CDC’s Reputation Takes Another Hit When Walensky Says Vaccinated People Can Take Off Their Masks

The switcheroo was too sudden.

The most obvious risk communication mistake – or just plain communication mistake – CDC made was the sudden switcheroo in its recommendations. The evidence had been accumulating for months that the COVID-19 vaccines were miraculously effective in keeping vaccinated people from getting sick or making others sick. Lots of commentators had already argued that the time had come to relax the recommended precautions for the fully vaccinated; not only would doing so be safe, they argued, but it would also give vaccine-hesitant people a powerful new incentive to roll up their sleeves.

CDC could have said, “You’re almost certainly right, but it’s a just a little early. Let’s wait a week or two more, till the case count gets even lower and the evidence gets even stronger.” As far as I know, it said nothing like that – no hints of what was coming. Just a couple of days before announcing the new guidance, in fact, Walensky told Congress that masks and social distancing were crucial. Some media stories say she had already given a tentative signoff to the new guidance when she stoutly defended the about-to-be-abandoned guidance. Certainly she offered no tipoff that a big change was probably coming within days.

If CDC didn’t want to hint that change was in the offing, other government agencies might have done so on its behalf – if they had known. But apparently other agencies and even the White House weren’t apprised, much less consulted. OSHA, for example, was in the middle of figuring out mask requirements for workplaces; it would have appreciated a heads-up, and might have suggested a less abrupt rollout.

Part of the suddenness: The new guidance didn’t have much of the communication apparatus that major government announcements usually have. Where were the background briefings? Why was there no presser in Atlanta to follow up on Walensky’s three-minute announcement at the White House? How come there wasn’t a Q&A ready to hand out?

The change in attitude was shocking – and it wasn’t said explicitly enough so it could be defended.

Before there were magnificently effective COVID-19 vaccines, “We’re all in this together” was a crucial pandemic message. The need to protect each other was at the heart of masks, social distancing, and other so-called “non-pharmaceutical interventions.” Though this explicitly communitarian message predated the Biden presidency, it was endlessly echoed by the new president. COVID-19 precautions weren’t only or even mostly things we were doing for ourselves; they were things we were doing for each other, and for our country.

Now, suddenly, CDC was dividing the U.S. population into two cohorts: the vaccinated and the unvaccinated. This dichotomy ignored the inadequately vaccinated, immunocompromised people whose vaccines leave them significantly less protected than other vaccinated people. But the more fundamental shift is the dichotomy itself. By almost all accounts the dichotomy is scientifically sound. The unvaccinated are a tiny threat to the vaccinated. The vaccinated are a tiny threat to the unvaccinated. The unvaccinated significantly threaten only each other. We’re not all in this together anymore.

The U.S. has never been as communitarian a country as it might like to be, certainly not as communitarian as many Asian cultures, for example. That’s part of why the U.S. has had such a tough time these past 16 months; individualistic cultures are intrinsically less able to unite to fight a pandemic than communitarian (or authoritarian) cultures. So a shift in CDC rhetoric from the communitarian to the individualistic might have gone down pretty well. But it needed to be explicit, and it needed to be defended. It wasn’t. It certainly wasn’t explicit and defended on the day the new guidance was announced, and for the most part it hasn’t been explicit and defended in the messaging cleanup efforts since then.

CDC didn’t explain the policy dilemma its new guidance created.

If you’re vaccinated (and your immune system is working properly), you no longer need to wear masks and socially distance in most situations – neither to protect yourself nor to protect others. That’s the key scientific conclusion that CDC was announcing. But unvaccinated people do still need to wear masks and socially distance to protect themselves and others. CDC said that too, though it didn’t underline it enough.

Here’s what CDC didn’t underline at all, and almost seemed not to realize: Since it’s hard to sort the vaccinated from the unvaccinated, it may still make sense to expect or ask or require everyone to wear masks and socially distance, even in situations where the science says vaccinated people could safely not do so.

The new CDC guidance leaves state and local governments, store managements, etc. (even the U.S. House of Representatives) with a dilemma. Or rather a trilemma, with three options:

• Require vaccinated people to take unnecessary precautions because those precautions are necessary for the unvaccinated (to protect themselves, each other, and the immunocompromised).
• Leave unvaccinated people free not to take those necessary precautions, which won’t significantly endanger vaccinated people (though it may frighten and anger them) but will lead to increased infections among the unvaccinated and the immunocompromised.
• Find a way to distinguish vaccinated from unvaccinated people, so you can make the latter but not the former take those precautions (or better yet, get vaccinated so they won’t have to anymore).

CDC should have acknowledged this trilemma, and how daunting it is. Then it would have had a choice. It could have offered recommendations for how best to resolve the trilemma. It might have recommended “vaccine passports,” for example. Or it might have urged a continued communitarian approach despite the science. Or it might have exulted in the new freedom of the vaccinated and urged the unvaccinated to catch up. Or it might have split the baby, recommending one approach when positivity and viral spread are locally high, and a different approach when they’re low. Or it might have suggested that others split the baby; a store, for example, might have “mask required” days and “mask optional” days.

The other choice: CDC could have explicitly disavowed any authority or expertise relevant to this difficult policy trilemma: “The scientific evidence says unvaccinated people need to wear masks and socially distance, but vaccinated people don’t. That’s our call, and we made it. What to do about it is a policy decision that’s beyond our pay grade.”

CDC took neither choice. It basically ignored the policy trilemma.

Some people criticized it for that, rightly so. More people misunderstood (in some cases willfully) what CDC had said. They interpreted CDC as having taken a stance it didn’t take: either that everyone, even the unvaccinated, can safely stop wearing masks and social distancing; or that we can all trust unvaccinated people to keep wearing masks and social distancing.

