“…To meet those goals, the report advises, avoid sending mixed messages from multiple experts, releasing information too late, taking paternalistic attitudes, failing to counter rumors and myths in real time and engaging in public power struggles and causing confusion.
Last week, as agency officials announced new mask guidelines and set the nation on edge, I had to wonder if they had swapped their “do list” and their “avoid list.”
The C.D.C. faces three major problems.
The first is reality: a sustained campaign of misinformation against vaccines and other public health measures, originating mostly with right-wing commentators and politicians, and a new media environment that has upended traditional information flows.
Second, the C.D.C. is still mired in the fog of pandemic, with too little data, collected too slowly, leaving it chasing epidemic waves and trying to make sense of information from other countries. Epidemics spread exponentially, so delayed responses make problems much worse. If the response to a crisis comes after many people are already aware of it brewing, it leaves them confused and fearful if they look to the C.D.C. for guidance, and vulnerable to misinformation if they do not.
Third, the agency is simply not doing a good job at what the pamphlet advises: being first, right and credible, and avoiding mixed messaging, delays and confusion.” (A)
“The new guidelines for the public, released Monday, allow for people who test positive for Covid-19 to leave isolation after five days if their symptoms are gone or getting better, so long as they wear masks for at least five more days.
As for quarantine, people who have received booster doses of vaccine are advised that they may safely stay out and about, even if exposed to the virus, if they wear masks for 10 days, and even the unvaccinated may leave quarantine after five days…
State and local health officials are often on the front line of communication about new policies, and they got no warning or preparation for the latest update, Freeman said. The CDC did not provide posters, charts or visual aids, or any of the background that might help communicate the new advice to the public.
Instead, CDC Director Dr. Rochelle Walensky and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have been defending and explaining the change in television and newspaper interviews this week.
Both have said, without offering data as evidence, that people are unlikely to transmit the infection after about five days from onset of symptoms.
“The thing about the guidance change for the general population is, the science and the data hasn’t come up,” Freeman said.” (B)
“If you are asymptomatic and you are infected, we want to get people back to the jobs, particularly those with essential jobs to keep our society running smoothly,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in an interview with CNN Monday.” (C)
“Some also believe that the decision isn’t being made solely on safety – which is in part true, according to the nation’s top infectious disease specialist himself.
Dr. Anthony Fauci said, “There is the danger that there will be so many people who are being isolated, who are asymptomatic for the full ten days, that you could have a major negative impact on our ability to keep society running.”” (D)
“The decision by federal health officials to shorten isolation periods for many Americans infected with the coronavirus drew both tempered support and intense opposition from scientists on Tuesday, particularly over the absence of a testing requirement and fears that the omission could hasten the spread of the highly contagious Omicron variant.
The new guidance, coming amid a crush of new infections that has starved many hospitals of workers, seemed to some scientists like a necessary step to shore up work forces in essential industries. And encouraging people to leave isolation early after testing negative could spare them the hardships of prolonged periods at home.
But letting hundreds of thousands of infected people forgo those tests — even if, crucially, their symptoms were not entirely gone — risks seeding new cases and heaping even more pressure on already overburdened health systems, experts said in interviews on Tuesday.
“To me, this feels honestly more about economics than about the science,” said Yonatan Grad, an associate professor of immunology and infectious diseases at the Harvard T.H. Chan School of Public Health, who has tracked coronavirus infections in the National Basketball Association.
“I suspect what it will do is result in at least some people emerging from isolation more quickly, and so there’ll be more opportunities for transmission and that of course will accelerate the spread of Covid-19,” he added, noting that people were unlikely to adhere strictly to masking advice after leaving isolation.” (E)
“What’s baffling is that the CDC isn’t asking people to test out of isolation, particularly with home tests. As Eric Topol of the Scripps Research Translational Institute has written, there’s enormous variation in how long individuals remain contagious with COVID, meaning that even after a five-day wait, some people will still spread the disease. And while masks might help reduce that risk some, it’s unclear how much good they’ll do with preventing the spread of omicron, given its high level of infectiousness.
Antigen tests, however, are very good at detecting people who are still infectious to others. Ashish Jha, the dean of Brown’s school of public health, calls them “contagiousness tests”: They won’t detect every speck of virus that their PCR counterparts are attuned to do, but they can detect the important part—if someone is producing enough of the virus that they’re likely to spread it. Plus, they do not require a drive to a testing site and a wait of hours or days for results. “It makes no sense,” Topol told me of the CDC’s omission. “Rapid antigen tests are perfect for this.”
Here’s how Walensky defended the decision to not recommend rapid tests, to CNN:
We opted not to have the rapid test for isolation because we actually don’t know how our rapid tests perform and how well they predict whether you’re transmissible during the end of disease. The FDA has not authorized them for that use. We don’t know how they perform. So what we said was, well, if you got a rapid test at five days and it was negative, we weren’t convinced that you weren’t still transmissible. We didn’t want to leave a false sense of security. We still wanted you to wear the mask. And if it was positive, we still know the maximum amount of transmission was behind you. We still wanted you to wear a mask. And given that we were not going to change our recommendations based on the result of that rapid test, we opted not to include it.” (F)
“But the shifting instruction from federal health officials has prompted some criticism that the administration is prioritizing a return to economic normalcy over the safety of Americans who could still be infected by asymptomatic co-workers, even after those individuals self-quarantine for five days.
