Senior White House advisor to Covid’s response, Andy Slavitt, told CNN chief medical correspondent Dr. Sanjay Gupta that we should expect more guidance on how to get back to normal as we see the vaccination rate rise.
“The rate of development of new guidelines is directly related to the speed with which we vaccinated the country,” said Slavitt to Gupta. “This is the key point. In vaccinations of 10% we have this guidance. At 20-30%, we will have a new guidance ”.
So, what can we really do? We discussed the main findings with CNN medical analyst, Dr. Leana Wen, an emergency physician and visiting professor of health policy and management at the Milken Institute School of Public Health at George Washington University. Here’s her advice.
Dr. Leana Wen: A person is fully vaccinated at least two weeks after the Johnson & Johnson single dose vaccine or two weeks after a second dose of the Pfizer / BioNTech and Moderna vaccines.
CNN: What is the CDC’s orientation for fully vaccinated people to get together?
Wen: The CDC says that people who are fully vaccinated can see themselves, indoors, without masks or social distance. This will be a great relief for many people. Those who live alone and have been isolated for many months can be together after vaccination. Vaccinated couples can see other fully vaccinated couples for dinner in their private homes.
CNN: Is there a size limit for how many fully vaccinated people can be together?
Wen: Since vaccination status is so important, I make sure that you trust that the people you are treating are vaccinated. You should feel free to ask them directly and see the proof of vaccination. The larger the group, the more likely you are to not know someone well in that group. If you are not sure about the vaccination status, do not meet at home with them.
CNN: What about dating? Can you and a partner finally be together if you are both vaccinated?
Wen: Yes, if you and the person you are dating are fully vaccinated, you can definitely be together again. The question of trust arises here for people who are dating recently or if you are meeting someone you don’t know well. Make sure to check that the other parties are really vaccinated. If you’re not sure, skip the face-to-face meeting or see only people outdoors, at least 6 feet away.
CNN: How about visiting a family where some or all of the individuals have not yet been vaccinated? Many grandparents really want to see their grandchildren.
Wen: The CDC provides very good guidance here, which should be a relief to many grandparents. They say visits are good for people vaccinated with unvaccinated people from a single home, as long as unvaccinated people have a low risk of severe Covid-19.
Let’s say that both grandparents are vaccinated. They are visiting a family called “mixed”, where only one parent is vaccinated and none of the children are. If all unvaccinated people in the household are generally healthy, this visit can happen – indoors, without masks or detachment, with grandparents free to embrace their family.
This becomes more complicated if someone in the house is at greater risk for serious Covid-19. It is here that there are many nuances and complexity. What if a parent, for example, has asthma and high blood pressure, or a child is immunocompromised? We know that grandparents are well protected and are likely to have a substantially reduced risk of carrying the coronavirus. I would say that it is safer for grandparents to reduce their other risks before seeing the family. For example, they must not see other people who have not been vaccinated in the previous 10 days.
CNN: How about a family reunion, with several families that have unvaccinated members?
Wen: The CDC is quite clear here. This should not happen, except in the open air, with masks and distance. The key is that unvaccinated people from different families should not mix, as they can be carriers and infect other people.
CNN: Many families live separate from each other. What does the CDC say about traveling to see loved ones?
Wen: This is where I disagree with the CDC’s guidance. The CDC also discourages non-essential air travel, which includes family visits. I don’t think it meets a test of common sense. Another part of the CDC’s guidance says that fully vaccinated people do not need to be quarantined if they are exposed to someone known to have a coronavirus. This is a high-level exhibition. The risk of exposure on a flight, train or direction is already low. If someone is vaccinated, the risk is even less.
I think people who are fully vaccinated should feel free to travel to see their families, but of course, take all precautions during the trip – including wearing a tight-fitting mask at all times in public places, trying to be physically distant whenever possible, and wash your hands thoroughly.
CNN: The CDC doesn’t talk much about other activities, like going to the restaurant or the gym. What about these settings?
Wen: Again, this is where I disagree with the CDC’s overly cautious guidelines. I understand that they don’t want people to let their guard down completely, but doctors know that we have to find people where they are and deal with each situation with the nuance it deserves.
Let’s say someone has been vaccinated and really wants to attend services in person at the church and return to the senior center for indoor activities. The risk for them is very low and the risk for other people is also low. On the other hand, the cost of continuous insulation will be high.
I think they should be able to return to the activities that interest them most, while, again, make sure to wear masks and stay physically apart. I would go so far as to say that a couple who really want to eat out at a restaurant again could do so occasionally, but not night after night.
People should be careful and not go to crowded bars. Definitely be sure to wear masks in public. Just because something is open in your state does not mean that it is safe to visit. We need to encourage vaccination as a way to return to pre-pandemic life and work with people to reduce their risk.
CNN: What would you say to someone who wants to go to these: a church, a restaurant, a museum, a cinema, a concert – all indoors?
Wen: That’s what I would say – it depends on your individual situation.
First, look at your own risk factors. Remember that the vaccine is not bulletproof protection. It offers very good protection, especially against serious illnesses – but there will still be some level of risk. Masks provide an additional layer of very good protection, as well as distance, ventilation and so on.
If you are at very high risk yourself due to age and the underlying medical conditions, consider limiting yourself to CDC guidelines and seeing only other people vaccinated in particular social settings. If you have high-risk conditions, but you also have something you really want to do, think about your own values and priorities. For some people, going to the religious service is so essential that the benefits far outweigh any possible risk, for example.
Then, look at the configuration itself. A restaurant is even safer outdoors. Dining indoors has some risk, but again, if people wear masks, except during meals, and there is good space and ventilation, that risk is low enough for some people to choose to eat indoors after vaccination. The other settings are similar. Most museums allow a good distance and should work well. Look at the cinemas and concert halls you are thinking about. If they offer good ventilation and spacing, and everyone is wearing masks, the risk will be relatively low.
Vaccines offer a lot of hope. I think the CDC and the entire public health community need to do a lot more to convey exactly how much incredible hope there is. We will not reduce the risk to zero, but we can reduce it to a level low enough for vaccinated individuals to return to many normal pre-pandemic levels.