Many states, including Indiana, have extensively reduced or eliminated COVID-19 restrictions. Additionally, the CDC recently issued the recommendation allowing fully vaccinated individuals to shed their masks and said social distancing is unnecessary for them in most indoor situations, regardless of the vaccination status of others present. There are some exceptions, like public transportation and health care facilities.
The CDC recommendation is reflective of the high efficacy vaccines provide against COVID-19. It’s also an indication that we now know that vaccinated people have extremely low asymptomatic infection rates and rarely spread the virus to others.
The recommendation is also reflective of several factors. COVID statistics have significantly plummeted in recent weeks, partially due to warmer weather, to the lowest numbers of daily cases, hospitalizations and deaths in nearly a year. Vaccination rates have continued to increase—41% of all Americans are fully vaccinated (36% in Indiana). Also, about 30% have been infected, at least temporarily adding to the total immunity in the United States.
But we are still far from the 80% herd immunity through vaccination necessary to be truly safe. There are still 20,000 new cases and hundreds of COVID deaths daily. With vaccine hesitancy and politicization of COVID vaccination, some authorities consider attainment of herd immunity as uncertain. The pandemic is not over.
The CDC recommendation is excellent reassurance for vaccinated individuals. But the CDC did not appropriately anticipate its unintended consequences.
The recommendation is ill-conceived for businesses and public venues where vaccination status is unknown. The CDC guidance regarding masks and other restrictions is being used inappropriately by businesses, state and local health departments, and mayors and governors as an open door to ending COVID restrictions altogether.
It’s not politically feasible in most situations to require people to prove vaccination status or even ask the question. Many states, including Indiana, have prohibited government from issuing vaccine “passports,” and in some states, the prohibition extends to businesses.
The new public health message regarding the pandemic is “personal responsibility,” otherwise known as the “honor system.” Without immunization-status verification, unmasked, unvaccinated persons entering public places extend the threat of spreading COVID-19 to other unvaccinated adults; to children too young to be vaccinated; and to the immunosuppressed, even those who are vaccinated. And with continued spread, the threat of generating more contagious, deadly or vaccine-resistant variants remains.
I am astonished that the CDC and local and state health departments are explicitly depending on the honor system for unvaccinated people to continue mask wearing. When did personal responsibility become an effective public health strategy? Public health officials have never relied on people to act responsibly or prudently. That’s why we have public health regulations.
Is relying on personal responsibility an indication health officials are capitulating on the goal of herd immunity and adopting a “time to move on” approach, or, for those choosing to remain unvaccinated, adopting a “time to accept the consequences” attitude?
Our progress is fragile. We should continue measured restrictions until herd immunity is achieved, while using widespread vaccine passports. Regrettably, we are probably at the point of no return, and these measures are unfeasible. As one World Health Organization official recently said, “We can see the light at the end of the tunnel, but let’s not be blinded by the light.”•
Feldman is a family physician, author, lecturer and former Indiana State Department of Health commissioner for Gov. Frank O’Bannon. Send comments to firstname.lastname@example.org.
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