A summer of freedom from lockdowns and face coverings is being punctuated by Centers for Disease Control and Prevention warnings to wear masks again. And officials in some states hardest hit by the Delta variant can already predict the public’s response.
Health experts and local leaders in Alabama, Arkansas, Louisiana, Tennessee and Washington state told POLITICO they expect the latest warnings and recommendations will be brushed off by a crisis-weary public that’s been whipsawed for a year and a half by sometimes conflicting federal orders and scientific evidence.
“The messaging is complex. The masks came down and people don’t want to wear them again,” said Tom Frieden, who was CDC director in the Obama administration.
The Biden administration might be in a stronger position had the CDC this spring not told vaccinated Americans that it was safe to remove their masks. Instead, the turnabout is providing fodder for critics and conspiracy theorists who say they’re proof that vaccines are overrated and that the government is winging it.
Polling and on-the-ground experience show that it will likely take more death and illness to convince people that public health precautions still are a necessity.
That complicates the Biden administration’s role in cutting disease spread amid new evidence that even vaccinated Americans can be unwitting spreaders of Covid-19 — and could be partly responsible for virus surges threatening local health systems. In the brittle political environment, more government warnings to reach people who don’t take the pandemic seriously are likely to trigger more pushback.
“It has been politicized and that’s made it really hard for public health officials to fight this thing like they need to,” said Umair Shah, Washington state’s health secretary.
Top Biden health officials have spent recent days debating how much more they can prod Americans to wear masks again — and acknowledge the fact that they have not been able to break through in more rural, conservative parts of the country.
“We just haven’t gotten there yet,” one senior health official involved with those conversations said. “We have to be doing a better job at speaking to them and making sure their questions are answered.”
The CDC’s guidance did prompt some of the nation’s largest businesses to reconsider their policies. Apple and Disney World both implemented indoor mask requirements following the latest CDC recommendations.
That, in turn, could prompt segments of the public to consider the dangers of Covid-19, said Julie Morita, an executive vice president at the Robert Wood Johnson Foundation and member of the Biden Covid-19 Transition Advisory Board. “It’s businesses that change their policies that will influence people’s behavior,” she said.
But local health officials and physicians are skeptical that a sizable number of people will resume wearing masks without clear mandates.
“In our previous surges, what we’ve seen is that when you roll out a mask mandate and limit capacity, you stem the surge,” said Catherine O’Neal, chief medical officer of Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana. “Mandates actually get people’s attention and they change their behavior.”
CDC Director Rochelle Walensky on Tuesday said the agency was leaving it up to state and local officials to find “motivational” ways to convince people to get vaccinated and to adhere to public health measures.
That’s going to be a challenge, especially in more conservative parts of the country where mandates are a political non-starter and the CDC’s changing stance on masks is enough of a reason to ignore its recommendations.
CDC leaders earlier this year believed that telling unvaccinated Americans they could unmask would encourage more people to get shots. It didn’t. And now, it’s complicating efforts to get people to put their masks on again.
“The issue in May was that the recommendations weren’t about the science,” said Ali Khan, the dean of University of Nebraska Medical Center’s College of Public Health. “It was about the desire to use unmasking indoors as a way to get people vaccinated.”
William Schaffner, a professor of infectious disease at Vanderbilt University Medical Center, expects some people who have always taken Covid-19 seriously to mask up again, but said the majority of the local population won’t, even though the number of hospitalizations in Tennessee has more than tripled since the beginning of the month.
“There are parts of our state not only indifferent to masks, they are hostile,” he said.
That shouldn’t stop public health officials from trying, said Karen Landers, an Alabama state health officer.
“If we look at the data, it shows we need to be wearing masks again,” she said. “If people don’t wish to take my advice, I am still obligated to provide it.”
What does seem to be having an effect is the sheer number of hospitalizations, which may be scaring some holdouts into getting themselves and their families vaccinated. In Louisiana, where hospitals have had to cancel elective surgeries, the number of vaccinations per day has quadrupled over the last two weeks, said Joseph Kanter, the state health officer.
Missouri and Mississippi, two states where hospitals are overwhelmed with Covid patients, are administering shots at their fastest pace in nearly three months.
A survey run by Frieden’s group Resolve to Save Lives found that describing long-term symptoms of Covid that plague some patients motivated about one-third of vaccine hesitant respondents to consider getting the shot. After watching video testimonials from “long Covid” patients, that proportion rose to 39 percent.
“There’s no doubt there’s a real phenomena,” Frieden said. “We’re at a turning point where people are coming to the realization that Covid is not over and there is an increased risk that it will kill you if you’re not vaccinated.”