Public health experts are recommending that the US resume using Johnson & Johnson’s coronavirus vaccine, after immunizations were halted to investigate reports of rare blood clots.
A Centers for Disease Control and Prevention advisory committee voted 10 to 4, with 1 abstention, on Friday that use of the shot should resume. US health regulators will now craft new language to be included along with the vaccine, warning of the risk of unusual clots in women under 50.
Use of the vaccine had been paused since April 13, amid rare reports that several people who’d gotten the shot had developed a rare type of blood clot, along with a drop in their platelet levels. Platelets are the part of your blood that binds together to form clots.
Officials have identified 15 cases of these clots, called cerebral venous sinus thrombosis (CVST), in women who’d received the shot. Three of the women have died. (A 16th case, in a young man, was observed during J&J’s clinical trials).
The risk is highest for women between the ages of 30 and 39, according to data presented to the committee Friday.
“The last 11 days, to me, have been reassuring because we haven’t identified hundreds of cases across the US,” said Dr. Grace Lee, an associate chief medical officer at Stanford Children’s Hospital , who serves on the committee.
The FDA will change the label on J&J’s shot
J&J’s vaccine was authorized for emergency use by the Food and Drug Administration in February. The FDA will need to update the emergency use authorization for J&J’s vaccine with information warning about the risk of rare blood clots.
Public confidence in the vaccine has dropped significantly in the week and a half since this pause began. Just 19% of Americans would now be willing to get the shot, according to data presented to the advisory group Friday.
J&J representatives said the company’s shot should be reintroduced because it holds up well against virus variants that are spreading in the US. The vaccine is also a single-shot that can be stored in standard refrigerators. That makes it easier to give to people who are homebound, homeless, scared of needles, or incarcerated.
Before the federal pause, 6% of Americans overall said they’d prefer to get a one dose coronavirus vaccine, a statistic that held true regardless of a person’s age, sex, or income.
These unusual cases of CVST clots in patients with low platelets have not been meaningfully connected in any way to the messenger RNA vaccines from Pfizer and Moderna. J&J’s shot is also significantly cheaper than both Pfizer and Moderna’s mRNA vaccines, making it a critical tool in fighting back the virus worldwide.
Without J&J’s vaccine, the CDC’s Dr. Sara Oliver estimated it would take 14 days longer to immunize all adults in the US.
These highly unusual brain clots, though exceedingly rare, have shown up in about one in a million vaccine recipients so far, resulting in one death. More cases may still be unreported (the clots we know about haven’t shown up until 6-13 days after vaccination), making it hard for experts to gauge the true scale of the issue.
Last week, an independent advisory committee that makes vaccine recommendations to the Centers for Disease Control and Prevention made a plea to shot-givers across the US: let’s continue to pause use of this vaccine for now, to gather more data on how many of these dangerous clots are really out there.
But all signs are suggesting that the pause could be coming to an end this weekend.
Insider spoke with five of the 15 CDC vaccine advisory committee members who are meeting on Friday to vote on whether to continue the J&J pause across the US. Barring any more major surprises in the data, they all seemed eager to get the vaccine back into syringes and arms across the nation ASAP.
Millions of Americans got the shot before it was paused
As of last Wednesday, monitoring from the federal government and J&J collectively had flagged a total of seven worrisome clot cases in women under the age of 60, plus one case (during clinical trials) in a young man.
CDC Director Rochelle Walensky hinted at a White House briefing earlier this week that at least another “handful” of cases have been spotted during this week and a half long pause.
Are these one-in-a-million clots caused by the vaccine, or just a fluke?
The clots, cases of cerebral venous sinus thrombosis (CVST) are especially worrisome because they come with low blood platelet levels (thrombocytopenia). That means one of the most common blood clot treatments (heparin) only makes them worse.
Symptoms almost always start with a headache and some chills. Then they progress into severe abdominal pain and loss of consciousness. Eventually they can lead to brain damage and language impairment.
Some on the advisory committee, like Dr. Kevin Ault, an OBGYN at the University of Kansas, still haven’t ruled out the possibility that these cases could just be a fluke, and not related to vaccine administration at all. Others are more convinced this rare but worrisome issue is a highly unusual vaccine reaction.
