Welp

I’m sure many of you have seen this by now, but on Thursday night the Washington Post reported on a leaked CDC document. It paints an even more dire picture than the newly updated guidelines imply.

The document is an internal Centers for Disease Control and Prevention slide presentation, shared within the CDC and obtained by The Washington Post. It captures the struggle of the nation’s top public health agency to persuade the public to embrace vaccination and prevention measures, including mask-wearing, as cases surge across the United States and new research suggests vaccinated people can spread the virus.

The document strikes an urgent note, revealing the agency knows it must revamp its public messaging to emphasize vaccination as the best defense against a variant so contagious that it acts almost like a different novel virus, leaping from target to target more swiftly than Ebola or the common cold.

It cites a combination of recently obtained, still-unpublished data from outbreak investigations and outside studies showing that vaccinated individuals infected with delta may be able to transmit the virus as easily as those who are unvaccinated. Vaccinated people infected with delta have measurable viral loads similar to those who are unvaccinated and infected with the variant.

“I finished reading it significantly more concerned than when I began,” Robert Wachter, chairman of the Department of Medicine at the University of California at San Francisco, wrote in an email.

It continues:

The document presents new science but also suggests a new strategy is needed on communication, noting that public trust in vaccines may be undermined when people experience or hear about breakthrough cases, especially after public health officials have described them as rare.

Matthew Seeger, a risk communication expert at Wayne State University in Detroit, said a lack of communication about breakthrough infections has proved problematic. Because public health officials had emphasized the great efficacy of the vaccines, the realization that they aren’t perfect may feel like a betrayal.

“We’ve done a great job of telling the public these are miracle vaccines,” Seeger said. “We have probably fallen a little into the trap of over-reassurance, which is one of the challenges of any crisis communication circumstance.”

The CDC’s revised mask guidance stops short of what the internal document calls for. “Given higher transmissibility and current vaccine coverage, universal masking is essential to reduce transmission of the Delta variant,” it states.

The CDC bears some responsibility for this state of affairs, and possibly not only for messaging during the Trump era.Some argue that it should not have previously relaxed masking guidance. Because there was no way to prevent unvaccinated people from going unmasked, the net effect was a collapse of masking norms.

I don’t know if that’s right, but its not obvious to me what kinds of communications strategies can overcome relentless anti-mask rhetoric from conservative media and Republican officials. Even the belated realization that killing your constituents isn’t a great political strategy seems to only extend to vaccines. Masks are still an instrument of totalitarianism. Or something.

To wit: I first learned about the new guidelines on Facebook – from conservatives blasting the CDC as “politicized” and “untrustworthy,” as well as channeling Kevin McCarthy’s “argument” against the new guidelines.

Without that evidence released though, this week’s mask announcement triggered fierce pushback among many conservatives, including House GOP Leader Kevin McCarthy who claimed the CDC’s decision relied solely on research from India that wasn’t peer-reviewed.

But that claim is misleading. The CDC indeed cites research from India on viral loads as adding to global concerns about transmission post-vaccination. The agency, however, also makes clear that other research and additional studies were under way. And at no point does the CDC cite the research in India as the sole justification for its new mask guidance.

“These early data suggest that breakthrough delta infections are transmissible,” the CDC said of the research in India. “Unpublished data are consistent with this, and additional data collection and studies are underway to understand the level and duration of transmissibility from delta vaccine breakthrough infections in the United States and other settings,” the CDC wrote in a science brief posted online.

McCarthy’s office did not respond to a request for comment on the misleading allegation, which was echoed by other Republicans on Twitter.

“Remember what I said about public health officials losing our trust?” tweeted Texas GOP Rep. Dan Crenshaw.

I’m still processing what this means in terms of visiting my parents – my father, it turns out, needs to be revaccinated. Georgetown is reopening this fall, albeit with a fairly strict vaccination and testing protocol. Still, I’d lay good odds on an outbreak and significant teaching disruptions.

How are you all doing?