After more than a year of false starts and premature promises that the coronavirus pandemic was nearing its end, the White House is close to announcing a “roadmap to normalcy,” according to public health experts who are helping draft the plan.
But as Democratic governors and mayors across the nation rush to announce the end of masking and vaccination mandates that have been in place since the darkest days of the coronavirus pandemic, President Joe Biden and the Centers for Disease Control and Prevention are under increasing pressure to move on—science be damned.
“The White House and CDC are in a no-win position,” said David O’Connor, a professor of pathology and laboratory medicine at the University of Wisconsin. “Not only is there not a one-size-fits-all solution that they can recommend to the entire country, but there are a spectrum of reasonable options given a receding Omicron surge in late winter.”
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“Are loosening mask mandates and replacing them with recommendations, along with providing high quality masks, a reasonable policy? Sure,” O’Connor said. “Is keeping mandates in place a bit longer to get through the winter, while more than 2,000 people continue to die each day, reasonable? Sure.”
Health experts and sources familiar with the administration’s deliberations on approaching an “endemic” phase of the coronavirus agree that as the Omicron surge wanes, the pandemic’s key indicators are moving in a positive direction. New cases have fallen by more than 80 percent since their peak last month, and the number of people hospitalized with the virus has fallen by nearly 40 percent in the past two weeks.
“There’s very good reason to believe that we’re approaching an endemic phase,” said Lawrence Gostin, a professor of global health law at Georgetown University. “We’ve got roughly 90 percent of our population that have either vaccine-induced immunity or disease-induced immunity, so you’ve got a very high level of immune protection in the population.”
But with more than 2,300 average daily deaths nationwide—and with the humiliating memory of premature declarations of victory and hastily implemented guidelines and “hopelessly confusing” messaging—the administration is taking a more deliberative track, one that experts say is justified both by science and by political realities.
“We spent so much time pulling out our hair over what we saw as a tendency for the administration—both the Trump and Biden administrations, frankly—to put politics ahead of sound public health measures, and now they’re taking a drubbing for actually putting the science first,” observed one public health expert who has consulted with the CDC on coronavirus policy since the pandemic’s first days. “To go from the ludicrous ‘declaration of independence’ from SARS-CoV-2 to this is progress, definitely, but can’t be easy.”
Biden now appears to be outpaced by many of his fellow Democrats in reliably blue cities and states who have announced rollbacks in masking and vaccination mandates in recent days as case rates have dropped and as their continued enforcement has become politically perilous.
In New Jersey, where Gov. Phil Murphy—a Democrat whose anti-mandate Republican opponent came within 3 points of unseating him in last November’s gubernatorial election—announced last week that students would no longer be required to wear masks in public schools. In New York, Gov. Kathy Hochul allowed requirements for businesses to check vaccination statuses to lapse (although New York City’s requirements remain in effect).
In Washington, D.C., Mayor Muriel Bowser followed suit, announcing that the district’s indoor masking mandate would expire at the end of the month—but the question of whether that would apply to the White House campus itself is still up in the air.
“We’ll wait for the CDC,” White House press secretary Jen Psaki said on Wednesday. “They’re continuing to review mask guidelines and how different communities in the country should assess them, but we’ll wait for the CDC to make any changes here.”
The widespread rollbacks of mandates in blue states, from California and Oregon to Connecticut and New York, reflects an increasingly bipartisan weariness of the restrictions, albeit for vastly different reasons depending on the demographic. Republicans have long chafed at the perceived government overreach of masking and vaccination mandates in schools and workplaces, even during the worst stretches of the pandemic; Democrats, meanwhile, who are more likely to be fully vaccinated and more likely to support mandates on mask-wearing, are increasingly frustrated by following restrictions that are in place to protect those least likely to follow them. A recent survey from Monmouth University found that 70 percent of Americans agree with the statement that “It’s time we accept that COVID is here to stay and we just need to get on with our lives.”
