No matter the reason you or someone you know chose to get vaccinated, instead of being rewarded, now the CDC has issued a reversal on their guidelines.
Many Americans who took the COVID-19 vaccine did so to free themselves from mask mandates. In cities like New York people did it in order to attend “vaccinated only” places and events, and rejoin society. Some Americans did it for the greater good of humanity, and the benefit of science.
Dr. Rochelle Walensky, Director of the CDC, states masks are now required [indoors] for all Americans—whether vaccinated or not. This comes just days after Fauci suggested that fully vaccinated Americans ought to return to wearing masks…again.
See the full transcript below:
Dr. Rochelle Walensky: “Thank you all for joining us today. As you have heard from me previously, this pandemic continues to pose a serious threat to the health of all Americans. I have said throughout my tenure at CDC that our guidance and recommendations will follow the science in our efforts to protect the health of as many Americans as possible. And today, we have new science related to the delta variant that requires us to update the guidance regarding what you can do when you are fully vaccinated. Delta variant is showing every day, its willingness to outsmart us, and to be an opportunist in areas where we have not shown a fortified response against it. This week, our data shows that delta remains the predominant in the United States. Eight intense sequence samples contain the Delta variants in recent days, I have seen new scientific data from recent outbreak investigations, showing that the delta various behaves uniquely differently from past strains of the virus that caused COVID-19 information on the Delta various from several states and other countries, indicates that in rare occasions, some vaccinated people infected with a delta variant after vaccination may be contagious and spread the virus to others. This new science is worrisome, and unfortunately warrants an update to our recommendations. First, we continue to strongly encourage everyone to get vaccinated. Getting vaccinated continues to prevent severe illness hospitalization and death. Even with Delta. It also helps reduce the spread of the virus in our communities. Vaccinated individuals continue to represent a very small amount of transmission occurring around the country. We continue to estimate that the risk of a breakthrough infection with symptoms, upon exposure to the Delta variance is reduced by seven fold the reduction is 20-fold for hospitalizations and deaths as CDC has recommended for months, unvaccinated individuals should get vaccinated and continue masking until they are fully vaccinated. In areas with substantial and high transmission, CDC recommends fully vaccinated people wear masks in public, indoor settings. To help prevent the spread of the Delta variant, and protect others. This includes school. CDC recommends that everyone in K to 12 schools, wear a mask indoors, including teachers, staff, students and visitors, regardless of vaccination status. Children should return to full time in person learning in the fall with proper prevention strategies in place. Finally, CDC recommends community leaders encourage vaccination and universal masking to prevent further outbreaks in areas of substantial and high transmission with the Delta variant. Vaccinating more Americans now is more urgent than ever. The highest spread of cases and severe outcomes is happening in places with low vaccination rates, and among unvaccinated people, this moment, and most importantly, The associated illness, suffering and death could have been avoided with higher vaccination coverage in this country. COVID-19 continues to prevent present many challenges and has exacted a tremendous toll on our nation. We continue to follow the science closely and update the guidance, should the science, shift, again, we must take every step we can adopt the Delta variant and the pandemic. And now, I’m happy to take your questions. Thank you.”
Q: [Our first question comes from Adriana Rodriguez.] “Hi, thank you so much for taking my question. I guess the number one question that a lot of people have right now is, You know what does this mean for vaccinated Americans, you know, who are these guidelines, trying to protect? The vaccinated Americans are not commonly hospitalized or dying from COVID and transmission is not as common, you know, are these guidelines mostly trying to protect them or the unvaccinated? And if it’s the latter, then how do these guidelines protect the unvaccinated?”
