Just in time to go back to school, the Centers for Disease Control and Prevention has issued updated COVID-19 guidelines that are practically guaranteed to increase the spread of the serious acute respiratory virus that has killed more than 1 million Americans, including 672 Shasta County residents since the ongoing global pandemic began in March 2020.
Under the new CDC guidelines, men, women and children who have been exposed to SARS-CoV-2 will no longer be advised to quarantine if they’re asymptomatic, regardless of vaccination status. Instead, they are advised, but not required, to wear a well-fitting mask and get tested.
This applies to students, teachers, administrators and school employees in the K-12 setting, where the CDC no longer recommends using cohorts for in-person learning to slow the spread of the virus. The 6-foot social distancing guideline has been scrapped. Screening testing at school sites is no longer recommended except for high-risk activities such as close-contact sports, choir and theater, but then only if a school chooses to test.
The CDC justified removal of the quarantine requirement based in part on a nationwide blood donor seroprevalence study that examined 1.4 million blood donations over an 18-month period and found that by December 2021, 95 percent of the U.S. population had either been vaccinated against COVID-19 or infected by it. About 66 percent of the study subjects were vaccinated; 39 percent were infected with COVID-19.
“In light of high population levels of anti–SARS-CoV-2 seroprevalence, and to limit social and economic impacts, quarantine of exposed persons is no longer recommended, regardless of vaccination status,” the new guidelines state.
Released earlier this year, the seroprevalence study has helped foster the notion that the United States has achieved a meaningful level of herd immunity against the novel coronavirus and it’s time to get back to business as usual. “Think You’ve Never Had COVID-19? Think Again,” blared a recent promotional tweet by the Wall Street Journal.
The CDC press release announcing the new guidelines touts vaccines, boosters and medical treatments in a layered approach that permits Americans to live and work with the virus, but not eradicate it.
“We’re in a stronger place today as a nation, with more tools—like vaccination, boosters, and treatments—to protect ourselves, and our communities, from severe illness from COVID-19,” said the CDC’s Greta Massetti, co-author of the new guidelines. “We also have a better understanding of how to protect people from being exposed to the virus, like wearing high-quality masks, testing, and improved ventilation. This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives.”
However, a closer read of the seroprevalence study reveals the problem with relying on its results too heavily. Scientists are dealing with a rapidly mutating coronavirus that continuously evolves, producing new variants with the potential to break through vaccines and natural immunity.
“Additional research is needed on the association between combined seroprevalence, protection, and herd immunity,” the authors state in the Journal of the American Medical Association. “[I]nfection- and vaccination-induced protection might be reduced in the setting of SARS-CoV-2 variants, and infection-induced protection might wane more quickly than vaccine-induced protection.”
No longer is the CDC claiming vaccination reduces transmission; breakthrough infections have turned out to be far more common than originally advertised, clouding the picture. One highly cited Israeli study found that protection from infection from the second Pfizer booster shot wanes after just four months, even though protection from serious illness and death remains high.
As it so happens, I received my second Pfizer booster shot four months ago. With no third booster shot yet in the offing and the Omicron BA.5 subvariant sloshing around Shasta County, waning protection from infection makes wearing a mask all the more important, at least for old timers like me.
“Older adults (especially those ages 50 years and older, with risk increasing with older age) are more likely than younger people to get very sick if they get COVID-19,” the new CDC guidelines state. “This means they are more likely to need hospitalization, intensive care, or a ventilator to help them breathe, or they could die. Most COVID-19 deaths occur in people older than 65.”
At 62 years old, I’m classified as high-risk for COVID complications by the CDC. In addition to having several underlying medical conditions, I’m a part-time caretaker for my parents, who are 85 and 81, don’t drive and have their own underlying medical conditions.
The three of us are fully vaccinated, including two booster shots each. We don’t go to restaurants or crowded indoor events. I quit substitute teaching because I didn’t want to infect my parents or myself.
We’ve been wearing well-fitting N-95 masks whenever we go out in public since aerosol researchers began warning COVID-19 was airborne in April 2020. (It took another year before the World Health Organization and the CDC acknowledged this reality.)
