We are public health scientists who conduct research to inform evidence-based policy. We were disappointed when the federal Centers for Disease Control and Prevention (CDC) took a radical turn in its COVID-19 prevention policy recommendations.
The CDC recently released new guidance on the assessment of community COVID-19 risk, lifting masking recommendations for most of the country. In their new metrics, the CDC has made a judgment call about what level of severe illness, disability and death is acceptable. Overnight, much of Minnesota was reclassified as low or medium risk, even as we were seeing COVID deaths every day.
We need to ask ourselves whether this is morally tolerable. Many Minnesota entities — cities, schools and institutions, including the University of Minnesota, have followed the CDC's lead.
The CDC's new goal is to focus on medically relevant disease and avoid overburdening health care systems. Their guidance suggests that it is now reasonable to forgo the use of masks in situations that previously were considered a high risk of COVID-19 exposure. The assumption is that, if infected with COVID-19, you will likely not be hospitalized, and if you are, there is hospital capacity to care for you.
As we have seen through previous waves of the pandemic, this is tenuous. It is true until it is not.
The CDC's guidance also assumes that frequent and repeated COVID-19 infections cause minimal long-term harm or severe illness. This ignores the poorly understood risk of long COVID, a risk that may be reduced but not eliminated by vaccination. This ignores the elevated risks of cardiovascular events, diabetes diagnosis and cognitive impairment observed in the months following a COVID-19 infection, including in initially mild cases. While much remains unknown, the evidence we do have is sufficiently compelling that long-term COVID-19 impacts should not be ignored.
We have good information about what works to reduce COVID-19 transmission: vaccination, ventilation and masks. A recent CDC study estimated that consistent N95 mask use reduces the odds of infection by 83%. We also know that universal masking is more effective than one-way masking. When one person masks, they reduce their own exposure to the aerosols of others. When everyone masks, there are far fewer aerosols released into the air in the first place.
The latest CDC guidance does away with universal masking recommendations in favor of putting the onus on individuals at high-risk of severe outcomes to protect themselves. In issuing this guidance, folks at the CDC are making lots of assumptions about your risk tolerance, your aversion to masks and your risks of long-term COVID-19 health consequences.