Understanding Changing COVID Guidelines

CDC guidelines about COVID-19 have been revised several times. As new facts about the virus emerge, some experts differ about exactly what’s safe — or not.

The Centers for Disease Control and Prevention (CDC) is the go-to source for the official U.S. guidance about how Americans can best avoid contracting and spreading the novel coronavirus known as COVID-19 (coronavirus).

The guidelines about preventing the spread of the virus have varied since the first cases hit the U.S., causing questions among the public and some in the medical community about COVID safety, giving fuel to pandemic deniers and others spreading false information.

The CDC differences in guidelines and opinions about safety measures have been based on information known at the time they were offered. So, as new data about the virus and its spread emerged, it’s no surprise the official health recommendations haven’t been written in stone.

That explains why the CDC’s latest guidelines are called “Interim Public Health Recommendations for Fully Vaccinated People.” The word “interim” is key, indicating the guidelines are provisional and likely to change when infection rates, new research, and other facts warrant revisions.

Throughout the pandemic, legitimate science and medical experts expressed opinions that differ, at least somewhat, from the CDC’s guidelines. And some government and other health officials changed their minds about COVID-19 safety and transmission in some ways. The result has been sometimes confusing news coverage and social media posts, supposedly indicating what is safe — and what’s not — when it comes to avoiding the virus.

To keep track of the ever-changing guidelines as information about the virus, and variants, continues to develop, you can keep track of updates to the guidelines here.

The U.S. federal public health emergency declaration ended May 11, 2023, but the CDC noted the spread of the virus did not end.

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The CDC’s interim mask guidelines

The CDC guidelines spelled out important changes in recommendations about who should wear a mask and during what circumstances. They were quickly met with some disagreements that resulted in some changes. Depending on whether the pandemic returns in the U.S. and infection rates following vaccination efforts — or variant infections swell — the guidelines may be tweaked again in the future.

The issue of wearing a mask is an example of how guidelines changed. In fact, the country’s government medical experts didn’t always push the concept of mask wearing to prevent COVID.

For example, back in January of 2020, when the coronavirus first flared in the U.S. with a few documented cases, the CDC discouraged the use of masks among the general public.

Anthony Fauci, MD, infectious disease expert and advisor to then President Donald Trump, said at the time that masks were "not effective in preventing the coronavirus.” In addition, Jerome Adams, MD, U.S. surgeon general during the Trump administration, tweeted this anti-mask admonition in late February of 2020: "Seriously people — STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus.”

Fauci later admitted that anti-mask public statements were issued because highly protective N95 masks were in short supply for doctors and other healthcare workers who needed them the most.

He also explained the CDC advice changed to promote wearing a mask when circumstances changed. Specifically, research showed the coronavirus was primarily transmitted when it was airborne, and some simple, non-medical grade masks could help protect from COVID-19.

As a result, masks were soon common in many areas of the country and required by numerous businesses and public buildings. With the rise of effective vaccines, there was a shift in emphasis, from pushing most adults to wear masks most of the time to less strict recommendations.

According to CDC data, more than 80 percent of Americans age 5 and older received at least one dose of a COVID vaccine. About 70 percent are fully vaccinated against the coronavirus (specifically, you are deemed fully vaccinated if two weeks have passed since your second shot of the Moderna or Pfizer vaccine, or it’s been two weeks after you had the one-shot Johnson and Johnson version). More than 95 percent of Americans at especially high risk because of their age — U.S. seniors 65 and older — have had at least one shot of the vaccine, and about 94 percent are fully vaccinated.

(Note that vaccination rates can change over time.)

If you are vaccinated or planning to get the shot, your top concerns about the CDC guidelines likely revolve around what you can to stay safe.

Controversy and revisions of the guidelines

Both earlyguidelines — and follow-ups — met with controversy. The CDC’s Rochelle Walensky (director of the organization under President Biden until the spring of 2023), who warned she had a feeling of “impending doom” about continued COVID-19 infections and severe consequences, drew criticism, not only for her non-accurate gloom and doom prediction but also about the CDC possibly exaggerating, or not reporting correctly, research showing the risk of outdoor transmission of the coronavirus is almost miniscule.

While there’s no doubt masks can reduce the spread of the coronavirus indoors where people are in close proximity, especially in poorly ventilated areas, the outdoors is a very different situation. Research shows particles carrying the virus quickly diffuse outside — too quickly to spread the infection.

For example, the CDC guidelines were based on the risk of outdoor transmission being under 10 percent. But multiple studies concluded the actual outdoor risk is only one tenth of one percent, far safer than the CDC guidelines had indicated.

Questions and controversy

If you’ve followed the course of COVID-19 in the U.S. and the fluctuating guidelines from the CDC, reported as the course of the coronavirus pandemic changed, it’s no surprise that the guidelines resulted in controversy.

The bottom line is the guidelines are not federal mandates, and states can make their own guidelines. After several rounds of changes to the guidelines were released, several states did away with mask requirements for vaccinated people and some backed off any mask requirements. Other states never had any requirements at all.

Depending on the level of COVID-19 infection rates, you will need to check with your state’s board of health to see whether there are required rules for mask wearing, even for people who are vaccinated.

It’s important to note that, during the lengthy pandemic, many states and local governments didn’t respond immediately about changing any public health guidance related to wearing masks and any other virus-related health mandates.

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