CDC's slow, cautious Covid-19 messaging seems out of step with moment - STAT

Separately, it took three months after Covid-19 vaccines began going into arms before the CDC issued its first attempt at outlining the activities vaccinated people could safely undertake.

Some public health experts are asking the same question.

Most experts interviewed for this story say the agency has struggled to take advantage of the latest scientific findings to communicate as rapidly as possible with the American public.

Two former CDC directors, Tom Frieden and Rich Besser, both acknowledged to STAT that the CDC has continually labored to quickly release guidance — though, like Benjamin, defended the agency.

Still, public health officials say the conservative nature of the agency’s approach to Covid is a marked departure from how it deals with other major public health issues, like HIV and opioid use disorder.

There, public health officials by and large embrace harm reduction: giving honest advice on how to make risky behaviors safer, rather than discouraging activities altogether.

For injection drug use, that means supporting needle exchanges and providing advice on cleaning syringes; for STDs, it means making sure those at outsized risk, like sex workers, have easy access to condoms.

It even discouraged vaccinated people from traveling in March guidance in which it laid out what vaccinated people can and cannot safely do.

The agency issued guidance that day saying “fully vaccinated people can travel at low risk to themselves.” But CDC Director Rochelle Walensky contradicted the guidelines almost immediately.

The CDC’s new guidance on reopening summer camps, for example, recommends that everyone at a camp, including children older than 2 and fully vaccinated adults, wear masks at all times — even outdoors — except when swimming or eating.

The guidance seemed disconnected from the science, which has continually shown that the risk of catching Covid-19 outdoors is low compared to the risk of indoor transmission.

Former FDA Commissioner Scott Gottlieb called the guidance “byzantine.” Libertarian publications are equating it with the government recommending “that summer camps treat kids like prisoners.” Even Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, acknowledged last week that the guidelines “certainly are conservative” and “a bit strict.”.

The CDC has faced similar criticism over its recent guidelines on when vaccinated and unvaccinated people need to wear masks.

That guidance recommends that vaccinated people continue to wear masks at crowded outdoor events, and at nearly all types of indoor gatherings.

Experts, like Emory University’s Carlos del Rio, have criticized the guidance as too timid, and everyone from talk show hosts, like Noah of “The Daily Show,” to public health experts, like Virginia Tech’s Linsey Marr, have complained that the guidance, with a color-coded chart attempting to explain when to wear a mask, is too confusing.

Even those who vociferously defended the CDC in interviews with STAT admitted that the CDC’s masking guidelines could have been clearer.

Public health officials worry that the CDC is making it harder to beat back the Covid-19 pandemic by issuing guidance that is so timid, and doing it slowly.

They worry, too, that guidelines, like the CDC’s advice on masking, so seriously underplay the benefits of getting vaccinated that they risk dissuading people from getting a shot in the first place.

“It looks like there’s still confusion, and what people are wanting from the CDC … is more certainty,” said Glen Nowak, a 14-year veteran of the CDC’s communications department who now teaches at the University of Georgia.

Even former CDC director Frieden told STAT he believes the CDC “needs to be better at emphasizing with how sick and tired people are with restrictions,” though he largely defended the CDC’s guidelines.

Besser, the former acting CDC director, also acknowledged that certain CDC guidelines, including advice on what vaccinated people can safely do, were released later than he would have liked.

If 100 volunteers got got vaccinated, then infected with virus in April and May, we would likely have the efficacy data in June and July – and then, on a volunteer basis , give the vaccine to anyone who wants it – or if you have too much demand, only to high risk people who want it