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With coronavirus infections soaring across the country, federal health officials on Friday urged Americans in the strongest language to take steps to protect themselves – starting with consistent and appropriate use of masks – and have urged local governments to adopt 10 public health measures deemed necessary to contain the pandemic.
The guidelines reflected the agency’s deep concern that the pandemic is escalating further and that many hospitals are reaching a breaking point, which could disrupt health care across the country.
Agency officials have issued increasingly harsh warnings in the final weeks of the Trump administration, and President-elect Joseph R. Biden Jr. has pledged a new national strategy to roll back the virus. On Thursday, Mr Biden said he would call on Americans to wear face protection for 100 days.
For some experts, the CDC’s call seemed to augur for a more comprehensive and coordinated national approach to controlling the pandemic – one consistent with messages from Mr Biden and his advisers.
“We are seeing the CDC and other public health institutions waking up from their policy-induced coma,” said Dr. Thomas R. Frieden, who was the agency’s director under President Barack Obama.
“They’re the ones who align themselves more with the science, which also aligns them more with the Biden administration,” he added.
While none of the guidelines are new, experts said the increase in the number of cases demonstrates the need for a more uniform approach, rather than the patchwork of restrictions adopted by states.
“The role of the CDC is to lead with science,” said Dr. Celine Gounder, infectious disease physician and member of Mr. Biden’s Covid advisory group. “In the absence of strong national guidelines from the CDC, we have had a variety of responses across the country, some more scientifically based than others.
Scientific evidence supporting the effectiveness of some health measures, such as wearing masks, has accumulated, and these measures are urgently needed now to stop the spread, CDC officials said.
While the agency released all of the recommendations from previous directions, the new summary represented the first time the CDC has released a multi-pronged list of state strategies, sort of a battle plan.
“This idea of a 50-state solution is totally unworkable when we live in one country,” said Jennifer Nuzzo, epidemiologist at the Bloomberg School of Public Health at Johns Hopkins University. “We are not going to overcome this pandemic without a concerted national approach.”
The new recommendations place a high priority on keeping schools open, K-12, saying schools should be both “the last to close” and “the first to reopen” because of the critical role they play. ‘they play in providing meals and support services to children. The closures have a disproportionate impact on low-income families, the agency noted.
Officials warned that eating in indoor restaurants was one of the “particularly high-risk scenarios” as diners had to remove their masks. The CDC urged communities to demand face blankets on public transport, which Mr Biden also endorsed, and to expand routine screening to identify asymptomatic people, responsible for around 50% of transmissions.
Failure to follow preventive measures will lead to continued spread of the virus and more unnecessary deaths, said Margaret A. Honein, the CDC’s first author of the report.
She stressed that Americans can take many important steps themselves: wear masks, physically move away from others, limit their contact and avoid non-essential visits to interior spaces.
“We want to make sure that each person is aware that it is in their power to take this critical step: to wear a face mask and prevent transmission, and to maintain a physical distance from others,” said Dr. Honein, member of the Covid-19 agency. emergency response team.
The scientific evidence that masks can both stop an infected person from spreading disease and protect the user from infection is “compelling,” she added. “Obviously not everyone hears how important this is,” she said. “It’s an action anyone can take to protect themselves.”
Americans should also avoid indoor spaces outside the home, as well as crowded outdoor spaces, the CDC said. This includes restaurants and could also apply to some with alfresco dining: the report suggests switching to take-out food service instead.
Americans should be tested if they are exposed to the virus and should cooperate with contact tracers if they are infected, the agency said. They should stay home and postpone their trips, air and ventilate rooms, wash their hands frequently and get vaccinated as soon as they are available.
The exercise should be done outdoors, with a mask and social distancing, the agency said. Remote working should be encouraged and social gatherings should be limited.
In a change, the CDC also urged states and local jurisdictions to encourage and enforce these behaviors, including making it mandatory to wear masks in public spaces and on public transport.
The Trump administration blocked a CDC order in September that would have required passengers to wear masks on planes, buses and subway trains and in transit hubs. Officials in some states continue to resist mask warrants in public spaces. In Florida, which has reported more than a million cases of the coronavirus, Governor Ron DeSantis reiterated his opposition to the masking of warrants earlier this week.
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The CDC urged officials to limit the use of high-risk non-essential indoor spaces, erect physical barriers and visual reminders stressing the need for social distancing, and start planning for distribution and distribution now. administration of vaccines.
The agency is also pushing to increase testing of essential workers who come in contact with the public and people who are otherwise at high risk.
Even with mass vaccinations seemingly imminent, Dr Honein stressed the need to implement such measures. “We see this light at the end of the tunnel, but we need time to get there,” she said.
Johns Hopkins’ Dr Nuzzo and other experts have praised the agency’s new emphasis on prioritizing schools over places like restaurants and bars, a recommendation echoed by Mr Biden and his advisers .
Previous CDC guidelines, released over the summer and processed by the White House, also prompted schools to reopen but were not offset by a scientific assessment of the associated risks, Dr Nuzzo said, adding: “It looked more like a treaty rather than a treaty. than an analysis.
Having all 10 measures in one document is helpful and underscores the message that no strategy can prevent the spread of the virus, experts said. But the document was thin on some details, said Dr Nahid Bhadelia, medical director of the special pathogens unit at Boston Medical Center.
Dr Bhadelia was struck by the suggestion that there could be a coordinated program to distribute masks to people. “I’ve never seen this before, especially for those who are at high risk,” she says. But the CDC has not clarified whether states or employers should provide the masks, she noted.
The new guidelines also highlighted the importance of improving ventilation in indoor spaces, where airborne viruses pose a threat. But the agency might have detailed best practices to minimize confusion, Dr Bhadelia said.
She cited fully enclosed outdoor dining “booths” as an example of misguided solutions that can result from unclear guidelines.
The agency also did not specify what should be the triggers for the restaurant or school closings or which groups were recommended for an increase in testing because of their greater interactions with other people. “I would have liked to see a little more detail,” said Dr Bhadelia.
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