I like to think that it’s thanks to these precautions we remain “COVID virgins.” None of us has ever tested positive for novel coronavirus. It’s possible we’ve just been lucky.
I wear an N-95 mask whenever I go out, whether it’s WinCo, Trader Joe’s, Harbor Freight or the County Recorder’s office. I am quite often the only person wearing a mask in these sometimes crowded, poorly ventilated indoor environments. No one has ever made fun of me or put me down for wearing a mask. I see scores of people a lot older than me with obvious underlying health issues yet almost none of them are masked up.
Wearing a mask can make the difference between catching a lethal infection and making it home safely, but don’t take my word for it. Here’s local infectious disease expert Dr. Kelly Kynasto commenting on the latest episode of “Ask the Experts” on Shasta County Public Health’s Shasta Ready website.
“The masking is incredibly effective, it’s worked, I’ve been in and out of numerous COVID rooms, sometimes 50 a day, and I have not gotten COVID,” Kynasto explained, describing her own anecdotal experience. “That’s made me extremely confident that the transmission precautions we’ve put in place are effective.”
On the same episode, local rheumatologist Dr. William Reeder cautioned residents not to be afraid of the ongoing pandemic.
“We should not be fearful of this coronavirus epidemic,” he said. “What we do need to do is change our habit. Who do we meet with, how long do we meet with people, when to wear masks, when can we go without them? Having some degree of immunity is going to be helpful. How do you get the maximum immunity? The easiest and the safest is the vaccine and then booster.”
No recognized expert recommends gaining immunity by infecting yourself with COVID-19 on purpose.
Reeder’s advice is in alignment with the primary message the CDC is sending with its revised guidelines, that keeping up with your vaccinations (and your child’s) is the most important thing you can do to prevent a COVID-19 infection from becoming a serious and life-threatening event—notice they’re no longer saying vaccination prevents infection.
Recognizing the threat COVID-19 presents to people over 50, the immunocompromised and the disabled and the fact that vaccine effectiveness against infections quickly wanes, the CDC has doubled-down on its masking recommendations for at-risk individuals.
People who test positive for COVID-19 are advised to isolate for five days and to wear a mask if they have to be around people. If they have no symptoms after five days, or their symptoms are receding, they may break isolation. If their symptoms are mild to severe, they’re advised to isolate for 10 days.
The new advisements have already been woven into the CDC’s low, medium and high COVID-19 community level framework. Remember, like Capt. Hector Barbossa’s approach to the Pirate Code, the community levels are more like what you call guidelines than actual rules.
When the community level of COVID-19 is low as measured by the percent of hospitalizations on the CDC’s county-level COVID Data Tracker, at-risk individuals should consult with their physicians about which precautions to take. I personally wear my mask even when the community level is low.
When the community level is medium, as it presently is in Shasta County, the CDC recommends that at-risk individuals mask-up with a well-fitting N-95 respirator in indoor public spaces. It also recommends that caregivers and other people around at-risk individuals mask up and get tested if exposed to COVID-19.
When the community level is high, the CDC recommends that high-risk individuals avoid meeting people indoors if possible and wear an N-95 mask if it can’t be avoided. It also recommends that everyone, not just high-risk individuals, wear a mask when indoors in public if the community level is high, including students, teachers, administrators and employees in K-12 schools.
It’s worth repeating that in the seroprevalence study, about 66 percent of the 1.4 million-member study group was vaccinated; 29 percent were unvaccinated. In Shasta County, just 48 percent of the population is vaccinated. Although the exact number of people with immunity from previous infections in Shasta County is unknown, the county’s herd immunity level is presumably lower than 95 percent, which means there’s still plenty of room for COVID-19 to spread.
How many more people die from COVID-19 in Shasta County depends on how many people take the CDC’s new guidelines seriously. We already know that most people who oppose COVID-19 vaccines also oppose wearing a mask to protect the community at large, especially when either item is mandated by local, state or national government. How likely are they to wear a mask and get tested if they’ve been exposed to someone with COVID? Will they self-isolate if they test positive?
