Vaccinated Americans Can Go Unmasked Outdoors, CDC Says

COVID-19
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Yes, but most U.S. citizens don’t have the time, access, or expertise to navigate this. That is one reason why institutions like the CDC exist.

I don’t think of it as “lowering the bar” at all. Some people are in a privileged position where they can telework and completely isolate from the world, removing all exposure to risk.

A lot of people can’t. If the CDC had acknowledged aerosols earlier then we could’ve focused on ventilation. Experts have been talking about ventilation since last summer. Instead the CDC let people continue spending money and resources sanitizing everything. Workers in high risk environments were not served well by the CDC’s refusal to acknowledge the role aerosols played.

Focusing on ventilation isn’t being more “lax.” It’s directing resources where they will make a difference.

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Not disagreeing, but was thinking about individuals, rather than businesses. That is what I assume you are referring to when you talk about spending money and resources.

For us, I think we’ve long known about the necessity of ventilation and the problem of aerosols, as well as criticism of some ventilation ideas that were not well thought out. Then again, I’ve also read about the upgrades going into buildings here, and that definitely includes better ventilation and air filtration systems.

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I guess I was referring to both. I think a set of guidelines regarding ventilation systems would help business owners create a safe work environment for employees- individuals. School districts would benefit from clear guidance on good ventilation systems in schools for students- also individuals.

Seems pretty strange to separate the two. We rely on businesses of all kinds even if we’re only teleworking. I care about the employees/individuals that work in those businesses.

OSHA guidelines for ventilation haven’t been updated since the beginning of the pandemic. I am not able to open the windows in my office building, and our ventilation systems satisfy OSHA’s guidelines defined before the pandemic. Not sure if/when OSHA will finally update their guidelines, but guidance from CDC would likely make a huge difference on that timeline. The result is that no one goes in the building unless they absolutely have to be there. I haven’t been in my office building since March 2020.

Some people can’t do that though. I’m lucky that I can work from home. My husband can’t, but his building has top-notch ventilation, and he only goes in 2x per week. We’ve been overall very fortunate. I’ve known many people who have gotten sick, a few long-haulers, and have several friends whose parents have died from COVID. The CDC’s lack of clear guidance when it was needed contributed to some of those illnesses.

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Not a criticism of @katers87 point, but although the CDC might be flawed, people themselves are much worse at making the right choices.

While only 44% of predictions from the expert group fell within their own 75% confidence ranges, the non-expert group fared far worse, with only 12% of predictions falling within their ranges. Even when the non-expert group was restricted to those with high numeracy scores, only 16% of predictions fell within the ranges of values that they were 75% sure would contain the true outcomes.

How accurate were early expert predictions on COVID-19, and how did they compare to the public? | EurekAlert! Science News

Looking back, which group was right more often than any other else, or which sources were the best sources?

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I think that sort of is my point though…

The CDC really failed us. While I acknowledge that politics played a role in that, I don’t think that fully explains it.

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But was anyone better? There are many organizations that provided information, but of those, which were the best? It seems like almost every organization failed.

For myself, I can’t remember a misstep by Nature, a source I trusted, and since is allowed cutting-edge science, it presented new material, although one has to understood the disclaimers on unpublished research when they included it. I have other quality sources, but since some of them are major news sites (NYT, Bloomberg), or are unvetted academic bulletins via Eurekalert, one needs to be able to separate solid information from the suggestive and/or questionable material. Although trivial in the scheme of things Consumer Reports was likely trustworthy but safe, a follower of CDC guidelines.

That said, was any organization stellar? Paraphrasing Churchill, Democracy is the worst form of government except for all others, just replace democracy with the CDC.

PS, Not wanting to be overtly political, but it seems to me that the CDC’s failures were largely an effect of the prior administration. It just seems so obvious that the mission of the CDC was undermined, and its messaging corrupted. Even then, it was known as a staid science-oriented organization. The failures of certain branches can often be laid at the persuasion of the political forces in DC, and what they make priorities.

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Most developed countries fared better than us. I believe we’ve had more cases per million people than any other country in the world. Some of that can be blamed on our culture and politics, but not all of it. We also had good access to testing after about June 2020, but we missed a lot of cases before then.

Sure, hindsight is 2020. I’m just saying, I don’t plan to ever trust the CDC with my health. The government failed us.

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I thought about this a bit more, and I think you may be right about the prior administration’s role in the failures. I guess in theory it is not supposed to work like that. Public health agencies should be able to provide guidance based on science and facts, regardless of what the administration at the time wants. That is how our system is supposed to work. It just didn’t work that way.

