Covid Prescription: Get the Vaccine, Wait a Month, Return to Normal The CDC claims to be ‘following the science,’ but its advice suggests it’s still paralyzed by fear. By Marty Makary M.D.
Dr. Makary is a professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health. He is chief medical advisor to Sesame Care and author of “The Price We Pay.”
The Centers for Disease Control and Prevention has lost a lot of credibility during the Covid-19 pandemic by being late or wrong on testing, masks, vaccine allocation and school reopening. Staying consistent with that pattern, this week—three months after the vaccine rollout began—the CDC finally started telling vaccinated people that they can have normal interactions with other vaccinated people—but only in highly limited circumstances. Given the impressive effectiveness of the vaccine, that should have been immediately obvious by applying scientific inference and common sense.
Parts of the new guidelines are absurdly restrictive. For example, the CDC didn’t withdraw its advice to avoid air travel after vaccination. A year of prevaccine experience has demonstrated that airplanes aren’t a source of spread. A study conducted for the defense department found that commercial planes have HEPA filtration and airflow that exceed the standards of a hospital operating room.
The guidelines do approve of vaccinated people meeting with low-risk unvaccinated ones—but only with people from the same household and in a small private setting. So much for restaurants, birthday parties and weddings.
An unpublished study conducted by the Israeli Health Ministry and Pfizer showed that vaccination reduced transmission by 89% to 94% and almost totally prevented hospitalization and death, according to press reports. Immunity kicks in fully about four weeks after the first vaccine dose, and then you are essentially bulletproof. With the added safety of wearing a mask indoors for a few more weeks or months—a practical necessity in public places even if not a medical one, since you can’t tell on sight if someone’s immune—there is little a vaccinated person should be discouraged from doing.
On a positive note, the CDC did say that fully vaccinated people who are asymptomatic don’t need to be tested. But that obvious recommendation should have come two months ago, before wasting so many tests on people who have high levels of circulating antibodies from vaccination.
In its guidance the CDC says the risks of infection in vaccinated people “cannot be completely eliminated.” True, we don’t have conclusive data that guarantees vaccination reduces risk to zero. We never will. We are operating in the realm of medical discretion based on the best available data, as practicing physicians have always done. The CDC highlights the vaccines’ stunning success but is ridiculously cautious about its implications. Public-health officials focus myopically on transmission risk while all but ignoring the broader health crisis stemming from isolation. The CDC acknowledges “potential” risks of isolation, but doesn’t go into details.
It’s time to liberate vaccinated people to restore their relationships and rebuild their lives. That would encourage vaccination by giving hesitant people a vivid incentive to have the shots.
Throughout the pandemic, authorities have missed the mark on precautions. Hospitals blocked family members from being with their loved ones as they gasped for air, gagging on a ventilator tube—what some patients describe as the worst feeling in the world. In addition to the power of holding a hand, family members coordinate care and serve as a valuable safety net, a partnership that was badly needed when many hospitals had staffing shortages. Separating family members was excessive and cruel, driven by narrow thinking that focused singularly on reducing viral transmission risk, heedless of the harm to the quality of human life.
As people yearn to be with their loved ones and rebuild communities, we shouldn’t repeat that mistake. We cannot exaggerate the public-health threat, as we did with hospital visitation rules, and keep crushing the human spirit with overly restrictive policies for vaccinated Americans.
Loneliness has become a public-health crisis. In pre-Covid times, it was estimated that 20% of American’s struggled with loneliness, a figure that has surely multiplied faster than research has been able to measure. We were reminded of this last week in a FAIR Health study that revealed self-harm among kids increased as much as 300% last year in some parts of the country. Future research will likely find that the harms of isolation are greater than is understood today.
Some experts selectively appeal to common sense when it comes to using discretion. Anthony Fauci said it was “common sense” to wear two masks at once. I too will invoke “common sense” to answer the big question so many are asking: What am I allowed to do after I’ve been vaccinated? Once a month has passed after your first shot, go back to normal.
Dr. Makary is a professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health. He is chief medical advisor to Sesame Care and author of “The Price We Pay.”
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