- MEDPAGE TODAY - MAY 19, 2021 - Cheryl Clark -
NNU charges CDC used unreliable data and disregarded variant threat, low vaccination rates
Labor union leaders representing 170,000 nurses came out swinging against the Biden administration's "dangerous" new recommendations that fully vaccinated people no longer need masks and that other COVID-19 precautions can be relaxed.
The new guidelines endanger public health and are not based on science, leaders of National Nurses United (NNU) said during a press conference Wednesday.
"We're calling on the CDC to revise this dangerous guideline and return to using the multiple measures of infection control that work," said NNU co-president Jean Ross, RN.
"It makes no sense to abandon simple and effective infection control measures such as masking, distancing, and testing when we know that doing so helps keep others safe," said Zenei Triunfo-Cortez, RN, co-president of NNU.
The NNU held the briefing to release its Scientific Brief, a 17-page point-by-point criticism of the studies the CDC relied upon to issue its interim guidance on May 13. Ross noted that much is still unknown about how protective the vaccine is against the many new variants that keep surfacing. She also noted the daily COVID death toll was about 600 as of Tuesday despite the vaccine, which is not fully protective and still faces questions about duration of immunity.
The guidelines say that fully vaccinated people no longer need to wear a mask or physically distance in any setting, except where required by governments, local businesses, or workplaces. Nor do they need to be tested following an exposure unless they are residents or workers at a correctional/detention facility or homeless shelter. They can resume domestic travel without being tested as well.
But what the new CDC guidance fails to recognize, Triunfo-Cortez continued, is that the people who are being put most at risk are essential workers like herself and people of color, "who have already borne the brunt of this pandemic. We keep the society running. We pick and sell your food; we drive your buses and trains. We provide care and comfort for you and your family. We have never had the luxury of sheltering at home. We're out there exposed."
"And now, the CDC is taking away the few infection control measures that help protect us," she said.
An 'Unacceptable' Ask
For essential workers such as healthcare providers, the new CDC guidelines will make life harder, Triunfo-Cortez said.
"Even worse, sadly we essential workers will now have the added burden of differentiating among vaccinated and unvaccinated people and potentially enforcing uneven masking rules in all kinds of settings," she said. "We know there is no good way to do this. This is an unacceptable thing to ask of us."
Jane Thomason, the NNU's lead industrial hygienist, said most of the studies that CDC relied upon to relax its guidance were either not yet peer reviewed or were conducted by parties with a conflict of interest (she included vaccine manufacturers among the conflicted). Many also had unreliable confidence intervals.
"Each study cited by the CDC was either a preprint -- not yet peer reviewed – or had a reported financial conflict of interest by the authors, except for one," Thomason said. One study of a healthcare setting published in the New England Journal of Medicine was conducted in Israel, where fully vaccinated rate -- 58.9% as of May 6 -- was much higher than in the U.S., at just 37.8% as of Wednesday.
Thomason also said the May 13 guidance "dangerously assumes that mild and asymptomatic COVID cases are not a big deal and not worth preventing. But we know that these mild and asymptomatic cases are a big part of how the virus spreads and can lead to long term, debilitating health impacts."
The agency "also dangerously assumes that it is okay for a proportion of vaccinated people to become infected, to be hospitalized and to die from COVID. No vaccine is 100% effective. There are breakthrough infections and deaths among people who have been essentially vaccinated," Thomason said.
As of May 1, the CDC is no longer tracking vaccine breakthrough cases that do not result in hospitalization or death, to "help maximize the quality of the data collected on cases of greatest clinical and public health importance," a policy with which the NNU also disagrees.
The labor union's representatives said they know the pressure the Biden administration is under. "We understand everyone's desire to get back to normal," said Ross. "We as nurses would like nothing better. But we are a profession based upon science, and the science shows this is exactly the wrong time to be relaxing our multipronged approach to infection control that studies show actually works to control the virus."
"Yes, a single person who is vaccinated has a very low chance of getting severely ill or dying of COVID," Ross acknowledged. "But that person may still harbor a mild or asymptomatic case and keep the virus in circulation to keep mutating."
Other Healthcare Groups Raise Concerns
It's not just the nurses union that wants the vaccinated portion of the nation to hold back on tossing their masks.
California, New Jersey, and Hawaii are among states where officials have said they will keep mask mandates in place for vaccinated individuals a bit longer.
Likewise, some leading infection control officials said it's still too soon to get back to normal even for those who have been vaccinated.
"I'm sticking with masking, despite being vaccinated, and I think we all should be sticking with that until our numbers are better," John Lynch, MD, medical director of infection control and prevention at Harborview Medical Center in Seattle and clinical lead of the University of Washington's COVID-19 response, said in a news release.
And the Infectious Diseases Society of America issued a statement saying that the CDC's shift "should not send the message that the pandemic is over," cautioning regional governments to set policies based on local transmission and vaccination data.
They should consider, for example, that the vaccine appears to be less effective in immunocompromised people, as well as take into account the potential for breakthrough infections in COVID high-prevalence areas.
"Less than half of the U.S. population is fully immunized," the IDSA statement said. "Increased vaccinations will be necessary to control and finally end the pandemic."
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