Things have certainly improved over the last few months- much better guidance overall. Hopefully that will continue, and hopefully there will be some changes implemented to ensure that CDC can provide guidance based on science, regardless of who is currently in office.

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As for culture, I did some basic statistical analysis in the beginning, correlating some aspects of culture against infection rates and deaths. For the parameters, I use things like Hofstede’s Cultural Dimensions - it’s backed by a large number of studies - as well as economic measures like income inequality.

This was from June of last year, and only some of these correlations make sense as it applies to the US, which by Hofstede’s definitions is moderate for Power Dx and Masculinity (traditional gender roles), very low for Long Term Orientation (LTO), very high for individuality, least when compared against all countries. I’ll probably redo the analysis, now that the results have mostly shaken out.

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Yes, our culture played a role. I’ve acknowledged that. I’m not sure what that chart is supposed to communicate. Are you trying to show that the case counts or deaths that the United States had as of last June correlate with certain parameters/dimensions? Are those values r? The values are pretty different for deaths vs. case counts…

I don’t think an in-depth analysis or model is really necessary. It’ll be heavily influenced by whatever assumptions are fed into the model (eg. garbage in/garbage out- though it sounds like your references are perfectly reasonable here… don’t mean to imply otherwise). Pretty much all models have been wrong at some point during the pandemic. The assumptions (especially those that could be manipulated) were more important than the numbers produced by the models- since those were often wrong anyway.

So as I said in my prior post, politics and culture played a role- but that doesn’t change the basic fact that the CDC failed us.

My acknowledgment that politics played a large role doesn’t rid the CDC of their failure. It’s simply a recognition that the CDC as an institution is disappointingly vulnerable to whoever is in office.

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Personally, I have not been confused about aerosols, and it is laudable that you are concerned enough with others to recognize flaws in guidance and how that can lead to harm. I live divorced from these concerns, and although I am aware of them, and treat people considerately that aren’t as fortunate, some concerns aren’t as prominent for me.

Yes, the CDC is ‘late to the game’ in some ways but it is also absurd to blame it for failures created by the prior administration. If the CDC was allowed to do its job the US would be in a much better position (see link as an example) but as I mentioned before, it is known as a slow-moving science-driven organization, so still would have failed in some ways, as you have mentioned. That said, even with absolutely correct information, it might have made little difference.

The medical establishments and corporations in NYC took the risk seriously, but much of the US ignored scientific guidance, and the guidance was trammeled by the administration and politicians. Even the best of information would have been dismissed, and was undercut repeatedly by ignorance, hoaxes, conspiracy theories, and misguided self-interest.

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I disagree. There’s no reason to believe we won’t have a president in the future that similarly impacts the agency. If it can happen again, then the agency’s trustworthiness has decreased.

I also disagree that all problems with the CDC can be laid at the feet of Trump and misinformation. Some of it can simply be blamed on the CDC and WHO being slow, “scientific” organizations. That is not an excuse- it is simply a depressing explanation for failure.

Note that that the author in the article below states,

“ Hitoshi Oshitani, a Japanese virologist who played an important role in his country’s response to the epidemic, said it was this ship outbreak that helped convince him this was airborne — and it’s why Japan planned around airborne transmission assumptions from as early as February 2020.”

Japan was able to recognize aerosol transmission as early as February- so it is not a requirement for a scientific institution to move slowly in the face of overwhelming evidence. It is simply what happened in our country- and with the WHO.

While the CDC has finally updated its website, there was no press conference outlining how this new information should impact mitigation strategies. There was nothing- so they’ve really only improved marginally.

These failures by the CDC caused harm to people I care about, so yes, I’m not divorced from them. The idea of being divorced from caring about people with whom I’m not in direct contact sounds equally absurd to me. I am grateful to not suffer from that malady.

In addition, I would’ve benefited greatly from better understanding what situations were safer for me personally and why. I was making decisions based on a few scientists recommendations and simple common sense- other scientists believed transmission was only caused by large droplets. It was very difficult to navigate these opinions because I am not an epidemiologist. I did not understand the safety levels of different scenarios. I lived on the 6th floor of an old apartment building last March. In order to get outside or do laundry- was it safer to take an elevator that many other people had used recently or take the unventilated stairwell which was used less often but people likely breathed more heavily while using it? I moved into a new residence in June. I purchased a vehicle last October- previously I’d used the metro and Lyft/Uber/Zipcar.

I made substantial changes to my life based on the opinions of some epidemiologists. The CDC’s guidance didn’t drive any of those decisions because it was obviously wrong. I have a friend who got the virus from a guy down the hall in his apartment building who refused to wear a mask, and that friend still hasn’t fully recovered his sense of smell/taste 8 months later. I’m very comfortable with my decisions now, but I would’ve liked to have felt confident a year ago. I also would’ve liked to have been able to tell my friends why certain situations were unsafe and have CDC guidance to back up my assertions. I would’ve liked fewer people to get sick and/or die as they prepared the groceries that I purchased from my privileged position at home on my couch.