“I think almost surely this is going to turn out to be related to the vaccine because of the clustering and because of the extraordinary, unusual presentation and findings of the patients who have it,” Dr. Sarah Long, a professor of pediatrics at Drexel University who’s serving on the committee, said.
Without more data, advisors say they are sort of flying blind
Every expert on the committee that Insider spoke to said they want to know if there have been any more cases of the rare blood clots reported in the interim.
That will help them better decide whether to warn certain populations (like young women) about getting this shot.
“We’re a data-driven group. So I want to see data,” Ault said. “We’re glad the system worked, that we were able to find a one in a million potential problem, with this rather unusual diagnosis.”
Advisors may ask for the shot may to come with a warning for women
Long said if cases continue to be clustered in younger women, there could be a warning given out with the shot, “or we could say we recommend it only for men and older women.”
Dr Wilbur Chen, a professor at the University of Maryland School of Medicine on the committee, is hopeful that with more public awareness about the rare condition, it can be recognized early and treated appropriately, avoiding prolonged hospitalizations and more deaths.
“For women 18 to 48 years, or 18 to 50 maybe, we may say ‘you may get vaccinated, but we’d like to just make sure that you are aware of this very rare event,'” he said.
Like putting on a helmet before riding a bike or fastening a seatbelt before driving a car, safety measures can be implemented, he added.
“You can’t completely remove risk with any vaccination, but you can darn well try to make sure that you reduce risk as much as possible,” Chen said. “And that’s what we’re trying to do at this point.”
Ultimately, all of the advisors want us to find a way to reap the benefits of this one-shot vaccine
Experts desperately want to put the J&J shot to use. It is the only one-shot COVID-19 vaccine on the market in the US, making it a critical tool in places like college campuses, homeless shelters, and for homebound adults who may all have logistical challenges to getting a second shot.
“I think it’s extremely unlikely that we’re going to say it’s too risky to use this vaccine,” Dr. Jose Romero, chair of the advisory committee, and director of the Arkansas Department of Public Health, said, suggesting that the issue is likely an “abnormal immune response” that a very small number of patients may have to the shot.
Romero, like others on the committee, is hopeful that the pause will reinforce public confidence in the vaccine safety system. But, with new variants spreading quickly, they all know time is of the essence.
“I’m not willing and eager to continue the pause for much further,” Chen said. “The truth is that the value of the vaccine is proven. 100% efficacy against hospitalization and death is virtually what the data is showing, so that’s terrific. And on the other side for the safety, we think that this [clotting] is super rare.”
‘Are we blowing this up out of proportion?’
Other committee members have warned that the longer this pause goes on, the more hesitant people may be to take the shot once it’s back in action.
“I have mixed feelings,” Lynn Bahta, an infectious disease nurse at the Minnesota Department of Public Health who is also on the panel, said. “Are we blowing this up out of proportion?”
She agreed it’s important that the public knows experts are being cautious and careful, taking vaccine safety seriously, but “to keep delaying is not helpful,” she said.
Some states, like Maine, were planning to rely heavily on J&J to vaccinate homebound residents, and they are now having trouble getting as many people vaccinated as quickly as they had originally intended.
Dr. Walensky has signaled that as soon as the advisory committee makes a final decision on Friday, the CDC and FDA will work together to quickly incorporate their advice into the national vaccination plan.
“I don’t want to get ahead of the advisory committee,” she told NBC’s Today show Thursday, while adding “I’m really hopeful that we’ll be able to use the [J&J] vaccine soon.”
An expert panel that advises the Centers for Disease Control and Prevention recommended continuing the pause on administering Johnson & Johnson’s COVID-19 vaccine.
The agency is weighing whether to adjust its recommendations for the shot after at least six cases of rare but potentially fatal blood clots surfaced in people who’d recently been vaccinated.
But a last-minute advisory-committee meeting on Wednesday failed to yield a definitive answer to that question, with the panel concluding that the pause should continue and more data should be gathered.
Doctors and public-health experts overwhelmingly felt uneasy making a firm recommendation based on the minuscule amount of data available.
