With coronavirus infections soaring across the country, federal health officials on Friday urged Americans in the most powerful language yet to take steps to protect themselves – starting with consistent, appropriate use of masks – and press on governments local authorities to adopt 10 public health measures deemed necessary to contain the pandemic.
The guidelines reflected a deep concern within the agency that the pandemic was spiraling further out of control and that many hospitals were reaching breaking point, potentially disrupting health care across the country.
Agency officials have issued increasingly prominent warnings in the waning weeks of the Trump administration, and President-elect Joseph R. Biden Jr. has pledged a new national strategy to reverse the virus. On Thursday, Mr. Biden said he would call on Americans to wear face covers for 100 days.
For some experts, the CDC’s appeal seemed to add to a more comprehensive and coherent national approach to pandemic management – one consistent with messages from Mr Biden and his advisers.
“We are seeing CDC and other public health organizations waking up from their politically motivated coma,” said Dr. Thomas R. Frieden, who served as the agency’s director under President Barack Obama.
“They are aligning themselves more with science, which is also aligning them more with the Biden administration,” he added.
Although none of the directives are new, experts said the increasing numbers of cases indicate the need for a more uniform approach, rather than the patchwork of restrictions adopted by states.
“The CDC’s role is to lead with the science,” said Dr. Celine Gounder, an infectious disease doctor and member of the Covid advisory group Biden. “In the absence of strong national guidance from the GDC, we have received a variety of responses across the country, some with a more scientific basis than others.”
The scientific evidence supporting the effectiveness of some health measures, such as wearing masks, has been accumulating, and those measures are now urgently needed to stop the spread, CDC officials said.
Although the agency had published all of the recommendations in earlier guidelines, the new summary represented the first time the CDC published a multilateral list of strategies for states, a kind of battle plan.
“This idea of a 50-state solution is completely impractical when we live in one nation,” said Jennifer Nuzzo, an epidemiologist at Johns Hopkins University’s Bloomberg School of Public Health. “We are not going to get past this pandemic unless we have a shared national approach.”
The new recommendations place a high priority on keeping schools open, from kindergarten through 12th grade, saying that schools should be “the last places to close” and “first to reopen” because of their vital role in providing meals and child support services. Closures take a disproportionate toll on low-income families, the agency noted.
Officials warned that eating in indoor restaurants was one of the “very high risk scenarios” because eating people had to remove their masks. The CDC urged communities to ask for face covers on mass transit, something Mr. Biden has also endorsed, and to expand routine screening to identify asymmetrical individuals, who are responsible for about 50 percent of transfers.
Failure to implement the preventive measures will lead to the continuous spread of the virus and more unnecessary deaths, said Margaret A. Honein, the first author of the CDC report.
He emphasized that Americans could take many important steps on their own: wearing masks, physically isolating others, restricting their contacts and avoiding unreasonable visits to indoor places.
“We want to make everyone aware that they can take this vital step: Wear a face mask and prevent transmission, and maintain physical distance from others,” said Dr. Honein, a member of the agency’s Covid-19. emergency response team.
Scientific evidence that masks can prevent an infected person from spreading the disease and protect the consumer from infection is “compelling,” he added. “Obviously not everyone is hearing how important that is,” he said. “It’s an action everyone can take to protect each other.”
Americans should also avoid indoor spaces outside the home, as well as overcrowded outdoor spaces, the CDC said. That includes restaurants and may also apply to those with outdoor dining: The report suggests a change to replace food service.
Americans should be tested for exposure to the virus and should cooperate with contact trackers if they are infected, the agency said. They should stay home and postpone travel, air out and ventilation of rooms, wash hands frequently and get vaccines as they become available.
Exercise should be done outdoors, with a mask and social distance, the agency said. Remote working should be encouraged, and social gatherings should be restricted.
In a shift, the CDC also urged states and local jurisdictions to encourage and enforce these behaviors, including enforcing wearing masks in public places and on public transportation.
The Trump administration in September blocked a CDC ordinance that would have required passengers to wear masks on planes, buses and subway trains and in transit hubs. Officials in some provinces continue to resist mask mandates in public places. In Florida, which has reported over one million coronavirus cases, Gov repeated. Ron DeSantis voiced his opposition to mask mandates earlier this week.
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The CDC urged officials to limit the use of high-risk nonessential indoor spaces, to remove physical barriers and visual reminders that underscore the need for social isolation, and to begin planning now for vaccine distribution and administration.
The agency is also pushing for the testing of more essential workers who come into contact with the public and people who are otherwise at high risk.
Even with mass vaccinations imminent, Dr. stressed. Honein the need to implement such measures. “We see that light at the end of the tunnel, but we need time to get there,” he said.
Dr. Nuzzo, of Johns Hopkins, and other experts reiterated the agency’s emphasis on prioritizing schools over locations such as restaurants and bars, a recommendation echoed by Mr. Biden and his advisers.
Previous CDC guidelines, published over the summer and doctored by the White House, also pushed for schools to reopen but were not balanced by a scientific assessment of the risks involved, Dr. Nuzzo, adding, “It felt more like an essay rather than an analysis. ”
Having all 10 measures in one document is helpful and underlines the message that no one strategy can stop the spread of the virus, experts say. But the document was thin on some details, says Dr. Nahid Bhadelia, medical director of the special pathogen 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 haven’t seen it before, especially for those at high risk,” he said. But the CDC did not specify whether the masks should be provided by states or employers, he noted.
The new guidelines also emphasized the importance of improving ventilation in indoor areas, where airborne virus is a threat. But the agency may have detailed best practices to reduce confusion, says Dr. Bhadelia.
He cited fully enclosed outdoor dining “cabins” as an example of the erroneous solutions that can result from unclear guidance.
Also, the agency did not clarify what the triggers should be for restaurants or schools to close or which groups were recommended for more testing due to their greater interaction with others. “I would have loved to see a little more detail,” said Dr. Bhadelia.