4 ms·

Slide 20: >Given increased transmissibility, lower VE, and current vaccine coverage, NPIs needed to reduce transmission of Delta variant >Masking: >• Source

Slide 20: >Given increased transmissibility, lower VE, and current vaccine coverage, NPIs needed to reduce transmission of Delta variant >Masking: >• Source control 40-60% effective >• Personal protection 20-30% effective >NO ADJUSTMENTS FOR OTHER INTERVENTIONS >• e.g., no distancing, no isolation, no gathering restrictions I'm... not sure about that? Delta is infecting people who just walk past each other in indoor spaces: https://www.wsj.com/articles/delta-variants-spread-outpaces-australias-covid-19-contact-tracers-11625045400 https://www.wsj.com/articles/delta-variants-spread-outpaces-... How can you get to 40-60% effectiveness if you have perfect mask wearing, but leave restaurants and bars open? Even wearing a N95 when going to the grocery store and post office or whatever isn't going to help if you then go to a bar and spend an hour maskless with your 100 closest unmasked friends.

SpicyLemonZest 5y ago
Restaurants and bars are open because people really want them to be, not because the CDC recommends it. The CDC offers some suggestions on how to manage the risks of opening restaurants, but there's nothing to change there because they've never revoked their early 2020 guidance that it's a big risk.
- sbierwagen 5y ago
  If there is a secret hidden footnote to "NO ADJUSTMENTS FOR OTHER INTERVENTIONS" and "no distancing, no isolation, no gathering restrictions" that reads "just kidding about that, all restaurants and bars need to be closed immediately" then this slide deck is doing a very bad job of clearly recommending what public heath interventions should be done. Again, why would they recommend universal masking if they know for a fact that it wouldn't do anything? What's the point?
  - SpicyLemonZest 5y ago
    Why hasn't the FDA approved the vaccines, when health experts universally agree they're safe and effective and everyone should get one? I always hate when conversations come to this, because it comes across as a wild hot take, but there's a point where you've just gotta blame organizational dysfunction. It wouldn't be appropriate for the CDC to say "everyone ought to close indoor dining again" or "masks are pointless if you have them off 80% of the time to eat", and they certainly can't say "let's just let the unvaccinated people get sick". So they have to say some other stuff instead.
    - sbierwagen 5y ago
      And in the end, we come to furious agreement: the CDC projections are nonsense, and "40-60%" is too high by orders of magnitude.
    - AndrewBissell 5y ago
      > when health experts universally agree they're safe and effective and everyone should get one This is not true.
    - jpster 5y ago
      Based on a podcast I heard this week FDA approval also looks at quality assurance of mass manufacturing, storage, supply chains, etc. It’s not just about efficacy and safety of the formulation, itself, but whether they can be assured at scale. It takes time to check all those boxes.
      - Throwawayaerlei 5y ago
        That's required to get an Emergency Use Authorization (EUA), is supposed to be why Novavax is behind schedule due to other cell culture based manufacturers soaking up resources, and why Emergent BioSolutions has never gotten approval for their Baltimore plant to make Janssen doses. Was in fact shut down, AZ/Oxford production at it canceled, etc. As I understand it the rolling reviews for mRNA vaccine approval are purely a matter of time to prove for real the length of efficacy of them, that's part of the risk/benefit analysis. Can only be done a day at a time....
  - deleted 5y ago
    [deleted]
aeontech 5y ago
Yeah, this is not a slide of recommendations; that’s describing the model assumptions illustrated by the charts. Essentially, it says “these charts don’t include modeling the impact of any additional mitigations aside from masking”; these charts show that we must enforce universal masking immediately at minimum. On the last slide, “Next Steps for CDC”, they explicitly list: > ▪ Prevention > – Consider vaccine mandates for HCP to protect vulnerable populations > – Universal masking for source control and prevention > – Reconsider other community mitigation strategies Which means they definitely think additional mitigations are worthwhile, but we must start with at least masking. They have a hard job to communicate the specific recommended actions while remaining calm and not causing a panic or making people think that they are over reacting… with everyone ready to jump on them, I do not envy the job.
- sbierwagen 5y ago
  I feel like we are in complete agreement on the facts, but are somehow coming to opposite conclusions. Slide 21, bold red text, surrounded by a red box: "Given higher transmissibility and current vaccine coverage, universal masking is essential to reduce transmission of the Delta variant" If this is supposed to imply that restaurants need to be closed, I feel like it should instead actually explicitly say that, because it means firing a million people, again. If universal masking requires restaurant closing, then masking by itself won't do anything! If masking by itself does nothing, then why dedicate two slides to just masking? If masking does nothing, why give it 40-60% effectiveness? If the graph is totally worthless and means nothing useful, why put it in the presentation? If closing restaurants is mission critical, absolutely required for any other NPI to have any effect at all, then why hide it inside "Reconsider other community mitigation strategies" on the last slide?
  - mafuy 5y ago
    I think you've misunderstood the slide. It says: If we do no other mitigations other than wearing masks (3 variants in the graph), this is what happens. If additional stuff is done, then the risk goes down. It does not say how much, maybe a little, maybe a lot. But such other mitigations are unlikely to happen if the easiest, most effective and most accepted way, wearing masks, is not enforced already. That's why it makes sense to look at the case of masks-only.

