetto State Teachers Association. In a statement, the group said, “many families and staff no longer have a choice for in-person learning if those individuals desire to follow the clear instructions of our public health authorities.”

Several districts in Utah are also now allowing parents to simply sign a form to exempt their children from schools’ face mask requirements. And, on Thursday, Utah’s governor announced a controversial move to end a statewide mask mandate in schools for the last week of the school year.” (I)

“US policy now focuses on getting more people vaccinated

With the news, America has entered a new phase in its Covid-19 response, in which it’s all-in on the vaccines.

It’s a reflection of the current reality: Now that the vaccines are widely available and more than half of US adults have gotten at least one dose, it’s less tenable to continue asking the vaccinated to make huge sacrifices. At the same time, the unvaccinated remain at risk of a deadly virus, and policymakers should do everything they can to make sure as many people as possible get the shot.

Much of the country had already moved to reopen, with 14 states already doing away with mask mandates entirely. The CDC’s guidance will likely nudge states further, perhaps causing them to, at the very least, find ways to let the vaccinated evade mask mandates.

Meanwhile, President Biden’s administration has emphasized that it’s now focused on vaccinating as many people as possible, adopting strategies to boost access, encourage the skeptical to get the shot, and reward those who do get inoculated. The administration has set a goal of vaccinating 70 percent of adults by July 4 — with the promise that at that point, much of the country can truly return to normal.”  (J)

“Many state and city officials welcomed news from the Centers for Disease Control and Prevention on Thursday that fully vaccinated people in the U.S. can forgo masks and social distancing.

But some still stopped short of immediately implementing the changes.

The CDC said vaccinated people must follow existing state, local or tribal laws and regulations on masks and social distancing, as well as policies at businesses and workplaces.

As of Friday morning, the rules looked very different from one state, city or county to the next.

Many Republican-led states, including South Carolina, Alabama and Texas, already lifted mask mandates to some degree. Once the CDC made its announcement, many Democratic-led states, including Kentucky, Oregon, Washington, Nevada and Illinois, began making changes.

Officials in Connecticut, Colorado and Vermont announced that, while they weren’t immediately implementing the CDC’s new standards, they would do so in the coming days.

In Connecticut, Gov. Ned Lamont announced that the state will adopt the CDC’s mask rules May 19, when much of the rest of the Nutmeg State’s coronavirus restrictions are set to lift.

Vermont Gov. Phil Scott called the new CDC guidance “incredibly encouraging.”

While the state reviewed the CDC recommendations’ implications Thursday, Scott said “Vermont will follow suit.” Updates on the state’s mask mandate are set to be shared publicly on Friday at 11 a.m. ET.

“COVID-19 is still very much a threat in our State and many Nevadans may choose to continue using masks based on their and their families’ personal health concerns,” Nevada Health Response said. “Others should respect this choice.”

The state is still allowing private businesses to have their own more-restrictive mask policies. Each of Nevada’s counties also still has the authority to establish its own social distancing standards.

Mask mandates remain in place in states such as California, New York, Massachusetts and New Jersey as state leaders confer with public health experts on next steps.

At the city level, mayors of Washington, D.C., and New York City said they are also reviewing the new guidelines before making any decisions.

San Francisco Department of Public Health shared that it’s waiting on the rest of California to decide on updated mask-wearing guidelines before altering local rules.

The department tweeted, “As we recently did with the new guidance on outdoor masking for fully vaccinated people, we must wait for the state to adopt the updated guidelines before making changes to the local health order that we consider safe.”” (K)

“New Jersey’s mask mandate requiring residents to wear face coverings indoors won’t be relaxed yet, Gov. Phil Murphy said Friday, one day after federal health officials said vaccinated residents could stop wearing masks.

Murphy said it could be weeks before the Garden State follows the U.S. Centers for Disease Control and Prevention’s latest guidance, which allows anyone who is fully vaccinated to do indoor and outdoor activities — of any size — without a mask or social distancing.

“I would guess in a matter of weeks we’ll get to the point where we can comfortably say inside, no matter what, you’re OK,” Murphy said after touring a vaccination site outside a ShopRite in East Orange on Friday.

“As of this moment in time, we’re not there yet.”

Murphy said residents could remove their masks outdoors if they are vaccinated, but those who are unvaccinated and “in close proximity” should continue to wear their masks.

“As it relates to folks outdoors, being among other vaccinated persons, I think we can do away with our masks,” the governor said. More details would be announced about mask rules and travel quarantines on Monday, he said…

New Jersey has seen a steep decline in new COVID cases and hospitalizations in recent months. Hospitalizations dipped below 1,000 people this week for the first time in six months.

But vaccinations have slowed, casting doubt on whether the state will reach Murphy’s goal of vaccinating 4.7 million people by the end of June. Murphy has acknowledged the slowdown, saying he would “scrap” to get to the goal.

Over 3.75 million residents have been vaccinated, and 2,600 children ages 12 to 15 had received the Pfizer vaccine on Thursday, the first day it was available to that age group, according to Health Commissioner Judith Persichilli.

“Folks are getting vaccinated and folks are doing the right thing,” the governor said. “As far as we can tell, as much as we want to get there, and we will get there as it relates to indoor masking, its only a matter of time. If you’re in a business or a public setting, we’re not there yet.”…

Though the indoor mask mandate will remain, the state will continue with the largest relaxation of restrictions yet on daily life since last March, when the pandemic began its first surge.

Most capacity limits are set to ease in the Garden State, part of a coordinated effort with neighboring New York and Connecticut, on May 19.” (L)

“Retailers started announcing changes to face mask policies for fully vaccinated customers a day after the Centers for Disease Control and Prevention issued new masking guidelines.

Trader Joe’s, Walmart, Sam’s Club, Costco and Publix were the first to confirm updates to mask requirements, leading the way for mask-free shopping except where required by state or local mandate. In some cases, vaccinated store employees can also go to work without a mask.

Many retailers, including Apple, Target, CVS and Walgreens, say they are still evaluating the CDC guidance but say they could update policies.

Starbucks updates its policy starting Monday and makes masks “optional for vaccinated customers beginning Monday, May 17, unless local regulations require them by law.”

So far, businesses have said proof of the vaccine won’t need to be shown and will be on the honor system.” (O)

_______________________

“Eight members of the New York Yankees have tested positive for coronavirus this week despite being inoculated with the Johnson & Johnson vaccine, the baseball team said Thursday.

The eight infected Yankees include coaches, staff members and a player. Seven do not have symptoms, said Jason Zillo, the team’s vice president of communications.

The Yankees said the eight infected members received the Johnson & Johnson vaccine at least two weeks ago.

The single-dose Johnson & Johnson vaccine was 72% effective against Covid-19 among US trial participants and 85% effective against severe Covid-19. The two-dose vaccines used in the US, from Pfizer/BioNTech and Moderna, are both about 95% effective.” (M)

“The Yankees have called all eight instances “breakthrough positives.” According to the Centers for Disease Control and Prevention, a breakthrough case occurs when a fully vaccinated person contracts the virus. It said a small number of such cases would be expected despite the effectiveness of vaccines, because none of the vaccines are capable of preventing illness in 100 percent of cases.” (N)

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