“I just don’t feel we have enough information to make an evidence-based decision” Dr. Beth Bell, a professor of global health at the University of Washington, said during the CDC Advisory Committee on Immunization Practices (ACIP) meeting Wednesday afternoon.
“It’s important from the perspective of the public: When we say rare, what does that mean? I want to be able to feel comfortable with my family members and myself getting this vaccine,” she added.
More data emerging on the people with rare CVST blood clots
The CDC and Food and Drug Administration had already recommended a pause on administration of J&J’s COVID-19 vaccine “out of an abundance of caution,” the two agencies said in a joint statement Tuesday morning.
That recommendation came after at least six cases of a rare type of blood clot called cerebral venous sinus thrombosis (CVST) were reported in women across the US. The clots occurred between six and 13 days after administration of J&J’s one-dose vaccine. One of the women, who was 45 years old, died, while two others are still in intensive care.
During the meeting, Aran Maree, the chief medical officer for Janssen, the medical-research arm of Johnson & Johnson, said a seventh woman, a 59-year-old, developed CVST after she received the vaccine in the US.
“Really, headache is the initial presenting feature,” Dr. Tom Shimabukuro from the CDC said during the ACIP meeting.
Many of the patients also had a low platelet count, which makes it difficult for the body to clot blood. A low platelet count also makes it dangerous to administer one of the most common blood-clot treatments, the blood thinner heparin.
An ‘abundance of caution’ prompted the pause
More than 7.2 million people across the US have received the J&J one-dose jab. It is both cheaper and easier to distribute than messenger-RNA vaccines.
With a goal to give out 200 million shots by President Joe Biden’s 100th day in office (April 30) – and a global push to build immunity quickly – a pause is a setback, some of the panelists said.
“Any extension of the pause will invariably result in the fact that the most vulnerable individuals in the country who would benefit from the Johnson & Johnson vaccine will remain vulnerable,” Nirav Shah, the director of Maine’s CDC, said during the meeting.
The news in the US also prompted worldwide movement away from J&J’s shot.
The company announced on Tuesday that it would “proactively delay” its vaccine rollout in Europe and pause all clinical trials of its vaccine around the world until guidance is updated. Australia also said it was not planning to buy any J&J shots.
South Africa is putting J&J’s vaccine on pause, effectively halting that country’s vaccine drive entirely, since no other COVID-19 vaccines are available there. Among the more than 289,000 healthcare workers who have been vaccinated in South Africa, none of these clots have been reported.
Tell Americans how to spot the signs of a blood clot, advisors said
One of the key reasons that the federal government recommended the pause, CDC Director Rochelle Walensky said during a White House press briefing on Wednesday morning, was to inform clinicians of the best ways to treat this type of rare clot.
“Usually, an anticoagulant drug called heparin is used to treat blood clots,” the joint statement from the CDC and FDA said. “In this setting, administration of heparin may be dangerous, and alternative treatments need to be given.”
There is a lot that isn’t known about these blood clots and what, if any, role J&J’s vaccine plays. Those open questions include how common it is for people to develop CVST blood clots when they have low platelet counts and how these clots compare with what’s been reported around the AstraZeneca vaccine.
Though CVST blood clots are exceedingly rare, symptoms to watch out for include severe headache, abdominal pain, leg pain, or shortness of breath within three weeks of vaccine administration, the CDC and FDA said.
Maree said: “We strongly support ensuring vaccine awareness of the signs and symptoms of this very rare event, as well as the recommendations to ensure the correct diagnosis, treatment, and reporting by healthcare professionals.”
J&J uses the same kind of vaccine technology as AstraZeneca
Regulators in the UK have recommended that people under 30 not take the AstraZeneca vaccine because of the very minor risk of clots, and other European countries are recommending the shots should be given to older adults only.
The Biden administration has said that removing the J&J shot from the nation’s vaccination article will not have a significant effect on its April 30 goal.
“Over the last few weeks, we have made available more than 25 million doses of Pfizer and Moderna each week, and in fact this week we will make available 28 million doses of these vaccines,” Jeff Zients, the White House’s COVID-19 response coordinator, said in a statement.
