CDC updates guidance for wearing masks
As coronavirus cases surge nationwide, Officials with the Centers for Disease Control and Prevention discuss updated guidance for wearing masks.
and not under embargo at this time I'd like to turn the call over to Dr Belinsky, thank you all for joining us today. As you have heard from me previously, this pandemic continues to pose a serious threat to the health of all americans. I have said throughout my tenure at cBc that our guidance and recommendations will follow the science in our efforts to protect the health of as many americans as possible. And today we have new science related to the delta variant. That requires us to update the guidance regarding what you can do when you are fully vaccinated. The delta variant is showing every day its willingness to outsmart us and to be an opportunist in areas where we have not shown a fortified response against it. This week our data shows that delta remains the predominant variant circulating in the United States. eight in 10 sequence samples contain the delta variants. In recent days I have seen new scientific data from recent outbreak investigations showing that the delta variants behaves uniquely differently from past strains of the virus that caused covid. 19. Information on the delta variants from several states and other countries indicates that in rare occasions some vaccinated infected with adults. A variant after vaccination may be contagious and spread the virus. Other this new science is worrisome and unfortunately warns an update to our recommendations. First, we continue to strongly encourage everyone to get vaccinated. Getting vaccinated continues to prevent severe illness, hospitalization and death. Even with delta, it also helps reduce the spread of the virus in our communities. Vaccinated individuals continue to represent a very small amount of transmission occurring around the country. We continue to estimate that the risk of a break for infection with symptoms upon exposure to the delta variant is reduced by seven fold The reduction of 20 fold for hospitalizations and deaths. As CBC has recommended four months, unvaccinated individuals should get vaccinated and continue masking until they are fully vaccinate in areas with substantial and high transmission. CDC recommends fully vaccinated people wear masks in public indoor settings to help prevent the spread of the delta variants and protect others. This includes schools. CDC recommends that everyone in K to 12 schools wear a mask indoors including teachers. Yeah, students and visitors. Regardless of vaccination status, Children should return to full time in person learning in the fall with proper prevention strategies in place. Finally, CDC recommends community leaders encourage vaccination and universal masking to prevent further outbreaks in areas of substantial and high transmission with the delta variant vaccinating. More americans now is more urgent than ever. The highest spread of cases and severe outcomes is happening in places with low vaccination rates and among unvaccinated people this moment and most important, the associated illness suffering and death could have been avoided with higher vaccination coverage in this country. COVID-19 continues to prevent, presents many challenges and has exacted a tremendous toll on our nation. We continue to follow the science closely and update the guidance. Should the science shift again, we must take every step we can to stop the delta variants and end this pandemic. And now I'm happy to take your questions. Thank you. Thank you. Dr Belinsky Katrina. We're ready for our first question. While we're waiting for our first question, it's going to take the opportunity to let everyone know that is You have questions following the briefing. You please feel free to call our main media line at 404 6393286 Or you can also email those questions to media at CDC dot gov will continue to stand by for our first question. Thank you. Our first question comes from Adriana Rodriguez. Your line is now open. Hi, thank you so much for taking my question. Um I guess the number one question that a lot of people have right now is you know, what does this mean for vaccinated americans? You know, who are these guidelines trying to protect vaccinated americans? Um are not commonly hospitalized or dying from covid and transmission is not as common. You know, are these guidelines mostly trying to protect them or the unvaccinated? And if it's the latter, then how do these guidelines protect the unvaccinated? Thank you for that question Adriana. Um I think the most important thing to understand is the vaccines continue to do an exceptional job in protecting the individual who is vaccinated from severe illness, hospitalization and death. And even against mild ill we have indicated. But your point is well taken. And what is different with the delta variant than what the alpha variant is that in those cases, those rare cases that we have breakthrough infections. We felt it important for people to understand that they have the potential to transmit virus to others. Now importantly to convey in all of this is that of the transmission that is happening in the country right now the vast majority of transmission occurring is occurring through unvaccinated individuals. But on that exception that there you might have a vaccine breakthrough we wanted. We thought it was important for people to understand that they could pass the disease on to someone else and that is important in the case. For example, of a vaccinated individual who might be going to visit an immuno compromised family member. We