On Wednesday, Walensky acknowledged that the CDC’s decision to alter the recommended isolation period “really had a lot to do with what we thought people would be able to tolerate.”
“We have seen relatively low rates of isolation for all of this pandemic. Some science has demonstrated less than a third of people are isolating when they need to,” Walensky told CNN.
“And so we really want to make sure that we had guidance in this moment — where we were going to have a lot of disease — that could be adhered to, that people were willing to adhere to and that spoke specifically to when people were maximally infectious,” she continued.” (G)
“One of the biggest criticisms was that shortening the isolation and quarantine requirement should be augmented with a negative test requirement. Today, California did exactly that with its updated guidelines…
The new Golden State guidelines add that all Covid-positive individuals can end isolation after day five if symptoms are not present (or are resolving) and if an antigen test collected on day five or later is negative. It also says unvaccinated individuals — or vaccinated but unboosted people — who are exposed to Covid “should stay home for at least five days and also get an antigen test on day five.”
The framework encourages upgrading mask quality, given the transmissibility and prevalence of Omicron. It says, “all persons should optimize mask fit and filtration, ideally through use of a surgical mask or respirator.”” (H)
“The CDC’s new guidance encourages co-workers who may still be infectious to return to work and run the risk of spreading the virus throughout their workplace.
This past week, many essential workers have again felt that they are being treated as expendable after the Centers for Disease Control and Prevention issued new guidelines that shortened the isolation period for those with Covid-19 from 10 days to five days — a move that many workers saw as a concession to business and a danger to workers…
The reduced isolation is on the condition that an employee is asymptomatic after five days. But with scientists saying that some Covid victims remain infectious at that five-day mark, the CDC’s new guidance encourages co-workers who may still be infectious to return to work and run the risk of spreading the virus throughout their workplace.
Moreover, in a nation where millions of Americans — showing contempt for public health and the public good — have ignored repeated pleas to wear masks and get vaccinated, many workers will no doubt fear that co-workers returning from isolation will ignore the CDC’s guidance that they wear masks for five more days after isolation. Considering that the new guidance doesn’t require employees to have a negative Covid test before leaving isolation and returning to work, it could be a recipe for serious trouble.” (I)
“As the COVID-19 omicron variant surges across the United States, top federal health officials are looking to add a negative test along with its five-day isolation restrictions for asymptomatic Americans who catch the coronavirus, the White House’s top medical adviser said Sunday.
Dr. Anthony Fauci said the Centers for Disease Control and Prevention is now considering including the negative test as part of its guidance after getting significant “pushback” on its updated recommendations last week.
Under that Dec. 27 guidance, isolation restrictions for people infected with COVID-19 were shortened from 10 days to five days if they are no longer feeling symptoms or running a fever. After that period, they are asked to spend the following five days wearing a mask when around others.
The guidelines have since received criticism from many health professionals for not specifying a negative antigen test as a requirement for leaving isolation.
“There has been some concern about why we don’t ask people at that five-day period to get tested,” Fauci said. “Looking at it again, there may be an option in that, that testing could be a part of that, and I think we’re going to be hearing more about that in the next day or so from the CDC.”” (J)
- A.The C.D.C. Needs to Stop Confusing the Public, By Zeynep Tufekci, https://www.nytimes.com/2021/08/04/opinion/cdc-covid-guidelines.html?referringSource=articleShare
- B.CDC changes to quarantine, isolation advice took local health officials by surprise, By Maggie Fox, https://www.cnn.com/2021/12/29/health/cdc-quarantine-guidelines-surprise/index.html
- C.New CDC guidance brings perfect storm of confusion and frustration, by KRISTINE FRAZAO, https://thenationaldesk.com/news/americas-news-now/new-cdc-guidance-brings-perfect-storm-of-confusion-and-frustration
- D.New CDC COVID guidelines cause confusion in northeast Wisconsin, https://fox11online.com/news/local/cdc-new-guidelines-health-care-confusion-wisconsin
- E.Will Shortened Isolation Periods Spread the Virus?, By Benjamin Mueller, https://www.nytimes.com/2021/12/28/health/covid-isolation-period-omicron.html?referringSource=articleShare
- F.The CDC’s Defense of Its New COVID Guidelines Is Complete Nonsense, BY JORDAN WEISSMANN, https://slate.com/technology/2021/12/cdc-covid-isolation-shorten-rapid-test.html
- G.CDC director explains new Covid isolation period rules in wake of Omicron variant, By QUINT FORGEY, https://www.politico.com/news/2021/12/29/cdc-defends-new-covid-guidelines-526234
- H.California’s New Covid Quarantine & Isolation Guidelines Are Stricter Than CDC’s, By Tom Tapp, https://deadline.com/2021/12/california-covid-quarantine-isolation-guidelines-1234903013/
- I.New Covid isolation guidance from the CDC leaves many workers feeling disposable, By Steven Greenhouse, https://www.nbcnews.com/think/opinion/new-covid-isolation-guidance-cdc-leaves-many-workers-feeling-disposable-ncna1286821
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