SpicyLemonZest 5y ago

Restaurants and bars are open because people really want them to be, not because the CDC recommends it. The CDC offers some suggestions on how to manage the risks of opening restaurants, but there's nothing to change there because they've never revoked their early 2020 guidance that it's a big risk.

sbierwagen 5y ago
If there is a secret hidden footnote to "NO ADJUSTMENTS FOR OTHER INTERVENTIONS" and "no distancing, no isolation, no gathering restrictions" that reads "just kidding about that, all restaurants and bars need to be closed immediately" then this slide deck is doing a very bad job of clearly recommending what public heath interventions should be done. Again, why would they recommend universal masking if they know for a fact that it wouldn't do anything? What's the point?
- SpicyLemonZest 5y ago
  Why hasn't the FDA approved the vaccines, when health experts universally agree they're safe and effective and everyone should get one? I always hate when conversations come to this, because it comes across as a wild hot take, but there's a point where you've just gotta blame organizational dysfunction. It wouldn't be appropriate for the CDC to say "everyone ought to close indoor dining again" or "masks are pointless if you have them off 80% of the time to eat", and they certainly can't say "let's just let the unvaccinated people get sick". So they have to say some other stuff instead.
  - sbierwagen 5y ago
    And in the end, we come to furious agreement: the CDC projections are nonsense, and "40-60%" is too high by orders of magnitude.
  - AndrewBissell 5y ago
    > when health experts universally agree they're safe and effective and everyone should get one This is not true.
  - jpster 5y ago
    Based on a podcast I heard this week FDA approval also looks at quality assurance of mass manufacturing, storage, supply chains, etc. It’s not just about efficacy and safety of the formulation, itself, but whether they can be assured at scale. It takes time to check all those boxes.
    - Throwawayaerlei 5y ago
      That's required to get an Emergency Use Authorization (EUA), is supposed to be why Novavax is behind schedule due to other cell culture based manufacturers soaking up resources, and why Emergent BioSolutions has never gotten approval for their Baltimore plant to make Janssen doses. Was in fact shut down, AZ/Oxford production at it canceled, etc. As I understand it the rolling reviews for mRNA vaccine approval are purely a matter of time to prove for real the length of efficacy of them, that's part of the risk/benefit analysis. Can only be done a day at a time....
- deleted 5y ago
  [deleted]

aeontech 5y ago

Yeah, this is not a slide of recommendations; that’s describing the model assumptions illustrated by the charts. Essentially, it says “these charts don’t include modeling the impact of any additional mitigations aside from masking”; these charts show that we must enforce universal masking immediately at minimum. On the last slide, “Next Steps for CDC”, they explicitly list: > ▪ Prevention > – Consider vaccine mandates for HCP to protect vulnerable populations > – Universal masking for source control and prevention > – Reconsider other community mitigation strategies Which means they definitely think additional mitigations are worthwhile, but we must start with at least masking. They have a hard job to communicate the specific recommended actions while remaining calm and not causing a panic or making people think that they are over reacting… with everyone ready to jump on them, I do not envy the job.

sbierwagen 5y ago
I feel like we are in complete agreement on the facts, but are somehow coming to opposite conclusions. Slide 21, bold red text, surrounded by a red box: "Given higher transmissibility and current vaccine coverage, universal masking is essential to reduce transmission of the Delta variant" If this is supposed to imply that restaurants need to be closed, I feel like it should instead actually explicitly say that, because it means firing a million people, again. If universal masking requires restaurant closing, then masking by itself won't do anything! If masking by itself does nothing, then why dedicate two slides to just masking? If masking does nothing, why give it 40-60% effectiveness? If the graph is totally worthless and means nothing useful, why put it in the presentation? If closing restaurants is mission critical, absolutely required for any other NPI to have any effect at all, then why hide it inside "Reconsider other community mitigation strategies" on the last slide?
- mafuy 5y ago
  I think you've misunderstood the slide. It says: If we do no other mitigations other than wearing masks (3 variants in the graph), this is what happens. If additional stuff is done, then the risk goes down. It does not say how much, maybe a little, maybe a lot. But such other mitigations are unlikely to happen if the easiest, most effective and most accepted way, wearing masks, is not enforced already. That's why it makes sense to look at the case of masks-only.