wanted to make sure that they took the precautions necessary to not pass the virus to the next question please. Our next question comes from Hillary Brick. Your line is now open. Hi, thanks for taking my question. I just wanted to ask, thinking back to um, the pandemic of the unvaccinated you were talking about last week, dr valencia, is there a better way to think about the situation with belt and now like what are you telling your vaccinated friends and family when they go out for dinner, for example. Um, so I think, thank you Hillary for that question. I think we still largely are in a pandemic of the unvaccinated. The vast majority of transmission, the vast majority of severe disease, hospitalization and death is almost exclusively happening among unvaccinated people. Which is why we're so very much want to double down on make sure people continue to get vaccinated. That said um, you know, if you have a vaccinated individual who is in a place that was substantial or high transmission, they're contacting a lot of people. Um one in 21 in 10 of those contacts that could potentially lead to a breakthrough infection if you have uh effectiveness of 90 to 95%. And so that's why we're saying in areas santa or high transmission, even if you are vaccinated that we believe it's important to wear a mask in those settings. Next question please. Our next question comes from Caitlin Collins of CNN your line is now open. Thanks so much. Dr. Walensky. two questions. One you said that you are seeing some people who are fully vaccinated contribute to the spread. Can you say exactly how many people you have seen from this data that are vaccinated that are spreading this? And secondly, when it comes to having everyone, regardless of vaccination status, where a mask in schools, can you explain the thinking behind that? And are you worried that it will take away the incentive for some parents to get their Children who are eligible to be vaccinated vaccinated. Thank you for those questions Caitlin. Um First with regard to your first question, we are now actively um conducting outbreak investigations of what um is occurring in places that are having clusters. Um and and many of you have heard of many of those clusters. What we've learned in that context is that when we examine the rare um breakthrough infections and we look at the amount of virus in those people, it is pretty similar to the amount of virus and unvaccinated people. Um We are now continuing to follow those clusters to understand the impact of forward transmission of those vaccinated people. But again, I want to reiterate, we believe the vast majority of transmission is occurring in unvaccinated people and through unvaccinated people. But unlike the alpha variant that we had back in May where we didn't believe that if you were vaccinated, we could transmit further. Um this is different now with the delta variant and we're seeing now now that it's actually possible if you're a rare breakthrough infection that you can transmit further, which is the reason for the change with regard to school. When we released our school guidance on July nine, We had less delta variants in this country, we had fewer cases in this country and importantly, we were really hopeful that we would have more people vaccinated, especially in the demographic between 12-17 years old. Next week. We have many school systems um, that are starting around the country and I think we we all agree that Children less than 11 and less are not going to be able to be vaccinated and with only 30% of our kids between 12 and 17 fully vaccinated. Now more cases in this country and a real effort try and make sure that our kids can safely get back to full in person learning in the fall. We're recommending that everybody wear masks right now. Next question please. Our next question comes from Jon lapook of cbs News. Your line is open hi dr walensky. Um, some people have asked me why change. Mass guides people who decide not to get vaccinated even though they can, can you say something about the role the unvaccinated person who gets infected, even if they have mild or no illness can play in the development of the next variant of concern with that variant, potentially going on to have a higher chance potentially infecting those of us who are back. Yeah, that's a really important question. Thank you for that. Um the first thing I think we all need to acknowledge that there is there are some people who are not able to be fully vaccinated like Children and some people who are not able to be fully protected even though they are, they are vaccinated like immuno compromised people. And um so so part of the reason for this guidance is to make sure that we can protect those and that people who are seeing immuno compromised people for example know how to protect them even though they themselves may be fully vaccinated. But your point is well taken about those who have made the choice to not get vaccinated and the amount of virus that is circulating in this country right now. So for the amount of virus is circulating in this country among uh largely among unvaccinated people. The largest concern that I think we in public health and science are worried about is that virus and the potential mutations away. We are from a very transmissible virus that has the potential to evade our vaccines in terms of how it protects us from severe disease and death right now, fortunately we are not there. These vaccines operate really well and protecting us about severe form severe disease and death. But the big concern is that the inexperience that might emerge. Just a few mutations