He added: “This is more than enough supply to continue the current pace of vaccinations of 3 million shots per day, and meet the President’s goal of 200 million shots by his 100th day in office.”
Massachusetts’ COVID-19 immunization program, for one, was “built primarily on the back on the Pfizer and Moderna vaccines,” Gov. Charlie Baker said Wednesday. The state received 11,600 doses of J&J’s vaccine last week, compared with a combined 380,000 doses of Pfizer’s and Moderna’s shots.
Federal officials have already said that Massachusetts will receive about an 8% increase in its Pfizer and Moderna vaccine allocation next week, Baker said.
Massachusetts had planned to allocate its Johnson & Johnson vaccine supply to homebound patients. Replacing that vaccine with the two-shot mRNA vaccines will double the work to vaccinate those people.
But a new Centers for Disease Control and Prevention study suggests that could be a great way to invite COVID-19 to spread aboard flights, especially when passengers might lower their masks to eat or drink.
The CDC report, out Wednesday, estimated how far coronavirus aerosols (airborne particles that can linger) could spread on a plane. To do this, researchers modeled how a similar virus spread among mannequins in a lab when they weren’t wearing masks.
The study found that leaving middle seats empty to space out passengers and their germs could help reduce viral exposure in flight when people take off their masks or if their masks have gaps in them.
For instance, the study found that sitting two seats from an infectious person could reduce a passenger’s risk of exposure to “viable virus” particles by 23% compared with their risk sitting right next to an infectious person with their mask off. That risk could be reduced by as much as 57% in a three-row section with vacant middle seats.
While masks are now required apparel on major airlines and very few cases of COVID-19 spreading aboard planes have been documented during the pandemic, masks aren’t perfect at trapping viral aerosols in flight.
A recent case study from New Zealand suggested that even masked airline passengers who have COVID-19 could emit aerosols capable of infecting passengers around them.
The new CDC study, though an imperfect approximation of how people behave on planes during the pandemic, is a good reminder that layers of protection – masks, distance, and frequent handwashing – are much better at preventing the spread of the virus than a single protocol.
If you’re still disinfecting just about everything you own to prevent the spread of COVID-19, it’s time to stop.
The Centers for Disease Control and Prevention (CDC) updated its guidance Monday for how to clean and disinfect surfaces properly to prevent the spread of COVID-19 at home and in facilities.
The agency now says, by and large, good old fashioned cleaning with soap and water or detergent can protect against COVID-19 infections just fine.
You don’t need to waste time trying to completely obliterate this virus on surfaces using sprays and disinfectant.
“In most situations, regular cleaning of surfaces with soap and detergent – not necessarily disinfecting those surfaces – is enough to reduce the risk of COVID-19 spread,” CDC Director Rochelle Walensky said on Monday during the White House’s COVID-19 briefing.
A growing body of research shows that regular soap and water cleaning is usually enough to wash away this virus and prevent infections. It’s more important to worry about wearing a mask in public and avoiding person to person spread of COVID-19 through close contact.
“People can be infected through contact with contaminated surfaces, but I mean, really the risk is low, based on the science,” a CDC spokesperson who helped develop the agency’s new guidance told Insider.
The risk of contracting COVID-19 from surfaces is low
Effective cleaning removes germs from surfaces. Disinfecting goes a step further, by killing them on the spot.
But disinfection for the coronavirus, which is a respiratory virus that is most often spread through person to person contact, is not really necessary most of the time.
Former Florida state toxicologist David Krause, an independent expert who used to chair the American Industrial Hygiene Association’s indoor environmental quality committee, generally agrees with the CDC’s new stance on cleaning and disinfecting.
“I’m a full advocate of soap and water effective cleaning,” he told Insider. “You’re better off trying to physically capture [the coronavirus] and remove it than you are trying to destroy its genetic capabilities.”
Applying disinfectant without properly cleaning surfaces first “consumes most of the disinfectant,” Krause said, and just spreads germs around.
The CDC raised doubts about high-tech UV disinfectants
What’s more, the CDC says that there’s no good evidence that “alternative” disinfection methods, like UV radiation, LED blue lights, or sanitizing “tunnels” really work to kill the virus.