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I’m not unsympathetic to your concerns, or the concerns of others, but we should probably agree to disagree. I never took the word of any single organization, never trusted that side of the political divide, look warily at the incentives of the businesses and medical establishments - mostly the pharmaceutical and device manufacturers - and feel comfortable filtering the information I take in. Even then, you can imagine where I place the largest share of the blame.

Like you, I suffered from the need to make decisions about stairwells versus elevators, and luckily for my safety, have a spouse that was very worried about others and made sure I didn’t stray too far. Also, we keep each other in check. I help her avoid excessive negativity and anxiety. She makes sure I am not cavalier about risk, although she mostly prevents me from helping others and forgetting about small safety tasks, although she deserves much more credit, handling our purchases and related research, keeping our friends engaged, and expanding into an online world when our close relationships were kept distant. Even then, regardless of whatever mistakes we made, mostly on the side of caution, I am not resentful. I look forward to the opening of the country, of the city, getting back to life if only somewhat normal. For the most part, I think I fared well, although as mentioned, I understand that others were not as able to get through this, and for those, I’ve been as sympathetic and as helpful as I can.

I was able to work from home as a software developer, have an equally concerned and loving spouse, have a good emotional disposition for lockdown, have an employer that is very concerned about the welfare of its staff, have friends and peers that can avoid risk, live in a very large condo community with a private park, and being in Manhattan. The last can seem contradictory, but people here are very concerned about infection, to themselves and others, and are willing to tolerate mask-wearing and social distancing. Only one person we know was ever at serious risk, my 85-year old mother-in-law, and she got over her infection while at home - it was scary, with her being easily breathless after short conversations and us being unable to assist - in April 2020.

Using the Big-5/OCEAN paradigm as it relates to the lockdown, some traits were shown to be more compliant with rules, as well as some traits faring better:

  • Openness - Less good emotionally (more compliant)
  • Extroversion - Better overall but worse relative to their prior state
  • Neuroticism - Less good emotionally (more compliant)
  • Agreeableness - Better emotionally
  • Conscientiousness - Better emotionally

By these tests, I tend to be very high open, middling introvert/extrovert, very low neuroticism, high agreeableness, and high conscientiousness. Emotionally, I have done well, and it is not that I am unaware or unconcerned about the welfare of others - I have repeatedly tested as having high levels of empathy - but I am not overly stressed by things outside of my influence. I do what I can to help others, as much as safety and my spouse allow. My middling extroversion means that I am mostly upbeat, while also finding being isolated easily to handle.

Am I an Introvert? The Personality Traits That Make Lockdown Coping Easier - Bloomberg

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About aerosols, we’ve avoided closed spaces, even if isolated, for quite some time, although to be honest, my spouse was more diligent than I was diligent.

I prefer a particular brand of KF-94 that fits my face snugly. I choose the elevator over the stairwell, as the 8 floors can be laborious, even though I am fairly fit. The building we are in limits number of people to 3, but even then I am usually riding alone, since there are 3 elevators and the building is somewhat empty. Masks are always on in the building, and in fact, outside as well, except maybe when I am completely isolated when walking along the river or in our inner courtyard. When we get deliveries, we wait until the person has left before bringing them in, and even then, I am wearing a mask. When I am outside, it is usually only for long lone treks through and around Manhattan, and recently I did spend time in a few museums, but they are both incredibly spacious with restrictions on capacity. When I was The Met I avoided the long lines that had formed at some major exhibitions, sticking to the emptier galleries.

As for other people, that can be harder to gauge. Living in Manhattan, there is much less work where people are in cramped or closed environments for long periods, although restaurants are worse for it, although the cash registers need to be attended to, some of that is avoided by scanners, and even then, high plastic barriers and masks for the people behind them. I haven’t been in a grocery store or a local restaurant for over a year, what used to be a several times a week activity, so I can’t really arrest to what I’ve seen, so the best I can do is large tips for anything involving food prep or delivery, charitable giving, and consideration for the people I do deal with.

Thinking about everything around me, the concern about aerosols has already been incorporated, for building staff, medical offices, local stores, and corporations, but seems to have mostly been lost on restaurants with semi-outdoor seating. There are likely several drivers, businesses that can’t survive on delivery or without seated guests and 20-somethings that feel a need to be out, as well having less fear of infection to themselves. Here, which is largely a service-driven economy, the job market has been decimated and many people’s lives ruined, but it is different in other areas, with a different job market.