potentially away could potentially evade our backs. Thanks next question please. Our next question comes from Yasmin abu talent from the Washington post the line is now open. Hi thanks for taking my question. Um I was wondering if you could talk a little bit more about the data showing that some vaccinated individuals have similar viral loads to unvaccinated. And if you could talk about whether the C. D. C. Is looking at expanding the math guidance um to maybe require masking indoors in public spaces and all circumstances or other public health measures given the spread of Delta. Um Thank you guys mean so as I mentioned in these outbreak investigations we are able to stratify the clusters that we're seeing unfortunately because we have so much disease right now some of these clusters are large and were able to stratify them by smaller proportion that are vaccinated and breakthrough infections and a larger proportion that are unvaccinated. And so when we look at their ct values or otherwise their viral load what we're seeing is that they're actually quite similar. That leads us to believe that the breakthrough infections where they are have the potential to forward transmit at the same with the same capacity as an unvaccinated person. So the burden is less because there are fewer of them. Uh people wise, but the amount of virus is the same between those two strata. Um in terms of uh otherwise updating our guidance, we're not looking at that right now. What I will say is if you are in a place that doesn't have very much disease out there, obviously I should mention is always a personal choice as to whether someone chooses to wear a mask or not and that should not be something that is stigmatized or or otherwise. Um but in terms of our guidance, if you have a vaccine that is 90-95% effective and you don't have very much disease around the chance of you getting infected. Should you meet somebody is is already pretty low. But then the chance that you're going to meet somebody who is um infected is also pretty low. So the the potential for this to be a problem is much much lower in areas with low amounts of disease which is why we really need to work hard to get these areas in the country that have substantial and high amounts of transmission right now. Down to lower amounts of transmission um to protect the unvaccinated and get them back made it also to protect the vaccinated. Thank you question please. Our next question comes from Julius in Khyber workers. Your line is open. Thanks. Hi um sector Lewinsky, can you tell me whether or not you are intending to start collecting and releasing data on the breakthrough cases. I mean a while back you had the CBC announced that they were not going to be uh reporting on this data but it looks like the delta variant changing the equation in a lot of ways. When will we start to see those data? Thanks julie. Thank you very much for that question because I would like to correct a misperception that is out there. The first thing I want to say is we are collecting passive reporting data on people who are hospitalized and have died but we recognize that epidemiologically that is not going to give us the best information with regard to rates of breakthrough infection because passive data collection is generally under reported. In order to counter that. We have been collecting data through more than 20 cohorts of people. These include tens of thousands of people who we are following nationwide and they include healthcare workers, essential workers, long term care facilities. And in some of these cohorts were collecting pcR data from every person in them weekly. So we are absolutely um studying and evaluating breakthrough infections in many different sites, many different people across the country. We are looking at those data on a weekly to bi weekly basis and we will be reporting on those soon. Okay, next question please. Our next question comes from trouble. Still burger of the new york times. The line is now open carol. Are you there Katrina? We move on to the next one and comeback tour again. Certainly. Okay. Our next question comes from Andrew joseph from Staten airline is now open. Hi, um, thanks very much for taking my question. Uh, and I apologize if you already did this, but can you just sort of define how you assess substantial and high transmission? Like if if someone, you know, reading one of our stories, wants to know if they if it's, this applies to them like how are they supposed to know what their community level of transmission is in, you know, in turn, like when they should, were you wearing a mask? And then, you know, maybe if rates fall when they can kind of get, you know, put them back away. Yeah, thank you for that question. Andrew. So, uh cbc Covid data tracker tracks the amount of community transmission by county and is updated daily is color coded. So substantial is orange and high is red, but I will give you, and in fact, most departments of public health and, and local jurisdictions track this pretty carefully as well. We can get you the link of course to find the data. But the important thing I want to, it was what it means. Um, substantial transmission is areas that have 50-100 cases per seven days, cases per 100,000 over a seven day period. And substantial places that have More than 100 cases in a seven day period. Per 100,000. So I do want to sort of articulate that. We have places, counties and states here that are now reporting over 300 cases per 100,000 over a seven day period. So really an extraordinary amount of viral transmission which is what we're concerned about. Next question. Okay our