Many so-called “disinfectants” made specifically for electronics aren’t fully effective against the coronavirus either, since they contain alcohol to dry quickly. (Disinfectants usually need to stay wet for several minutes to take full effect.)
If you are going to disinfect, the CDC says read the product label first, follow the manufacturer’s instructions for safe use, and wear gloves.
Disinfection without proper ventilation is bad for our health
“Fogging disinfectants willy-nilly in a building is usually ineffective,” Krause said.
That’s because most foggers are designed to work in very specific (high) concentrations, and on very specific surfaces. Fogging at the levels needed to truly nix viruses from a space can make it difficult for people to breathe.
Disinfection should exclusively target high-touch surfaces and common spaces where strangers meet
The CDC said that disinfection of shared spaces may be beneficial if it’s in an area where COVID-19 case rates are high, it’s not easy to wash your hands, or there are vulnerable populations using a space.
“If people are caring for people who are sick, that’s constant exposure to infectious virus,” a CDC spokesperson said. “People should be cleaning and disinfecting high-touch surfaces and things that that person has touched.”
Krause recommends taking special care with high-touch surfaces including TV remotes, doorknobs, kitchen counters, and shared bathrooms.
“Hopefully, there’s less burden on facility managers and teachers and just people trying to follow our guidance,” the CDC spokesperson said. “They’ll realize ‘OK, essentially in most cases, routine or daily cleaning is enough.'”
How to safely use disinfectant products if you have to
According to Krause, “most cleaning and disinfecting products are very safe, if used in accordance with the label.”
Still, he stresses that if you are disinfecting at home, you should:
Make sure to properly clean the surfaces you’re disinfecting first. (So the disinfectant can then actually do its work).
Read the product instructions in full, so that you know how the disinfectant works (most will need to stay wet for at least a few minutes).
And finally, “open up the windows, open up the doors” to ventilate the space as you’re cleaning and disinfecting, Krause said.
Centers for Disease Control and Prevention Director Rochelle Walensky is touting new CDC data that suggests people who have been fully vaccinated almost never carry COVID-19.
During an MSNBC interview with Rachel Maddow on Monday, Walensky said: “Our data from the CDC today suggests that vaccinated people do not carry the virus, don’t get sick, and that it’s not just in the clinical trials, but it’s also in real-world data.”
Fully vaccinated people almost never test positive for COVID-19
Walensky was referring to a new CDC study of nearly 4,000 frontline workers, some vaccinated and some not, who tested themselves weekly for COVID-19 infections between December and March.
Among fully vaccinated people in the study, there were only three “breakthrough” COVID-19 infections detected. In stark contrast, unvaccinated participants in the study logged 161 COVID-19 cases.
In other words, getting vaccinated with two shots of Pfizer or Moderna’s vaccines, and then allowing those vaccines two full weeks to take effect, quite nearly zeroed out all detectable infections – whether they were asymptomatic or not.
This is a great sign, because it means that vaccinated people likely protect those around them from catching the coronavirus very, very well.
But, more data is still needed to say so definitively, which is why researchers are currently recruiting thousands of college students across the country to find out more about the likelihood of asymptomatic spread of this virus among vaccinated people.
“We hope that within the next five or so months we’ll be able to answer the very important question about whether vaccinated people get infected asymptomatically, and if they do, do they transmit the infection to others,” Dr. Anthony Fauci, the nation’s top infectious-disease expert, said at a White House COVID-19 task force briefing on Friday.
Walensky is still worried about a fourth surge, because many Americans are not vaccinated yet, and variants are here
On MSNBC, Walensky also spoke about the challenges ahead for the country to exit the pandemic.
New, more transmissible virus variants are spreading fast, at a time when a majority of younger US adults have not been vaccinated quite yet. Walensky shared her fears about a forth surge on the horizon this spring.
“We’ve done so well in vaccinating the more senior members of our society that deaths might not be what we would expect with prior surges. It’s also the case, though, that, you know, if we don’t see those number of deaths, the deaths that we’re going to see is among younger people,” Walensky told Maddow. “Obviously, we don’t want to see those either.”
