CDC
In a widely anticipated move, the Centers for Disease Control and Prevention have announced new guidelines for the use of masks and other precautions to limit the spread of COVID-19. While the precautions people should take — vaccinations and mask use — are largely unchanged, the metrics that trigger changes in proposed precautions will shift from focusing solely on the number of cases to including information on case severity and hospital capacity.
The move has been alluded to for weeks, and it comes in response to a wide range of pressures. These include the rapidly declining number of new cases following the peak of ommicron infections earlier this year, changes in state-level policy and a general public fatigue regarding pandemic precautions. However, at a press conference announcing the changes, CDC head Rochelle Walensky said the agency had been considering the changes for some time.
What’s new
Walensky announced the changes by saying, “We are in a stronger position today,” before explaining that this is because “with widespread immunity in the population, the overall risk of serious disease is lower.” Given that situation, the CDC has decided to shift the focus of its advisory to cases of serious illness and the strain placed on the health care system.
To measure that load, the system will use three types of information: new hospital admissions due to COVID-19, the number of hospital beds occupied by COVID patients, and the number of new cases. These will be combined into one metric to differentiate between low, medium and high risk scenarios. The CDC will obtain this data through a hospital reporting system and PCR-based testing labs, both of which will produce information that is believed to be reliable.
The change makes a big difference. Based on the previous standard of case count, most of the US was typically in the high-risk category. Under the new system, only about 30 percent of the US is currently at high risk. People interested in the status of their area can check out the CDC page for county-level information or mask use and care, both of which were updated this afternoon.
Under low-risk conditions, people are advised to stay up to date on their vaccinations and get tested when experiencing potential COVID-19 symptoms. As the risk increases to moderate, people at high risk for serious symptoms should consult medical professionals about appropriate precautions. Once the risk reaches a high level, everyone should wear masks when indoors in a public place.
The CDC emphasized that people are still welcome to evaluate their personal comfort and risk levels and can wear a mask in low-risk situations if they wish. And there are situations, such as when people experience symptoms, where masks should always be used.
What can actually change?
It’s probably safe to say that the CDC’s earlier guidelines were not widely followed. While the new recommendations could be used to guide government agencies, the CDC does not have the power to force states to follow its suggestions; a number of states have even actively sought to restrict the use of mask mandates for their citizens. In other countries, the mandates have been maintained as the number of cases has risen and fallen, although the CDC recommends different levels of caution based on the number of cases.
While individuals can track local numbers of cases and positivity levels and use those stats to follow up on the CDC’s recommendations, that’s probably going to be pretty rare — even though the CDC tries to make it easier through a widget that pinpoints your location and returns the local infection levels. It is therefore unclear whether this new directive will have a major practical effect.
Walensky didn’t shy away from talking about what is arguably the biggest hurdle: a seemingly inevitable rise in the number of cases that puts more of the country in the high-risk category. “We recognize that we need to be flexible,” she said. “We need to be able to call” [restrictions] if we have a new variant or a new wave, you have to back up again.”
However, once people get used to seeing their day-to-day lives as low-risk, “dial-in backup” can become a major challenge.