It should be noted that, in most ways, things are more “back to normal” than they have been in two years: restaurants are once again at full capacity, gyms and movie theaters are bustling, music festivals and concerts are dropping masking and vaccination requirements, and commercial air travel is at its highest levels since March 2020, despite no vaccination requirements.
But announcing a step-by-step plan for a return to normalcy that all states can follow, with a “redesign” of the metrics used as benchmarks, would go a long way toward shoring up waning confidence in the government’s handling of the pandemic, said Jason Schwartz, a professor of health policy at the Yale School of Public Health. Schwartz pointed to the CDC’s color-coded “transmission map,” which has been coast-to-coast crimson for months, as a particularly outdated method.
“That tool, which focuses exclusively on raw numbers of positive test results in a county or state over a seven-day period and the test positivity rate, was flawed from the start, since those numbers have been heavily influenced by how robust a state's testing operation has been,” Schwartz said. “But it's even less useful today, given the widespread use of rapid tests that fail to be captured in those numbers as well as the fact that a positive test results means something very different now, particularly in a vaccinated or boosted individual or in highly vaccinated communities, than it did many months ago.”
Sources familiar with the CDC’s discussions about potentially remodeling its COVID-19 guidelines told The Daily Beast that the agency is likely to rely more on measures of severity than on raw transmission and positivity rates—things like hospitalization rates, capacity in medical facilities, and death rates—to inform its guidances.
In addition to changing the metrics to more accurately reflect the comparably lower danger of viral spread within more-vaccinated populations, such a shift would also effectively justify the liberalization of COVID mandates already underway in many states.
Dr. Timothy Brewer, a professor of epidemiology at UCLA's Fielding School of Public Health, said that the current CDC metric for rolling back mask mandates depends on “moderate” community transmission, defined as test positivity rates below 8 percent and fewer than 50 new cases per 100,000 people per week.
“Based on that metric, some communities are probably relaxing their mask mandates too early if just based on public health criteria,” Brewer said. “However, these decision-makers may feel that given that COVID-19 cases, hospitalizations and deaths are now falling in most communities, relaxing mask mandates allows them to maintain reasonable protection of the public's health while moving closer to normalizing life. In this case, both political and public health concerns are probably coming into play to find what is hopefully an acceptable compromise.”
But changes in guidelines can have their own political risks when made too rashly. Dr. Rochelle Walensky, the director of the CDC, was lambasted when the announcement was made that the quarantine period for individuals who test positive for COVID-19 was cut in half without an accompanying testing recommendation.
In a press briefing held by the White House’s COVID response team on Wednesday, Walensky would only preview that the incoming policy changes would be the result of “a very thorough, inclusive process,” with “the science and the medicine at the center.”
“I want to be clear that everything is driven by science and public health,” echoed Jeff Zients, the president’s COVID-19 response coordinator. “Obviously, it’s important to understand the perspectives of different constituencies, including for businesses—how they think through bringing workers back to work, as an example. But public health, science, medicine is the center of the work here.”
That deliberative approach makes sense from both a public health and political perspective, Schwartz said.
“It’s likely that CDC will want to live with this revision to these metrics and frameworks for some time to come, so I understand the desire to take the time necessary to get it right,” Schwartz said. “The backlash—even from inside the administration—and subsequent revisions to the testing guidance at the end of isolation a few months ago might still be fresh in their minds.”
But the White House is acutely aware of the damage that prematurely spiking the football could cause, both from the perspective of pandemic management and from a more crass political calculus. Last summer, with less than half of U.S. adults fully vaccinated, Biden announced that the nation would “celebrate our independence from the virus” on Independence Day, only for a spike in breakthrough cases over that holiday weekend presaging a massive summer surge that forced many localities—and the White House itself—to re-implement masking rules that have been in place ever since.
“I think it was the single greatest mistake of the Biden administration on the COVID response,” Gostin said of that premature declaration of victory. “To call ‘Independence Day’ from COVID at that time raised expectations, and so now, frankly, there’s very little trust.”