“I’m watching the cases tick up, I’m watching us have increased numbers of hyper-transmissible variants, I’m watching our travel numbers tick up,” she said. “I have seen what it looks like to anticipate the oncoming surge. You know, we`re still losing people at 1,000 deaths a day.”
Walensky stressed the renewed importance of getting shots into arms quickly now, not just to curb the spread of new variants, hospitalizations, and deaths, but also to tamp down on the potential for lasting effects of COVID-19.
“We know that about 10% of the population that gets sick with COVID has long haul syndrome, has symptoms beyond three weeks, cardiac challenges, depression and mental health challenges, pulmonary challenges, renal failure, clotting,” Walensky said.
Some long-haul COVID-19 patients are now finding that getting vaccinated can help them feel better, after many months of such lingering issues.
“Right now I’m scared,” Walensky said during the White House’s COVID-19 press briefing, citing troubling trends in new coronavirus cases, hospitalizations, and deaths across the US.
After the country’s daily coronavirus case rates peaked in early January at more than 315,000, they dropped steadily through mid-March. But average daily cases have risen about 15% in the last two weeks and average weekly hospitalizations have increased 5%, even as vaccinations continue to ramp up.
Twenty-eight US states have seen an uptick in daily cases over the last few weeks. Michigan’s average weekly cases increased almost four-fold in the last five weeks, while New York’s average weekly case number rose 42% in the last two weeks.
US deaths are still trending down for now, overall, but they typically follow at least three weeks behind rises in cases. An increase in hospitalizations is usually a sign that deaths will follow. At least eight states have already seen daily deaths increase in the last two weeks.
“I’m asking you to just hold on a little longer, to get vaccinated when you can, so that all of those people that we all love will still be here when this pandemic ends,” Walensky said.
Walensky fears a 4th surge
Walensky warned of “the recurring feeling I have of impending doom,” when looking at the nation’s COVID-19 case numbers lately.
“I’m speaking today not necessarily as your CDC director, not only as your CDC director, but as a wife, as a mother, as a daughter, to ask you to just hold on a little while longer,” she said. “I so badly want to be done. I know you all so badly want to be done. We are just almost there, but not quite yet.”
Some experts think that as the three authorized COVID-19 vaccines become widely available, Americans are getting the false impression that it’s safe to dine indoors, go to bars, or attend large gatherings – whether or not they’re fully vaccinated. Several states, including Texas and Georgia, have already eliminated capacity restrictions for restaurants and bars. At least 16 states no longer have mask requirements.
“For the health of our country, we must work together now to prevent a fourth surge,” Walensky said.
At the same briefing on Monday, Dr. Anthony Fauci, President Joe Biden’s chief medical advisor, attributed the recent increase in US cases to the nation “really doing things prematurely right now with regard to opening up.”
‘I know what it’s like … to be the last person to touch someone else’s loved one’
Walensky reminded Americans that “we are not powerless” against the virus. She encouraged everyone to continue continue masking, distancing, washing hands, and staying home.
Roughly a third of the country’s adults have had at least one vaccine dose, and a growing body of emerging evidence suggests vaccines do indeed reduce coronavirus transmission, in addition to blunting severe COVID-19 symptoms. But more transmissible variants mean the virus is “probably less forgiving” when people don’t take precautions, Walensky said.
“I know what it’s like as a physician, to stand in that patient room – gowned, gloved, masked, shielded – and to be the last person to touch someone else’s loved one,” she said. “I know what it’s like to pull up to your hospital every day, and see the extra morgue sitting outside.”
The change came after new research from Massachusetts published earlier this month showed that it made little difference to coronavirus case rates whether students and staff in elementary, middle, and high schools in that state were spaced 3 feet or 6 feet apart.
But the new 3-foot rule does not apply in every situation.
The CDC says teachers and staff still need to maintain 6 feet
The CDC’s new guidance does not extend to adults and teachers in schools, who should still maintain 6 feet of distance between one another, the agency said.
“Transmission between staff is more common,” the CDC’s new guidance reads, citing numerous studies that suggest the same.