Dr. Rochelle Walensky: “Thank you for that question, Adriana. I think the most important thing to understand is the vaccines continue to do an exceptional job in protecting the individual who is vaccinated from severe illness, hospitalization, and, and even against mild illness as we have indicated. But your point is well taken and what is different with delta variant than what the alpha variant is that, in those cases, those are rare cases that we have breakthrough infections, we felt it important for people to understand that they have the potential to transmit virus to others. Now importantly to convey in all of this is that of the transmission that is happening in the country right now, the vast majority of transmission occurring is occurring through unvaccinated individuals, but on that exception that there, you might have a vaccine breakthrough, we wanted, we thought it was important for people to understand that they could pass the disease on to someone else, and that is important in the case for example of vaccinated, individuals who might be going to visit an immunocompromised family member. We wanted to make sure that they took the precautions necessary to not pass the virus to those.”
Q: [Our next question comes from Hilary brick. Your line is now open.] “Thanks for taking my question. I just wanted to ask, thinking back to the pandemic of the unvaccinated you were talking about last week, Dr. Walensky, is there a better way to think about the situation with delta now like: what are you telling your vaccinated friends and family when they go out for dinner for example?”
Dr. Rochelle Walensky: “So I think thank you Hilary for that question. I think we still largely are in a pandemic of the unvaccinated. The vast majority of transmission, the vast majority of severe disease hospitalization and death, is almost exclusively happening among unvaccinated people which is why we still very much want to double down on making sure people continue to get vaccinated. That said, you know, if you have a vaccinated, individual who is in a place that with substantial or high transmission they’re contacting a lot of people, one in 20, one in 10 of those contacts, could potentially lead to a breakthrough infection if you have an effectiveness of 90 to 95%. And so that’s why we’re saying in areas of substantial or high transmission, even if you are vaccinated, that we believe it’s important to wear a mask in those settings.”
Q: [Next question comes from Caitlin Collins of CNN Your line is now open.] “Thanks so much, Dr Walensky. Two questions. One, you said that you are seeing some people who are fully vaccinated contribute to the spread. Can you say exactly how many people you have seen from this data that are vaccinated that are spreading this? and secondly when it comes to having everyone regardless of vaccination status wear a mask in school, can you explain the thinking behind that and are you worried that it will take away the incentive for some parents to get their children who are eligible to be vaccinated vaccinated.”
Dr. Rochelle Walensky: “Thank you for the questions Caitlin, first with regard to your first question. We are now actively conducting outbreak investigations of what is occurring in places that are having clusters, and many of you have heard of many of those clusters what we’ve learned in that context is that when we examine the rare or breakthrough infections and we look at the amount of virus in those people. It is pretty similar to the amount of virus in unvaccinated people. We are now continuing to follow those clusters to understand the impact of forward transmission of those vaccinated people but again I want to reiterate, we believe the vast majority of transmission is occurring in unvaccinated people and through unvaccinated people, but unlike the Alpha variant that we had back in May, where we didn’t believe that if you were vaccinated, you could transmit further. This is different now with a Delta variant and we’re seeing now, now that it’s actually possible, if you’re a rare breakthrough infection that you can transmit further which is the reason for the change. With regard to school. When we released our school guidance on July 9. We had less Delta variants in this country we had fewer cases in this country. And importantly, we were really hopeful that we would have more people vaccinated, especially in the demographic between 12 to 17, years old. Next week we have many school systems that are starting around the country, and I think we all agree that children less than 11 And last, are not going to be able to be vaccinated, and with only 30 30% of our kids between 12 and 17 fully vaccinated now more cases in this country and our real effort to try and make sure that our kids can safely get back to full in person learning in the fall, we’re recommending that everybody wear masks right now.”
Q: [Our next question comes from John Luke of CBS News. “Your line is now open.] Hi Dr Walensky. Some people have asked me, Why change mass guidance to protect people who decide not to get vaccinated, even though they can. Can you say something about the role the unvaccinated person who gets infected, even if they have mild or no illness can play in the development of the next variant of concern with that variant potentially going on to have a higher chance of potentially infecting those of us who are vaccinated.”
