Wednesday, July 28, 2021

The Morning: A confusing message

Where do the new C.D.C. rules apply?

Good morning. The C.D.C. recommends indoor masking for the vaccinated — but only in some places.

A New York City health care worker speaking to pedestrians about testing and vaccines last week.Desiree Rios for The New York Times

Regional or national?

The C.D.C. has both a polarization problem and a communication problem.

Let's start with the polarization problem: The parts of the country that would benefit most from a new crackdown on Covid-19 — including more frequent mask wearing — are also the places least likely to follow C.D.C. guidance. Many of these communities have been rejecting the advice of medical experts for months, on both masks and vaccines. Another C.D.C. announcement won't change that.

Yet these are the communities that the C.D.C. is trying to influence the most. In its updated guidance yesterday, the agency did not recommend that all vaccinated people again begin wearing masks indoors. The C.D.C. said that only those vaccinated people living in "an area of substantial or high transmission" should do so and published a map online showing which areas qualify:

Centers for Disease Control and Prevention

As you can see, most of the Northeast and upper Midwest, as well as much of the West, have only "moderate" or "low" transmission. If that stays true, vaccinated residents in those places can generally remain unmasked, the C.D.C. says.

There are good reasons for this distinction. Breakthrough infections among the vaccinated appear to be only a modest reason that the number of new cases has been rising, as I explained in Monday's newsletter. When vaccinated people do get the virus, they are less likely to pass it on to others — and much less likely to get very sick.

The chart below offers a snapshot of each state, comparing the share of residents who have received at least one shot with the number of people hospitalized per capita:

'Less likely to succeed'

Who, then, is most likely to listen to the C.D.C.'s new request that vaccinated people wear masks indoors? People who live in the places where it will do the least good. These tend to be politically liberal, highly vaccinated communities where people have been willing to wear masks even more often than the scientific evidence calls for (outdoors, for example).

Dr. Aaron Carroll, the chief health officer of Indiana University, predicted that the new mask guidelines would be less effective than last year's versions. "Leaning heavily on masking and distancing is what we did when we didn't have vaccinations," he wrote in The Times. "Today, such recommendations are less likely to succeed because they are more likely to be followed by those already primed to listen — the vaccinated — and to be fought and ignored by those who aren't."

Much of this reality is beyond the C.D.C.'s control. The country was polarized long before Covid. But the C.D.C. has not maximized its chances of being heard, either. That's the communication problem I mentioned above.

Its announcement of the new guidelines was both vague and technical, making it hard for many nonexperts to understand. The agency did not make clear which parts of the country were affected or how that might change in coming days. Instead, officials used the phrase "high transmission" areas, as if it meant something to most Americans. President Biden, in a public statement, referred to "areas covered by the C.D.C. guidance," leaving listeners to guess what they were.

The White House added to the confusion late yesterday by sending an email to staff members telling them they would again need to wear masks. The email explained that the C.D.C. had recently upgraded Washington, D.C., to having "substantial" transmission, from "moderate." The online C.D.C. map, however, still showed the city as yellow, meaning it had only modest transmission.

All of which raises a question: Should Americans assume that the new mask guidelines will soon apply to almost the entire country — or will remain highly regional, focused on the south and other less vaccinated regions? I asked government officials yesterday, and they didn't have a solid answer.

The power of clarity

Clear messaging is one of the most powerful tools that public health officials have, but only when they use it. And the C.D.C. and the Biden administration did not do so yesterday. They failed to convey whether they wanted the entire country to begin changing its behavior — or whether they were focusing on only some regions, which happen to be the very places that require special attention to reach.

The new guidelines will still probably help somewhat. The highly contagious Delta variant has fueled a rise in cases across the country, which means that masks may make at least a small difference almost everywhere. But more frequent masking in heavily vaccinated communities will almost certainly not make a major difference. The much larger problem is that more than 30 percent of eligible Americans have not been vaccinated.

"The C.D.C.'s new masking recommendations seem fine to me, but it's pretty low stakes as compared to anything related to vaccine policy," Nate Silver of FiveThirtyEight wrote. "If you want to get mad at the public health agencies, get mad at them for not having fully authorized the vaccines yet."

Some experts also said that Americans, frustrated by the long pandemic, need to hear a clear plan for what will allow the masks to come off. "If we want to continue to ask people to step up," Jennifer Nuzzo, a Johns Hopkins University epidemiologist, told The Times, "we need to give them a vision of what we're working toward."

Latest virus news:

  • Students lost months of learning during the pandemic, with the largest losses among Black, Latino and Native students, data shows.
  • Biden said he was considering a vaccine mandate for federal workers. The Washington Post enacted one for its employees, and California State University did so for students and employees.
  • "There are 401,032 people waiting in front of you": South Korea's lag in vaccinations is fueling despair.

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Representatives Liz Cheney of Wyoming and Adam Kinzinger of Illinois greet Capitol Police officers.Oliver Contreras for The New York Times
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One example: outdoor concerts in the Brooklyn neighborhood of Ditmas Park. Before the pandemic, Ditmas Park wasn't exactly a destination for music: It barely has any concert venues. But last summer, it transformed. Artists and musicians already lived there, and because of the pandemic, they stayed local, Robert Elstein, an artist who organized "Artmageddon," a festival on local porches and gardens, told The Times.

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Thanks for spending part of your morning with The Times. See you tomorrow. — David

P.S. A tweet from The Times's Jeanna Smialek, who covers economic policy from Washington:

"The Daily" is about the Jan. 6 investigation. On "The Argument," is the future of work remote?

Claire Moses, Ian Prasad Philbrick and Sanam Yar contributed to The Morning. You can reach the team at themorning@nytimes.com.

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