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Opinion: Latest COVID-19 Guidance from the CDC Endangers America’s Most Vulnerable

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On August 11, 2022, the U.S. Centers for Disease Control & Prevention (CDC) issued new guidance, which includes updated recommendations for how individuals should respond to a potential or confirmed exposure to COVID-19.

By: Andrew Wylam

President, Pandemic Patients

On August 11, 2022, the U.S. Centers for Disease Control & Prevention (CDC) issued new guidance, which includes updated recommendations for how individuals should respond to a potential or confirmed exposure to COVID-19. The agency’s new recommendations represent a significant shift in the government’s approach to the coronavirus pandemic, and the changes place less emphasis overall on reducing the spread of the virus. The CDC’s new guidance has the potential to endanger the health of many of America’s most vulnerable populations, including patients with long COVID, frontline health workers, individuals with compromised immune systems, the elderly, and others at high-risk for severe COVID-19 outcomes.

Regarding face masks, which have been proven to be one of the most effective preventive measures for reducing the spread of COVID-19, the CDC now only recommends wearing a mask following a suspected or confirmed exposure to COVID-19. This recommendation does not recognize the well-established science demonstrating that face masks reduce community transmission of COVID-19 most effectively when used near-universally in public. Face masks are a cost-effective and straightforward solution to reducing the spread of COVID-19, but the CDC has deprioritized their use.

Regarding quarantine, the CDC’s new guidance instructs individuals to isolate from others only following a positive COVID-19 test result, which fails to account for the fact that asymptomatic people can still spread the virus to others. This recommendation may also have the damaging effect of dissuading people from getting tested for COVID-19 once they begin experiencing symptoms to relieve them of the responsibility of isolating away from others for several days. Furthermore, the CDC’s guidance relies heavily on individuals using at-home COVID-19 tests as an indicator of how long they should isolate and when they are no longer infectious. This approach is troublesome, as at-home tests often provide false-negative results.

More relaxed masking requirements and more lenient quarantine measures send a mixed message to Americans who are vulnerable to severe COVID-19 outcomes while the virus is causing nearly 500 deaths per day in the United States. These guidelines place the burden of avoiding exposure to COVID-19 entirely on high-risk individuals instead of encouraging all Americans to take responsibility for reducing the spread of COVID-19, which can be achieved by wearing a face mask in public and indoor spaces. Further, the agency’s relaxed messaging on the coronavirus pandemic will likely encourage less rigorous prevention efforts among the American public, which can undermine the ability of high-risk individuals to avoid being exposed to COVID-19.

In October 2020, researchers published a paper in the Journal of the American Medical Association, which projected the total cost of the coronavirus pandemic from lost economic output and reduced overall health to exceed $16 trillion. The lead author of that paper affirmed the accuracy of that projection in May 2022. The projected economic burden of the coronavirus pandemic will only continue to grow as public health efforts to reduce the spread of COVID-19 lose their urgency. Unfortunately, failing to reduce the spread of COVID-19 is already causing economic turmoil that is threatening the financial security of American families.

The CDC issued its updated guidelines as the Fall semester begins at schools across the country. This situation is reminiscent of Fall 2021 when schools reopened as the Delta variant became the dominant strain of COVID-19 in the United States. Between mid-June and mid-August 2021, hospitalizations for children and adolescents up to the age of 17 increased from 0.3 per 100,000 to 1.4 per 100,000. For those under the age of 4, there was a ten-fold increase in hospitalizations. Similarly, there were nearly ten times as many hospitalizations among unvaccinated adolescents when compared to their vaccinated peers.

The outlook for the Fall semester this year is slightly different, as all children are eligible to receive the COVID-19 vaccine. However, as of this month, the CDC has reported that only 5 percent of children between the ages of 6 months and 4 years have received at least one dose of the COVID-19 vaccine. For children between the ages of 5 and 11, only 17 percent have received at least one dose of the COVID-19 vaccine in some parts of the country and the national average for this population is a mere 37 percent. The population of children who experienced the most severe COVID-19 outcomes during the Delta wave are the same children who now have the lowest vaccination rate.

Now, schools are starting the Fall semester with relaxed masking policies, less effective quarantine measures, low vaccination rates among students, and the highly infectious BA.5 variant of COVID-19 circulating in the air. The consequences may be higher COVID-19 case numbers, more hospitalized children, more children developing long COVID symptoms, more children suffering preventable deaths, and a fertile breeding ground for more dangerous variants. Stronger public health measures are necessary to prevent these outcomes and to protect the health of America’s most vulnerable populations.

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On January 13, 2023, a major study authored by Hannah E. Davis, Lisa McCorkell, Julia Moore Vogel, and Eric J. Topol was published in Nature Reviews Microbiology. This study, titled “Long COVID: major findings, mechanisms and recommendations,” provides a comprehensive overview of long COVID and the current understanding of the associated pathophysiology.

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