And, in “areas of high community transmission,” everyone in middle school and high school should still continue to maintain 6 feet of distance at all times, unless classrooms are podding students together, the CDC added.
More distance is also critical when masks can’t be worn (such as in cafeterias where students are eating), and when kids are breathing heavily, as they do when singing, playing music, and exercising.
“Move these activities outdoors, or to large, well-ventilated space when possible,” the CDC said.
The new 3 foot rule will make it easier to arrange classroom space
Experts (including Dr. Anthony Fauci) have been heralding the change in recent days, knowing it will make a big practical difference in classrooms where there isn’t always enough space to keep every child six feet from their classmates.
“One of the things that’s going to hamper return to schools is the 6 feet rule,” Dr. Ashish Jha, dean of the Brown University School of Public Health told reporters earlier this month, after the Massachusetts study came out.
“I really think that the evidence right now does not back up the need for that,” Jha added. “Teachers and students can be kept safe without that rule.”
Other strategies the CDC suggested to help curb the spread of disease in the classroom included facing students’ desks in the same direction when possible, eliminating or reducing staff meetings and lunches, and more widespread screening tests.
The new guidance also stresses the continued importance of cohorting students into distinct groups or pods that stay together throughout the day, to prevent widespread transmission if there ever is an outbreak.
6 feet was never a hard and fast rule built for every situation
The guidance change is our latest reminder that 6 feet is an arbitrary number, and that people may be able to get away with less spacing (or need more) depending on the situation they’re in, as well as what the coronavirus is doing where they live and work.
Important factors to consider when deciding how much space you need to make between people from different households include: how old the people are, how rampant coronavirus transmission is in the area, how good the ventilation is, whether people have been tested and/or vaccinated, and if everyone is wearing masks, or not.
“Everybody’s gotta be masked up in schools,” Jha said.
The World Health Organization already recommends a 1-meter distance (that’s about 3.3 feet) between people to prevent the spread of COVID-19, but the agency also stresses that “the further away, the better,” and adds that indoors, people should be spaced out more than that.
In addition to prioritizing more ventilation and adequate spacing in the new guidance, the CDC got rid of the agency’s previous recommendations for more physical barriers (like sneeze guards) to prevent the spread of COVID-19 in schools. The CDC said there just isn’t enough evidence to suggest such physical dividers really do much to prevent the spread of this virus between people at all.
President Biden is taking a victory lap around the US, even as COVID-19 continues to spread.
On Wednesday, he toured parts of Pennsylvania, and on Friday he’ll be in Georgia, as part of the White House’s “Help is Here” tour touting the new COVID-19 relief money – which includes a fresh round of $1,400 payments to qualifying Americans.
Health experts agree: domestic travel should be a perk for the vaccinated
Dr. Carlos del Rio, a distinguished professor of medicine at Emory University, is just one of the latest to join other health professionals in recommending behaviors that the CDC does not yet.
“Yes, you can travel if you’ve been fully vaccinated,” del Rio said Monday on a JAMA livestream. “You know, wear a mask et cetera, but it’s going to be safe.”
Other big public health names arguing it’s alright for vaccinated people to travel, as long as they’ve given their shots several weeks to take effect include: Dr. Leana Wen (former Baltimore health commissioner), Dr. Preeti Malani (chief health officer, University of Michigan), Dr. Ashish Jha (dean, Brown University School of Public Health), and many, many more.
“To continue telling people not to travel is not going to help us,” del Rio added. “People are just not listening.”
Vaccinated people still need to wait several weeks after their shots, and continue wearing a mask in public
President Biden was vaccinated with his first dose of Pfizer’s COVID-19 vaccine on December 21, and completed his two dose course on January 11. Health experts recommend waiting at least two weeks after that before traveling, to make sure the shots have had enough time to take effect.
There are still some minor concerns that vaccinated people may be able to catch, and then spread COVID-19 to others, even if they show no symptoms themselves after that, which is why it’s important for vaccinated people to continue wearing masks. But more and more research is suggesting that is highly unlikely, especially with the vaccines which have been authorized for emergency use in the US, from Pfizer, Moderna, and Johnson & Johnson.