next question is Cheryl stolberg. Your line is now open. Okay can you hear me now? I can thank you. Okay that's great. Thank you for taking my call. I am wondering if given what you now know about the delta variant and the transmissibility if the C. D. C. Is giving any thought to recommending vaccine mandates for instance of the federal workforce or of the military which President biden could impose or mandates perhaps for schools or employers. Um Thank you Sheryl. So that is not something that the C. D. C. Has jurisdiction over. Um We certainly will be technical advisers to the government as they're making these decisions. Um What I will say is that um we are working uh we are recommending that communities um look to their community levels and really look to what would motivate their communities. Two help get vaccinated. If businesses believe that it would be a mandate then we encourage them to do so we're encouraging really any activities that would motivate further vaccination. Not all communities are going to be responsive to a mandate in the same way. So we're really encouraging communities to look to their own areas and see what would be most motivational to get back. Next question. Thank you. Our next question comes from Asylum Ed of a sp. Your line is now open. Yeah. Hi thanks for doing this. Dr walensky high caliber mosques because in areas where there is low vaccination rates, one would expect that mask adoption would also be low in order to sort of maximize personal protection. Are you emphasizing? And 95 masks over cloth and surgical. Thank you. Thank you assad. Right now, we're really motivated to get people mask to prevent transmission. Um, if people have a personal choice as to whether they have access to and want to wear an N 95 leave that to their personal decision, the CbC does have guidance is, um, what are the best mask to wear? Multi layered cloth masks, uh, surgical mask. So, so we're leaving that the CDC guidance on my skin. Next question please. Thank you. Our next question comes from Michael maloney of K and B. C. T. V. Your line is open. Very good. Thank you very much. Doctor Given the definitions that you've had here of behind substantial transmission and I understand that you're doing it county by county. Would you consider much of the state of Missouri now as uh in a high or substantial transmission and subject to uh, the recommendations that CDC is making this afternoon and are some of the clusters that you're investigating also in the state of Missouri. Um, I, the state of Missouri, I'm actually just even looking but my understanding is the state of Missouri is largely classified as higher, substantial. It's not entirely classified. It's not entirely, but it's largely classified as substantial or high with few exceptions in the counties. Um, and we are collaborating with the state. When they asked for us related to the outbreak investigation, Katrina, we have time for two more questions. Thank you. Our next question comes from Jonathan Wilson of SAn Diego Youth Union Tribute. Your line is open. Hi, thank you for taking our questions. I guess one of the big, you know, outstanding questions here is how much compliance we may get from you might expect to get in terms of folks masking up indoors. Have you done any type of modeling work to get a sense of, you can get a certain percent compliance whether that would be sufficient and helping to drive down cases at this time. Just curious about that. Um, you know, we, we worked together. Thank you. Um, we work together with numerous modelling groups. I, I don't specifically know which ones might have examined that. So I think I should probably refrain from asking that right from answering that right now. I suspect that one of the modeling groups has examined this question. I really do believe that masking right now, especially for those unvaccinated, is the temporary measure. What we really need to do down these transmissions in areas of high transmission is to get more and more people vaccinated and in the meantime to use last question mm Next question comes from Kimberly Russell. Your line is open. Okay, Kimberly has disconnected. If if I may may I just have one closing remark. Louis thank you. So I just want to indicate um, That this is not a decision that we are CBC have made lightly. Um, this weighs heavily on me. I know in 18 months through this pandemic. Um, not only are people tired, they're frustrated. We have mental health challenges in this country. We have a lot of continued sickness and death in this country are health systems are in some place being overrun. What is preventable And I know in the context of all that it is not a welcomed piece of news that masking is going to be a part of people's lives who have already been vaccinated. Um So it's this this new data weighs heavily on me. This new guidance weighs heavily on me and I just wanted to convey that this was not a decision that was taken lightly. Um public health experts, scientific experts, medical experts. When we when I shown them these data have universally said that this required action. Um I saw it and I felt it when I saw the data myself. So I just wanted to perhaps close and say that this was not something that we took lightly and something that I know weighs heavily with me and with all of America. Thank you dr Belinsky and thank you all for joining us today. Like I've mentioned earlier, if you have any additional questions, please call our media line at 404 six, Or you can email media at CDC. Thank you. Thank you. This concludes our conference. You may all disconnect. Thank you for your participation.