The CCC = Confusing Coronavirus Communication: Clarifying CDC guidance.

On May 13th, the CDC basically eliminated mask wearing protocols for vaccinated people.

On news shows and in press interviews since then, doctors and scientists repeatedly stipulate that unvaccinated people need wear masks in order to protect themselves.

This message, however, promotes a fundamental misconception.

Mask wearing supports humanity by diminishing risk— yet not in the way most people believe. It’s a bit counterintuitive.

I wear a mask not predominantly to protect myself, but rather, to keep others safe around me.

By preventing the shedding and spreading of personal droplets when exhaling, coughing, speaking, or singing, my wearing a mask protects the people in my vicinity from possible coronavirus infection.

Nevertheless, the messaging of scientific experts usually goes as follows:

Vaccinated people are largely protected; both from becoming infected, and from shedding virus.

In the rare outlying case when a vaccinated person comes down with Covid, symptoms are mild.

The risk now centers on non-vaccinated people, who need to wear a mask in order to protect themselves.

The fallacy in this reasoning is that unless I as an unvaccinated person wear two masks simultaneously — a cloth mask over a surgical mask (and even then, protection isn’t guaranteed), or outfit myself in full PPE regalia, including a properly fitted N95 — wearing a mask does not insure my health.

Were I to venture about unvaccinated, the only real way I could protect myself would be to make sure other unvaccinated people wear masks in my presence. Of course, in return, they would almost certainly insist I, too, wear a mask. In this manner my mask wearing would, in fact, protect me; but only by implicitly encouraging fellow unvaccinated people to reciprocate.

Complicating matters, however, I have no way to tell who among the strangers I mingle with every day is vaccinated, and who is not.

Yet, this is not the end of the story of ongoing protection.

While I as a vaccinated person may be at greatly reduced individual risk, this doesn’t relieve me of my responsibility for communal safety. More on that, later.

Part of the reason for Confusing Coronavirus Communication (CCC) is that the culture of the United States is largely a ‘me first’ culture.

I do what’s good for me before I consider what’s good for my community or my country.

Part of the cause for CCC is that generating public policy, during a deadly pandemic is tricky business.

Science is ever increasingly understanding the unfolding dynamics.

It’s a complex and challenging picture. There are many scenarios to advise about and plan for. Govermental agencies must create specifc messaging which influences masses of people.

Consider, for a moment, the case of a group of vaccinated people congregating with an unvaccinated person.

The party line holds that the unvaccinated person should be the only one wearing a mask.

Unfortunately, this reasoning makes little sense.

Pursuant to the widely disseminated thinking, the vaccinated people are in almost no danger. If by some chance they came down with Covid, we’re assured their infections would be minimal.

Accordingly though, the unvaccinated person, also, is in almost no danger.

Mr/Ms/Mrs. Unvaccinated doesn’t have to bear the guilt of possibly infecting the vaccinated people because, well, they have all been vaccinated. And, Mr/Ms/Mrs. Unvaccinated won’t get infected by the vaccinated people because the vaccinated people are not shedding virus.

The only time I as an unvaccinated person need wear a mask is when I come into proximity with other unvaccinated people. In this case, the purpose of my mask is not to protect myself, but rather to protect the unvaccinated people around me.

Of course, the rub in all this is that it is impossible to tell who has, and who hasn’t been vaccinated.

And, as no vaccine is 100% effective, there are breakthrough cases; which means some vaccinated people are, in fact, shedding virus.

Adding to the possible confusion, it remains unclear how, and if, I might suffer from long haul Covid, should I happen to become coronavirus infected even after receiving my vaccination.

The life and death stakes involved, the prior mixed up public messaging, and the sometimes previously downright misguided pronouncements all contribute to making accuracy, clarity, and transparency more vital, even than normal.

Public health conversations urgently need to begin to inspire implicit trust.

Zeynep Tufekci’s well conceived opinion piece in the New York Times on May 14th, Maybe We Need Masks Indoors Just a Bit Longer, cites the difficulties in disseminating guidlelines which meet all needs. Even so, she makes a persuasive call for more explicit information.

…rules for behavior in public still need to stay in place indoors to protect the unvaccinated and the immunocompromised, because we’re all in this together.