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I think we may primarily disagree on the role of the CDC. Before the pandemic, I believed that if we were ever to encounter a pandemic, the CDC would play a heavy role in the overall management of the pandemic - through science-based guidance. I do not consider the CDC to be equal to Nature or any scientific magazine. It is a government agency funded by tax-payer dollars. The CDC’s mission statement is this: “To promote health and quality of life by preventing and controlling disease, injury, and disability.”

Whether or not the CDC failed depends on what you perceive their role to be. If you perceive it to be only very limited with each state’s health department basically being required to see past the CDC’s guidance and figure out the best recommendations on their own, then sure, the CDC didn’t fail. Given that borders are open between states, I think that sounds like a very ineffective system. I perceive the CDC’s role to be larger and I believe that they failed in that role since we now have over 500,000 people dead and many with longterm complications from COVID.

If your community has installed safeguards that were outside of CDC recommendations, then the question becomes - are those safeguards effective? Plexi-glass only offers limited protection against aerosols because aerosols are small and can remain in the air for long periods of time in poorly ventilated spaces. Plexiglass is generally not recommended in schools but has been installed all across the country (to the tax-payers detriment) because CDC guidance was lacking until a couple of months ago. I could see plexi-glass being helpful for brief interactions at a cash register, but it won’t help in places where people are staying in the same place for more than a brief period of time - the small droplets will just go around the barrier. Plexi-glass helps most with large droplet transmission.

I’m not at all surprised that NYC was ahead of the curve when it comes to safeguards against aerosols. I would be surprised if it wasn’t especially since many other parts of the country didn’t really seem to take COVID seriously until it finally hit their community, and of course, NYC was hit hard first. Manhattan is largely comprised of wealthy, well-educated individuals with access to resources, so definitely not surprising.

Anyway, I’ve agreed with you that Trump played a role. Since you posted the CDC guidelines here, I’m not sure if you perceive their role to be significant or not - your recent comments would indicate no, but posting the guidance would indicate yes. If you perceive their role to be smaller than what I’ve described, then yes, I agree - we should agree to disagree.

However, I think it is worth stating that if proper measures had been implemented earlier on in the pandemic, the economic hardship may not have been as severe. If investments had been made in ventilation, spaces that would’ve been considered unsafe could be considered safe as long as you wore a mask. There was a lot of confusion about the big tents being installed outside restaurants in my area - isn’t an enclosed tent the same thing as being inside? Why is this huge, expensive tent a better option than multiple HEPA air filters throughout the restaurant. My younger sister’s significant other works as a server in a restaurant and came down with COVID in the fall during a surge. Masks were worn by all employees and the restaurant abided by state law/guidelines, but I’m sure they didn’t have any air filtration systems in place.

I think we could’ve significantly reduced the economic hardship by providing people solutions to the problem rather than businesses just shutting down, going out of business because no one wanted to enter their premises, or their employees getting sick and dying because the company didn’t know how or if they even should improve their ventilation systems - it can be an expensive undertaking, and it would be helpful to have guidance on which systems would be best to invest in. The husband of another friend of mine worked in an office environment in an essential business. He and other workers were required to wear a mask, but that clearly wasn’t sufficient. Masks are super helpful, but layering ventilation (opening windows or using HEPA filters) could’ve made a difference there.

Obviously Trump advocating for masks would’ve helped a lot too…

I have done this too. I tried going to the grocery store last summer during a lull in cases, but people had very different comfort levels with distance, and I wasn’t comfortable with how close people got to me as I shopped. Now that I’m vaccinated, I go to the grocery store. It seems people are distancing better now - not sure if it is because the winter surge was so bad or if messaging has gotten better.

Anyway, glad you and your family made it through what seems to be the worst of the pandemic (in the US) safely.

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BTW, great article, but it also points to the failure of the history of the medical establishment to understand aerosols, as well as to change rapidly, not just the CDC. As you say, and explanation, not an excuse, but still, the issues at the CDC are larger than the CDC itself.

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Zeynep Tufekci has been an excellent resource this last year. I’ve found reading her articles to be very helpful.

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Yes, she’s often touted as prophetic. I don’t follow her specifically, but will check her out. BTW, I enjoy reading in systems thinking and complexity, something she lays claim to…

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I think it’s unfair to put blame on CDC from the official announcements in 2020-early 2021. An amazing number of super qualified individuals there quit in disgust at the way the administration was politicizing a supposedly scientific institution. And others were scared to open their mouths to the public because firing and/or reassignment to some less meaningful area would result. It’s going to take a good while to rebuild that and other parts of the government from the damage that was done.

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