Dr. Rochelle Walensky: “Yeah, that’s a really important question, thank you for that. The first thing I think we all need to acknowledge that there is there are some people who are not able to be fully vaccinated like children, and some people who are not able to be fully protected even though there are they are vaccinated like immunocompromised people. And so, so, part of the reason for this guidance is to make sure that we can protect those, and that people who are seeing immunocompromised people for example, know how to protect them, even though they themselves may be fully vaccinated. But your point is well taken about those who have made the choice to not get vaccinated and the amount of virus that is circulating in this country right now. So for the amount of viruses circulating in this country among largely among unvaccinated people, the largest concern that I think we in public health and science are worried about is that virus and the potential mutations away we are from a very transmissible virus that has the potential to evade our vaccines in terms of how it protects us from severe disease and deaths. Right now fortunately we are not there, these vaccines, operate, really well in protecting us about severe forms of severe disease and death. But the big concern is that the next variant that might emerge. Just a few mutations potentially away could potentially evade our vaccines. Thanks. Next question please.”
Q: [Our next question comes from Yasmeen Yasmeen Abutaleb from the Washington Post, the line is now open.] “Hi. Thanks for taking my question. I was wondering if you could talk a little bit more about the data showing that some vaccinated individuals have similar viral loads to unvaccinated. And if you could talk about whether the CDC is looking at expanding the mask guidance to maybe require masking indoors and public spaces in all circumstances or other public health measures given the spread of Delta. Thanks.”
Dr. Rochelle Walensky: “Thank you Yasmeen, so as I mentioned in these outbreak investigations we are able to stratify the clusters that we are seeing unfortunately because we have so much disease right now some of these clusters are large, and we’re able to stratify them by a smaller proportion that are vaccinated and break for infections and a larger proportion that are unvaccinated. And so when we look at their C.T. values or otherwise their viral load, what we’re seeing is that they’re actually quite similar. That leads us to believe that the breakthrough infections rare they are, have the potential to forward transmits at the same with the same capacity as an unvaccinated person so the burden is less because there are fewer of them. People wise but the amount of virus is the same between those two strata. In terms of. Otherwise, updating our guidance, we’re not looking at that right now, what I won’t say is if you are in a place that doesn’t have very much disease out there, obviously I should mention is always a personal choice as to whether someone chooses to wear a mask or not, and that should not be something that is stigmatized or, or otherwise. But in terms of our guidance, if you have a vaccine that is 90 to 95% effective and you don’t have very much disease around the chance of you getting infected should you meet somebody is is already pretty low, but then the chance that you’re going to meet somebody who is infected is also pretty low. So we, the potential for this to be a problem is much much lower in areas with low amounts of disease which is why we really need to work hard to get these areas in the country that have substantial and high amounts of transmission right now down to lower amounts of transmission to protect the unvaccinated and get them vaccinated and also to protect the vaccinated.”
Q: [Thank you. Our next question comes from Julie [inaudible] “Your line is now open.] Thanks. Hi, Dr. Walensky, can you tell me whether or not you are intending to start collecting and releasing data on the breakthrough cases? I mean, a while back you had the CDC announce that they were not going to be reporting on this data, but it looks like the Delta variant is changing the equation and a lot of ways. When will we start to see those data?”
Dr. Rochelle Walensky: “Thanks, Julie. Thank you very much for that question because I would like to correct a misperception that is out there. The first thing I want to say is, we are collecting passive reporting data on people who are hospitalized as has died but we recognize that epidemiologically, that is not going to give us the best information with regard to race a breakthrough infection because passive data collection is generally under reported in order to counter that we have been collecting data through more than 20 cohorts of people. These include 10s of 1000s of people who we are following nationwide, and they include healthcare workers, essential workers. Long term care facilities, and in some of these cohorts we’re collecting PCR data from every person in them weekly. So we are absolutely studying and evaluating breakthrough infections in many different sites many different people across the country. We are looking at those data on a weekly, to bi weekly basis and we will be reporting on those soon.”
Q: [Our next question is Cheryl Stover of the New York Times.] “Thank you for taking my call. I am wondering if given what you know know about the Delta variant and the transmissibility, if the CDC is giving any thought to recommending vaccine mandates for instance of the federal workforce, or of the military, which President Biden could impose or mandates, perhaps for schools, or employers?”
