HEALTH CARE BRIEFING: How U.S. Decided to Change Mask Guidelines

For a nation mired in a pandemic for more than a year, the biggest step toward a return to normal came suddenly, even to President Joe Biden.

After warning the country last Monday to stay vigilant amid the threat of coronavirus variants, the president found himself three days later striking a different tone, celebrating that the U.S. had already reached a sort of finish line.

Late Wednesday evening, Biden’s White House learned from Rochelle Walensky, head of the Centers for Disease Control and Prevention, that vaccinated Americans could safely shed the face masks that have become a staple of their wardrobes in almost all occasions.

That decision—the most momentous yet in the nation’s battle against Covid-19—was kept under wraps among a small circle of top White House aides that night as they began making arrangements for the president to address the watershed moment the following day.

Thursday’s announcement not only turned the page on painful social restrictions brought on by the pandemic, but also eased tensions around public health directives that have sowed acrimony and division over the past year, largely because of resistance among Republicans.

While it appeared abrupt, the decision was the result of weeks of mounting evidence on the efficacy of coronavirus vaccines collected by the CDC. The agency has erred on the side of caution throughout the pandemic, drawing criticism for doing so even as the number of vaccinated Americans soared.

After making her decision on Wednesday, Walensky briefed Health and Human Services Secretary Xavier Becerra that afternoon before telling the White House around 9 p.m. She and other health officials held television appearances that night and gave no hint of the coming change.

The White House has said it was Walensky’s decision, made “not by us, not by the White House, not by the president, to be very clear,” Press Secretary Jen Psaki said Friday. “Even here, only a small number of people knew” ahead of the announcement, she said.

Walensky understood she’d be criticized regardless, one official familiar with her thinking said—some would say she moved too fast while others would say she moved too slow. She viewed her job as weighing the science and then deciding, the official said.

“The CDC is a science-based organization. They accumulate data and they make decisions based on the data,” Anthony Fauci told MSNBC on Friday. “As more and more data come in, it becomes clear how spectacularly effective these vaccines are.” Read more from Josh Wingrove.

  • Pfizer’s and Moderna’s vaccines were 94% effective against symptomatic Covid-19 in a real-world study of health-care workers that was key to the decision to ease face mask rules. The study “provided the most compelling information to date that Covid-19 vaccines were performing as expected in the real world,” Walensky said in a statement. Read more from Elaine Chen.
  • The decision is creating new challenges for employers trying to comply with federal workplace regulations. The new guidance from the CDC effectively rendered the Occupational Safety and Health Administration’s mask recommendations outdated, Bruce Rolfsen reports.

Biden Speaks Today: Biden will speak at 1 p.m. from the White House on the U.S. Covid-19 response and vaccination program.

Schools Should Maintain Mask Rules, CDC Says: U.S. schools should maintain mask requirements at least through the end of the academic year, the CDC said in its latest guidance. “Universal and correct use of masks should be required” at K-12 schools providing in-person instruction, it said Saturday. “Physical distancing should be maximized to the greatest extent possible.” Read more from Tony Czuczka.

Walmart, Starbucks Among Retailers Dropping Mask Rule: Walmart said fully vaccinated staff and customers can now leave their masks at home, a decision that could influence how other businesses respond to the latest government guidance. Starbucks also dropped a mask requirement for vaccinated customers starting May 17, while staff will continue to be required to wear facial coverings. Walt Disney World Resort made masks optional in common outdoor areas. Read more from Matthew Boyle.

More on the Pandemic

Walensky Says Vaccine Mandates to Be Set Locally: Any mandates in the U.S. to require people to be vaccinated against Covid-19 will be set at the local level by companies and institutions such as colleges, Walensky said. “It may very well be that local businesses, local jurisdictions, will work towards vaccine mandates,” CDC Director Rochelle Walensky told NBC. “That is going to be locally driven and not federally driven.” Read more from Craig Torres and Yueqi Yang.

More on the Pandemic:

No Hidden U.S. Vaccine Stockpile to Send Abroad: Why isn’t the U.S. sharing its extra vaccine doses with the rest of the world? America led the world in buying up the messenger RNA vaccines that have proven most effective against Covid-19. It’s now starting to lead the world in not using them.

Across the U.S., there are more than 27 million unused Moderna doses and 35 million from Pfizer and BioNTech, according to data compiled by the CDC. That’s led to calls by prominent public health voices to pack America’s surplus in dry ice and ship it to places like India, where the outbreak is still raging. “You’re seeing supply exceed demand here and you just know there are excess doses,” said Monica Gandhi, a physician and professor of medicine at the University of California, San Francisco. But while it might seem simple to box up the spares and send them out, the reality is far more complex. Read more from Drew Armstrong and Josh Wingrove.

More Global Headlines:

Happening on the Hill

Pregnancy Protection Bill Passes With GOP Votes: The House passed stronger protections for pregnant workers by a 214-vote margin Friday, highlighting widespread support for one of the few labor measures that could break through the Senate’s partisan logjam. The Pregnant Workers Fairness Act (H.R. 1065) also passed the House in 2020 with broad support, but it wasn’t considered by the GOP-held Senate. Read more from Andrew Kreighbaum.

Hearings on the Hill:

  • CDC Budget: The Senate Appropriations Labor-HHS-Education Subcommittee holds a hearing Wednesday on the Centers for Disease Control and Prevention‘s fiscal 2022 budget. Walensky will testify.
  • Hospital Consolidation: The Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights convenes for a hearing Wednesday on antitrust concerns related to hospital consolidation.
  • Drug Prices: The House Oversight and Reform Committee scheduled a hearing tomorrow on drug prices and will hear testimony from AbbVie CEO Richard Gonzalez.
  • Virus, Supply Chain: The Senate Homeland Security and Governmental Affairs Committee holds a hearing Wednesday on Covid-19 and the medical supply chain and pandemic response gaps.
  • Paid Leave: The Senate Health, Education, Labor and Pensions Committee scheduled a hearing tomorrow to examine access to paid leave for working families.
  • Health Workforce Shortage: The Senate Health, Education, Labor and Pensions Primary Health and Retirement Security Subcommittee meets for a hearing Thursday on health care workforce shortages.
  • Health Care Flexibilities: The Senate Finance Committee holds a hearing Wednesday on Covid-19 health care flexibilities.
  • Emergent & Health: The House Select Subcommittee on the Coronavirus Crisis scheduled a hybrid hearing on Wednesday to examine Emergent BioSolutions, public health and public funds.

What Else to Know

HHS Delays Rule on Medicare Payments for Devices: Medical device companies will see delays before getting paid for new devices after the HHS again postponed Friday a rule that promised cash for companies as soon as their new products were approved. The Biden administration in March had postponed the effective date of the rule as part of its overarching regulatory strategy to review policies released toward the end of Donald Trump‘s presidency for “fact, law, or policy” problems. Read more from Jacquie Lee.

Biden Revokes Immigrant, Health Care Burden Ban: Biden Friday overturned a Trump proclamation suspending entry of immigrants seen as a financial burden to U.S. health-care system. In a statement, Biden said that his administration’s goal of expanding affordable health care access doesn’t require “barring the entry of non-citizens who seek to immigrate lawfully to this country,” Brody Ford reports.

More Headlines:

To contact the reporter on this story: Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com

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