The great news from the CDC
During my career I have worked with the US Centers for Disease Control and Prevention (CDC) and other national organizations to construct guidelines to reduce the likelihood of new infections in people with an HIV infection, a bone marrow transplant, or who are at risk for tuberculosis.
Each of these documents required countless hours and lots of haggling. When all was said (much was said) and done (not so much was done), we ended up with a cautious, minimal-harm sort of guidance, the predictable outcome of too many disputatious experts elbowing each other to be heard.
This personal experience is why I am wildly impressed with the CDC’s just-released “Recommendations for Fully [Covid-19] Vaccinated People” document. It is clear, decisive, and it puts its proverbial nickel down where the public most needs guidance. The core of the document can be summarized by the simple and great news that a vaccinated grandparent can visit with an unvaccinated, healthy grandchild. In some significant ways: mission accomplished.
The details of the document find more reason for optimism and also attest to the thoroughness of the guidance. Various combinations of visitors — vaccinated from this household, not vaccinated from that; a young adult with an underlying medical problem in this house, everyone healthy in that — are carefully considered. The text uses both words and the latest in public health messaging, a fancy pictographic representation — half children’s book and half dizzying math problem — to explain the dos and don’ts of having a visit.
Spoilsports might complain that the document falls short in non-visit-related specifics. It says nothing, for example, about what to do regarding the upcoming wave of scholastic graduation ceremonies or New York Mets baseball games, other than preserving the deservedly cautious approach such as “taking precautions in public” and avoiding “in-person medium- and large-sized in-person gatherings.”
But by picking the most fraught of all human interactions — the multigenerational family gathering — the CDC has more than done its job.
The upbeat news doesn’t stop with the specifics of this guidance, though. The document likely signals a more basic change in how public health decisions will be made and disseminated. The timeliness and boldness seem to indicate that the CDC under President Joe Biden, and led by Dr Rochelle Walensky, is ready to leave behind its mumble-mouthed voice and rather resolve difficult issues by deciding, not equivocating.
It also suggests that the data behind the grandma-can-hug-grandchild guidance must be quite strong. The new CDC may be bold and daring, but it will never be improvident or capricious. To declare that vaccinated seniors can indeed visit with kids and grandkids — a mix that, should it cause harm, would surely bring re-socialization to a screeching tragic halt — means that the back-room CDC analysts have squeezed the data thoroughly and have made the happy conclusion that the coast, finally, is clear for certain types of interactions.
But perhaps most of all, this new guidance shows the crucial role of government in people’s lives. Tax dollars should and must be used to gather experts, analyze results, draw conclusions and inform the public without political interference. In the last six months, we have seen up close the consequences when politics, not evidence, lead public health policy, crippling public health programs. Now we can experience an amazing sense of both safety and freedom created by allowing specialists to do their jobs.