Dr. Rochelle Walensky: “Thank you Cheryl so then that’s NOT something that the CDC has jurisdiction over, and we certainly will be technical advisors to the government as they’re making these decisions. What I will say is that we are working. We are recommending that communities look to their community levels and really look to what would motivate their communities to help get vaccinated if businesses believe that it would be a mandate that we encourage them to do so we’re encouraging really any activities that would motivate further vaccination not all communities are going to be responsive to a mandate in the same way so we’re really encouraging communities to look to their own areas and see what would be most motivational to get back to the-“
Q: [Next question comes from Andrew Joseph of STAT Your line is now open.] “Alright. thanks very much for me my question. And apologies if you already did this but can you just sort of define how you assess substantial and high transmission like if someone you know is reading one of our stories wants to know if they, if this applies to them like, how are they supposed to know what their community level of transmission is and, you know, in turn, like when they should be wearing a mask and then you know maybe if rates fall when they can kind of get, you know, put them back away.”
Dr. Rochelle Walensky: “Yeah, thank you for that question Andrew So CDC COVID data tracker tracks the amount of community transmission by county and is updated daily is color coded so substantial is orange and high is red, but I will give you an In fact, most departments of public health and local jurisdictions practice pretty carefully as well we can get you the link of course to find the data. But the important thing I want to do is what it means. Substantial transmission is areas that have 50 to 100 cases per seven days, but cases per 100,000 over a seven day period, and the sample is places that have more than 100 cases per, in a seven day period, or 100,000. So, I do want to sort of articulate this that we have places counties and states here that are now reporting over 300 cases per 100,000 over a seven day period so really an extraordinary amount of viral transmission, which is what we’re concerned about.”
Q: [Thank you. Our next question comes from our Assad Ahmed of AFP. Your line is now open.] “Yeah thanks for doing this Dr. Walensky. Is high caliber masks, because in areas where there’s low vaccination rates, one would expect that, you know masks adoption would also be low, in order to sort of maximize personal protection are you emphasizing N95 masks over cloth and surgical? Thank you.”
Dr. Rochelle Walensky: “Thank you Assad. Right now we’re really motivated to get people masks to prevent transmission, if people have a personal choice as to whether they have access to and want to wear an N95 I believe that’s in their personal decision, the CDC does have guidance as to what are the best masks to wear multi layer cloth masks surgical masks so we’re leaving that to the CDC guidance on masking.”
Q: [Our next question comes from Michael Maloney of KMBC Your line is now open.] “Very good, thank you very much, Doctor, given the definition that you’ve had here of behind substantial transmission, and I understand that you’re doing it county by county. Will you consider much of the state of Missouri. Now, as you know high or substantial transmission and subject to the recommendations that the CDC is making this afternoon, and are some of the clusters that you are investigating, also in the state of Missouri?”
Dr. Rochelle Walensky: “I, um, the state of Missouri. Um, um, I’m actually just even looking but my understanding is the state of Missouri is largely classified as, um, high or substantial it’s not entirely classified it’s not entirely but it’s largely classified as, uh, substantial or high with, With a few exceptions in the counties. Um, and, um, we are collaborating with the state, um, when they ask for assistance related to the, uh, outbreak investigation.”
Conclusion – Dr. Rochelle Walensky: “Thank you so I just want to indicate that this is not a decision that we or CDC have made lightly. This weighs heavily on me I know in 18 months, through this pandemic, not only are people tired, they’re frustrated. We have mental health challenges in this country, we have a lot of continued sickness and death in this country, our health systems are in some places, being overrun for blood is preventable and I know, in the context of all that, it is not a welcomed piece of news that masking is going to be a part of people’s lives who have already been vaccinated. So, this new data weighs heavily on me, this new guidance weighs heavily on me and I just wanted to convey that this was not a decision that was taken lightly, public health experts scientific experts medical experts when we, when I shown them these data have universally said that this required action. I saw it and I felt that when I saw the data myself, so I just wanted to perhaps close and say that this was not something that we took lightly and something that I know weighs heavily with me and with all of America.”
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