Masks, Messaging And COVID: Ed Yong On Why Public Health Is A Shared Responsibility
The CDC now says if you’ve had a COVID vaccine, the choice is yours to wear a mask. Science writer Ed Yong says that’s bad public health PR. We’ll hear why he thinks the message to the nation must be: saving other people’s lives is a shared responsibility.
On the shifting question of the pandemic
Ed Yong: “From a year ago, everyone wanted to know how will the pandemic end. And as vaccinations rise and we actually enter the start of the end game, I think the question is different now. The question really should be for whom has the pandemic not yet ended? Who still bears the risk that remains? And what should the rest of us be doing? How is society still shunting the full collective problem of COVID-19 onto people who are still vulnerable to it?”
On the concern among some public health experts about the CDC’s mask announcement in mid-May
Ed Yong: “The concern is that the CDC is the nation’s top public health agency. Its goal is to protect the health of entire communities, of the entire nation. Its job is to coordinate safety across the entire country. And as a public health agency, its job is to center equity. To think about equity and the most vulnerable at the very core of its advice and its actions.
“And instead its guidance, which revolve mostly around what vaccinated people could or could not now do, centered people who actually have quite a lot of privilege. People who had the earliest and easiest access to the vaccines. And not to the folks who are still incredibly vulnerable to the pandemic, people who are immunocompromised, people who are essential workers, Black and Latino communities with low rates of vaccinations.
“By instead casting their guidance as great news for people who are vaccinated, it’s sent out this cultural signal … that masks are no longer needed, that the pandemic is nearly over, that we are heading back towards this air of normalcy. And that cultural signal led to the lifting of mass mandates in many, many states in creating a situation that further disadvantaged those vulnerable communities who are already disadvantaged during the pandemic.”
On continued access issues to the vaccines
Ed Yong: “My understanding from talking to local public health people and folks who work on the ground and the vaccination game is that there are still access problems in terms of like that physical element. But there are certainly access problems in terms of the other bit that we talked about. Like just being able to take the time to actually get the shots and then to recover from possible side effects.
“And you can see that in some of the surveys that are being conducted. The Kaiser Family Foundation has done some great work on looking at attitudes among people who are unvaccinated. According to their surveys, a third of unvaccinated Hispanic adults want a vaccine as soon as possible, and that’s twice the proportion of unvaccinated white people. But among that group, a large proportion were worried that they might need to miss work because of repeated side effects.
“They were worried that getting vaccination might jeopardize their immigration status or their family’s immigration status. And that’s what I’m talking about. There are still these societal barriers that stand in the way of vaccination, just as there have been societal barriers that have stopped people from taking precautions or keeping themselves free from infection in the first place.”
On the opposing argument that the CDC’s guidance was the right call
Joseph Allen: “I think where the CDC is right, is that they have the science right. And let’s be clear, the vaccines are extraordinarily safe and extraordinary, extraordinarily effective at protecting you and protecting you from others. So that’s quite clear. Then it follows that their guidance is clear. If you’re vaccinated, you can start to pull back from some of these controls.
“If you’re not, the same playbook that has existed for the past year must be followed, or should be followed. That includes masking and everything else. Where I also think they got it right and critics have it wrong is that we’re moving past the point where we need this top-down, prescriptive approach, considering look what’s happening across the country.
“Should Vermont have to follow this top-down guidance when they have extraordinarily or excellent vaccination rates and other states have lower vaccination rates? To me, we needed this freeing up a bit in terms of the top-down guidance. So individual states and even companies could make these separate decisions based on the current risk in their area.”
On the populations that want to get vaccinated, but are having difficulty doing so
Joseph Allen: “Our goal is to protect the most susceptible subpopulations. But I guess I disagree in that having people who are vaccinated not wear masks doesn’t put other people at risk. And so if the vaccines were not effective at preventing transmission, as there was concern about this in early winter, then that would be a different scenario.
“But we know that, for example, if I’m vaccinated, I’m a low risk to anybody else I’m around. And so that’s why I don’t think the CDC’s stance on this isn’t really putting others at risk. I think where it gets interesting is the implementation of this. There are some states that moved too quickly and some organizations and companies that took CDC guidance, which did not say the pandemic is over, but took it to mean that.
“Now, I think we could argue about how the CDC messaged that, and maybe that was the wrong impression they gave out. But really, the guidance is if you’re masked, you don’t need these other controls. And it’s straightforward in that sense, but not so straightforward in the implementation.”
On the future of the pandemic response in the U.S.
Ed Yong: “I think the argument from a lot of public health folks is that the CDC’s responsibility, while it exists for an individual, also primarily exists for the population. And specifically for the most vulnerable people in that population. Like, I am fully vaccinated now, and the CDC should be happy for me. Thank you. But it doesn’t have to prioritize me in its thinking. It needs to prioritize the people who are very unlike me, who have not had access to those vaccines yet.
“And it’s not just an issue of policy, I think. It’s also an issue of framing and of rhetoric. And this goes back to what we talked we said about Walensky’s statement about how your health is in your hands. President Biden also echoed the sentiment. He talked about how it’s your choice. Well, of all people, the director of the CDC should know that your health is not fully in your hands, for two reasons.
“Firstly, it’s an infectious disease. So by its nature, it spreads. But also because your health is determined by all these societal factors, by matters of class, and race and privilege that have echoed across the centuries to influence how individuals bear their risk right now. In place of rhetoric around your health being in your hands, which we know is not true, we could have had consistent messaging about how we are still in this together.
“That we need to look after each other, that we need to look after the people who have less privilege, less access than we do. And I feel that that rhetoric has been incredibly missing. This was an opportunity for us to once again [band] together in a way that we haven’t over the last year, because of divisive messaging.”
From The Reading List
The Atlantic: “The Fundamental Question of the Pandemic Is Shifting” — “During a pandemic, no one’s health is fully in their own hands. No field should understand that more deeply than public health, a discipline distinct from medicine. Whereas doctors and nurses treat sick individuals in front of them, public-health practitioners work to prevent sickness in entire populations.”
Washington Post: “Opinion: The CDC’s critics are wrong. The agency was right to relax indoor masking.” — “Before the coronavirus vaccines arrived, we had few options to help slow the spread of this virus. Masks provided one of the simplest means to help slow the spread and protect yourself and others.”
New York Times: “Many Parts of the U.S. Needed Persuading to Get Vaccinated. Not South Texas.” — “Gabby Garcia did not expect to feel like crying when she sat down for her first dose of the coronavirus vaccine. But as the long needle pierced her skin, she thought back to the agonizing outbreak in her family that killed her sister, hospitalized her brother and also left her ill for days.”
Axios: “Fauci says people are “misinterpreting” the new CDC mask guidance” — “Dr. Anthony Fauci told me for an Axios virtual event airing later today that many Americans are ‘misinterpreting’ the CDC’s new mask guidance, which lets vaccinated individuals forego masks indoors.”
This article was originally published on WBUR.org.
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