“Bottom line: the vaccines work in the real world,” Dr. Anthony Fauci said, during a White House COVID-19 briefing on Wednesday.
Jet-setting around the globe may not be practical just yet, but short flights to visit extended family members and domestic vacations should be a vaccination perk, according to Wen.
“We can’t have an abstinence-only view on this,” Dr Preeti Malani, the University of Michigan’s chief health officer said on JAMA, stressing the importance of in-person gatherings to our emotional well-being. “We also need to remember that COVID is not the only risk in our life, and that all the other risks need to be balanced with this.”
Biden seems to have already accepted this. It would be nice if his public health agency did too.
It’s been a painful learning curve, but we’ve discovered during this pandemic that when dealing with a virus that often spreads without symptoms, one for which people are generally most contagious before they know they’re sick, masks can help us keep our germs to ourselves in ways that are life-saving and yet simple.
The truth is that masks are going to be with us for many months to come, especially in public spaces, indoors. Yet, we are still largely left in the dark about how to put on a good one when we leave the house. There’s no way to fit test your mask, no one (really) enforcing mask wearing in public, and no clear guidance about the best masks for different purposes.
Researchers and health policy experts agree there are 3 simple ways to make our masked life better
1. Copy NASA’s playbook
NASA often has to tackle tough logistical issues when planning how to get humans (and their digestive systems) into space.
Toilets, especially, have been a topline challenge for decades. When the agency’s in-house engineers come up empty handed, it crowdsources creative new solutions.
In 2020, NASA offered $20,000 to anyone who could design a toilet that could work on the moon. In 2017, the agency awarded $15,000 to a flight surgeon who found a way for astronauts to …. relieve themselves while stuck inside their spacesuits.
Why couldn’t the Centers for Disease Control and Prevention engage in the same kind of crowdsourced, challenge-based hack-a-thon for masks?
“There’s a mask that’s waiting to be invented,” Dr. John Brooks, the CDC’s chief medical officer for COVID-19 response, recently told Insider. “A mask that is easy and comfortable to wear, that filters beautifully, that is simple to take care of, and that’s attractive.”
So where’s the prize money for that?
2. Make good, clear, evidence-based mask rules – and make it expensive to break them
You don’t need the same kind of viral protection in a crowded supermarket that you would going for a run in a quiet neighborhood.
Virus expert and University of Maryland professor Don Milton knows this well: he wears a simple surgical mask if he strolls out for a walk.
“But, when I go to the grocery store, I put my N95 on,” he told Insider.
In South Korea, it’s expensive not to be properly masked in public, but only when it matters most. Masks are mandatory on public transportation, in buffet lines, and at the gym.
Scarves, valved masks and chin-masking won’t cut it, the Korea Disease Control and Prevention Agency says, suggesting that people stick to wearing the country’s Ministry of Food and Drug Safety-approved models (but still allowing any “cloth masks or disposable masks that completely cover both mouth and nose” to do the job.) Violators can be fined around $85.
3. Give people better quality masks
Early on in the pandemic, University of Wisconsin mechanical engineering professor David Rothamer turned his home into a high-quality mask factory, enlisting his partner as its chief seamstress.
“I just wear the masks that my wife makes,” he recently told Insider. “It’s kind of everyone for themselves.”
If he has to run a quick errand to the hardware store, he pops on a mask she’s made that has been lab-tested for performance against tiny viral particles. He says it’s “just three layers of spun-bonded polypropylene” that have been sewn together, using a pattern.
But, he doesn’t think everyone should have to create this kind of sophisticated, homegrown mask-making operation.
“The somewhat frustrating thing is I think there was an opportunity to say, ‘okay, we can use scientists to design this, use experts, design something that’s cheap to produce, do it at high quantities, and get these things out there,'” he said. “But instead you have basically an unregulated bunch of products, nobody really knows how they perform, unless you’re someone like me who has a couple hundred thousand dollars worth of equipment to test it.”
The government could create better mask standards (as South Korea has), regulate, and impose labeling protocols that would keep us safe, all while demonstrating that different masks come with different levels of performance. Then, it could make hundreds of millions of good quality masks available to people across the US.