CDC made neither claim. But the misunderstanding is mostly CDCs fault. (This is a communication truism: The job of communication is to be understood correctly, so all misunderstandings are mostly the source’s fault.) CDC didn’t take a stance on the trilemma. So listeners made up their own minds what CDC’s stance is.

Many critics have willfully compounded the misunderstanding. Expert critics who say “it’s too early to tell people they can take off their masks” rarely say CDC is mistaken that vaccinated people can safely do so. But they intentionally give vaccinated people that impression. They are trying to frighten vaccinated people into continuing to take precautions that vaccinated people no longer need to take. The expert critics rarely explain their real (and defensible) reason, that they don’t want unvaccinated people to take off their masks as well. This is fearmongering. It is dishonest. It creates the misimpression that CDC’s science is wrong. And it leaves the public confused – not by CDC, as they claim, but by them.

CDC didn’t address COVID-19 polarization and outrage.

Just about everybody has noted that COVID-19 policy isn’t just an awful set of policy challenges with uncertain answers. It is also a polarizing set of controversies that have left virtually all Americans angry and mistrustful. Just about everybody, that is, except CDC, which continues to act and speak as if polarization and outrage were not a factor.

It is clear from the media coverage that many people are experiencing high levels of fear, anger, and mistrust (in a word, outrage) as a result of the new CDC guidance. That makes sense for people who are severely immunocompromised; the new guidance genuinely leaves them in the lurch. But why should successfully vaccinated people respond that way to learning that CDC thinks they have next-to-nothing to fear from unmasked unvaccinated people?

Their reaction reminds me of the way neighbors of a polluting factory react when EPA says the factory’s emissions are extremely unlikely to give them cancer. It’s partly that they don’t trust the assurance; what if CDC/EPA is wrong. But in many cases they don’t want to trust the assurance – they see it as an offense. That’s what happens when people are outraged enough. We cheer news that we are endangered because it validates everything we’re thinking and feeling: our previous beliefs; our anger, fear, and mistrust; our hatred and disdain and virtuous sense of superiority vis-à-vis the “other” (the factory management, the willfully unvaccinated). News that we’re not endangered paradoxically exacerbates our outrage because it invalidates all those thoughts and feelings.

I think that’s largely why so many vaccinated people have misinterpreted CDC as claiming they can trust unvaccinated people to keep wearing their masks and social distancing. The misinterpretation frees them to reject the unwelcome news that they are no longer vulnerable; those horrible unvaccinated people can’t be trusted, so we virtuous vaccinated people are still at risk, even though CDC says we’re not.

CDC should have made it much clearer that it wasn’t claiming we can trust unvaccinated people. It was claiming we don’t have to trust them. (Again, the immunocompromised are an exception; so are children who can’t be vaccinated, though their risk is much lower.) People who weren’t outraged heard this message clearly enough in CDC’s announcement of the new guidance. But outrage made it hard to hear.

In addition to making the message clearer, easier to hear and harder to misinterpret, CDC might have addressed the reasons so many people were having trouble hearing it: “After month after month of fearing each other’s very breath, it’s understandably a major adjustment to learn that if you’re vaccinated, you have almost nothing further to fear from your fellow citizens, whether they’re vaccinated or not, even whether they’re infected or not. And to those of us who are angry at their fellow citizens who resisted vaccination: It may take a while to let go of that anger, now that they’re not a risk to you anymore.”

CDC didn’t acknowledge that many people will find it difficult to stop taking precautions like masks and social distancing.

There are several reasons why a vaccinated person might decide to continue taking precautions even under circumstances where CDC now says it’s unnecessary. Maybe they doubt CDC’s understanding of the data. Maybe they’re more risk-averse than most people. Maybe they’re more vulnerable than most people (or think they might be). Maybe they want to make common cause with people who can’t stop taking precautions, perhaps their child or an immunocompromised relative. Maybe they want to send a signal to unvaccinated people that they, too, should keep taking precautions.

But the likeliest reason is that it’s just as hard to adapt to the downward arc of a receding crisis as to its upward arc when it first arrived. Just as many people were slow to adopt precautions that are now second nature, many people – and many of the same people – will be slow to abandon those precautions. That’s a natural, predictable, inevitable phenomenon. I have been struck by the extent of people’s self-knowledge about this. Social media content is full of people ruefully saying they’re having trouble adjusting. It would have helped for CDC to validate that.

CDC didn’t pay enough attention to the people its guidance left in the lurch.

There is zero doubt that some unvaccinated people will abandon masks and social distancing because of the new CDC guidance. Even though the guidance says they shouldn’t, resulting new policies will mean they can. The new guidance will lead other unvaccinated people to decide to get vaccinated. But at least in the short term, various public places will become risker – not meaningfully riskier to successfully vaccinated people, but meaningfully riskier to the unvaccinated and the unsuccessfully vaccinated.

CDC has to have calculated this risk and decided that it is small enough to accept. In most of the U.S., the virus is spreading a lot less right now than it was a few months ago, so the risk is lower than it was. This risk is nonetheless the major downside of the new guidance – and CDC should have acknowledged it. More than acknowledged it: mourned it.

The risk to children who can’t get vaccinated yet is pretty low – though the case for parents policing their children’s masks just got stronger. But the main downside is the risk to severely immunocompromised people, whose vaccinations may have been much less effective than everyone else’s. Their risk will undoubtedly be increased, and their freedom of movement diminished, by the increased number of unmasked people in their midst, people who might or might not be vaccinated.

By not focusing specifically and sadly on this downside, CDC gave many immunocompromised people the impression that it didn’t care about them. Insofar as policy-makers respond to the guidance by loosening mask and social distancing requirements, the guidance did immunocompromised people real harm. By not acknowledging and mourning that harm, CDC added insult to injury.