Perhaps that’s why there’s nary a whiff of a mandate in the CDC’s new guidelines. The agency knows a large percentage of the population is suffering from COVID fatigue. Plus, an election is coming.
A recent Pew Research poll found just 41 percent consider the ongoing pandemic a major public health threat, even though on a seven-day average it’s currently killing nearly 500 Americans daily, down from 2000 deaths per day during the height of the Delta surge in 2021.
That includes two people killed in recent weeks by COVID in Shasta County, a man in his 40s and a man in his 60s, according to the Shasta Ready COVID-19 dashboard. Shasta County has recorded 33,850 COVD-19 infections since March 2020, resulting in 2076 hospitalizations and 672 deaths.
The vast majority of the deaths, 91 percent, were people over the age of 55. More women have died in Shasta County, 57 percent, than men. There are currently 191 active COVID cases in the county, including 36 people in the hospital and 3 in the ICU.
In an ideal world, everyone would get vaccinated, wear masks and do whatever was required to keep the community safe. Numbers like those above wouldn’t be taken for granted. Obviously, that’s not the planet we’re living on. The overarching attitude in the United States seems to be if you haven’t had COVID yet, don’t worry, you’ll catch it eventually.
It doesn’t have to be that way, especially if you’re an at-risk COVID virgin like me. There are still plenty of good reasons not to catch COVID.
According to the CDC, one-in-five infected people develops Long COVID, with symptoms that can last more than a year or longer. Ask someone who’s constantly short of breath and lost their sense of taste and smell how much fun they’re having.
As COVID has mutated from Alpha to Delta to Omicron, immunity from both vaccination and previous infection has waned with the advent of new variants. To what degree is uncertain. As more cases of COVID-19 reinfection arise, evidence continues to mount that damage to the heart, lungs, kidney, liver and brain by repeated infections may be cumulative.
If you’re over 50 and you have underlying health issues, it doesn’t matter whether you’re vaccinated, have immunity from a previous infection, or you somehow lucked out and never caught COVID-19. Even if you’ve never taken precautions, it’s still time to take precautions.
“You don’t want to catch this” is a frequent refrain from the newly infected seen on Facebook, Twitter and Reddit. It’s no longer unusual to hear news of someone fully vaxxed succumbing to COVID-19, although to be certain vaccination reduces the symptoms of disease for most people.
That means in addition to following the CDC’s advice and catching up on your vaccinations if necessary, you should wear a well-fitting N-95 respirator mask in public spaces where there’s people around, in my opinion even if the COVID-19 community risk level is low. I’ve taken my mask off to eat indoors on several occasions during lulls in the pandemic, but generally I use the drive-thru.
If you have serious underlying health issues or you’re caring for someone who does, you definitely want to wear your mask and avoid large indoor public gatherings when the community level is medium or high, as the CDC recommends.
If the community level is high, the CDC’s new guidance is fairly clear. Everyone is advised to wear a mask indoors in public spaces, including K-12 schools.
Honestly, I don’t expect anyone under 50 to follow the CDC’s advice to mask up when the community COVID level is high, at least here in Shasta County. I never really felt old until the pandemic struck. Now I not only feel old, I feel expendable, even though my demographic comprises one-third of the population.
The CDC’s decision to no longer recommend isolating asymptomatic people who’ve been exposed to COVID-19 may very well lead to an Omicron surge in the fall. For me, it makes returning to substitute teaching, which I enjoy very much, impossible.
I know I’m not alone. I’m part of the Great Resignation, in my case older at-risk workers who’ve voluntarily left the workplace because of COVID-19 safety issues. Many of us have been fortunate to get by working remotely from our homes. Others have gone into early retirement. We’re part of the reason you’re seeing all those help-wanted advertisements.
Apparently, despite the unrestrained divisiveness of our time, some of us over the age of 50 still want to live. If that means wearing a mask in public or not going out in public at all, so be it.
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