She goes on to say:

If the unvaccinated still need to wear masks indoors, everyone else needs to do so as well, until prevalence of the virus is more greatly reduced.

Even if the only people not protected by the vaccines were those hesitant to use them or who had false beliefs about them, public health principles would not allow us to say that any threat to their health is their problem, at least not while the virus is still spreading at substantive levels. Infectious diseases create risks for others.

Ms. Tufeckci’s main point is that it is vital to provide detailed clarification which people can rely on to understand how decisions are reached and the foundation for new policy. So that general calm and understanding might prevail, she suggests the pubic be given specific data points at which increasingly relaxed precautions can proceed

If we knew we could eliminate indoor rules when cases go down to a certain level and vaccinations reach a certain percentage of the population, people would better understand rules they were asked to follow.

That would provide greater clarity, and help Americans see the clear data behind crucial government decisions and accept government guidelines.

Dr. Anthony Fauci was specific and reassuring when he appeared on television on MSNBC’s All in with Chris Hayes Monday, May 17th. Even so, he concentrated on prioritizing the new safety and freedom vaccinated people may now enjoy, which has only recently been scientifically verified. While he made the distinction that unvaccinated people need wear masks, he said the purpose for continuing this preventive behavior is primarily to reduce risk for the unvaccinated person. He didn’t emphasize the collective responsibility of both vaccinated or unvaccinated people, to keep unvaccinated people safe.

Dr. Fauci did mention that breakthrough infections, while exceedingly rare, are inevitable. The remote chance exists that a vaccinated person may get infected. Though studies show that virus shedding is also rare in vaccinated people, an infected vaccinated person may be able to infect a non-vaccinated person.

It is complicated in the sense that you’ve got to look at each individual situation.

Take an example of an establishment, a store.

We don’t have passports for vaccines. We don’t know who’s vaccinated and who’s not vaccinated.

I’ve heard of situations I think are quite reasonable that a person who owns an establishment says, ‘OK. They say you don’t have to wear a mask indoors if you are vaccinated. But, I have an establishment in which there may be people who are unvaccinated and infected, and other people who are unvaccinated and not infected.

There’s a risk of transmitting it in my establishment.’

Therefore, that person has every right to say, ‘when you come into my establishment, you better put a mask on, otherwise don’t come in.’

That’s actually happening under certain circumstances.

Dr. Juliet Morrison, Dr. Linsey Marr, along with Dr. Caitlin Rivers, answered pertinent topical questions in So … When Should I Wear a Mask Now?, an informative New York Times ‘Opinion Today’ column by Alexandra Sifferlin, featured on May 17th.

As ascribed in the piece’s credits, Dr. Marr is a professor of civil and environmental engineering at Virginia Tech; Dr. Morrison is a virologist at the University of California, Riverside.

Among other topics, they weighed in on the wisdom of vaccinated people, perhaps, prematurely rushing into returning to a mask-less existence.

Juliet Morrison: I think it was unwise for the C.D.C. to lift the mask mandate for vaccinated people so early in the vaccination campaign. Only 37 percent of people in the United States have been fully vaccinated. The same communities that have been disproportionately affected by the pandemic have also struggled to access vaccines due to poor vaccine distribution efforts. The point of vaccinating most of the population is to get us all to the point where we halt viral transmission. Once we get to that point, everyone can then interact unmasked.

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Linsey Marr: I was surprised, too, by the C.D.C.’s latest guidance on masks for vaccinated people. I did not expect this change for another month or two, after more people have had the chance to be fully vaccinated. If you want to be cautious, it’s a good idea to continue wearing a mask in crowded indoor spaces while the vaccination rate in your community remains low and there are still a lot of cases, particularly if a lot of other people are unmasked. Continuing to wear a mask will reduce the chance that you will experience a breakthrough infection. I hope you’re able to encourage other members of your community to get vaccinated, because the vaccines are very effective and will help us get back to normal.

The CDC’s Thursday, May 13th announcement abruptly relaxed mask wearing restrictions for vaccinated people when congregating with others who are certain also to have been vaccinated.

Unfortunately, the ‘CCC’ remains an important factor.

And so, the safest and wisest course continues to be, even as a vaccinated person, that I predominantly wear a mask; most especially when encountering unfamiliar acquaintances and unvetted strangers.

Mostly, for their sake.

And so, correlatively, for my own.

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