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What public health experts say about the about the CDC's new quarantine guidelines


The U.S. set a record for new COVID cases yesterday, with the seven-day average hitting more than 240,000. The White House continues to encourage vaccinations and boosters to fight the pandemic. At the same time, it's issued new recommendations reducing isolation times for those who get infected and are asymptomatic. The Biden administration acknowledges it's trying to account for a pandemic-weary public. Joining us to discuss this are NPR White House correspondent Asma Khalid and consumer health correspondent Yuki Noguchi. Hi there.



SHAPIRO: Let's start with this new guidance from the CDC for how long people should isolate after testing positive for COVID. For asymptomatic folks, it is now five days instead of 10. Asma, what motivated the administration to make that change now?

KHALID: Well, the CDC's director, Dr. Rochelle Walensky, says this decision is based on science. It's based, she says, on what we know about the transmission of this virus now, and what she says is that people are most infectious a day or two before symptoms develop and then two or three days after. And so that's how they got to the five days of isolation. The president - you know, whenever he is asked about changing recommendations, he usually defers to advice from his medical team and says you should trust the scientists. But on this there have been questions - a lot of questions, I will say - about whether this was a purely scientific decision or whether economic pressures were a factor or how much of a factor potentially they were. Dr. Walensky acknowledged that you've got to take into account how people are going to behave. And, you know, Ari, I know she spoke to you about this yesterday.


ROCHELLE WALENSKY: We also want to make sure that we can keep the critical functions of society open and operating. We started to see challenges with that, you know, with airline flights and other areas. We can't take science into a vacuum. We have to put science in the context of how it can be implemented in a functional society.

KHALID: And today she made additional comments saying it had a lot to do with what they thought people would be able to tolerate. So basically, she says, you've got to give people a medicine that they're willing to swallow, especially when there are indications that many of these cases are mild, especially in vaccinated people.

SHAPIRO: Yuki, what do public health experts say about these guidelines?

NOGUCHI: You know, it's a mixed message, right? The head of the largest nurses' union told me, you know, here we are, trying to warn people about this rapidly spreading virus while also suggesting that people can move about more freely, even if they get it. You know, but more broadly, Ari, I think there's concern about the efficacy of public health messaging right now, and especially when you shift that message, you know, how is that received? Adriane Casalotti represents the National Association of County and City Health Officials. And she worries people are oversimplifying their takeaways from this latest guidance and ignoring some of the nuances.

ADRIANE CASALOTTI: I can tell you people are like, oh, it's just five days now. I was like, well, read the rest of the guidance. It's five days and then, like, really strong masking. So, yeah, there's that conversation of, you know, what's the top-line message, but, also, what's the full guidance?

NOGUCHI: And the full guidance is to wear tightfitting masks for another five days after isolating five days. But, you know, how many people are absorbing that second part of the message? You know, the unfortunate reality for public health is a lot of people are getting tired of getting into those complex but potentially consequential details.

SHAPIRO: Asma, what is the White House emphasizing right now as the primary way out of the pandemic?

KHALID: Well, the main strategy, Ari, has remained relatively consistent, I would say, ever since Joe Biden stepped into the White House. He and his team have been pushing the public to get vaccinated. And now they've also been pushing people to get boostered (ph). The thinking is that boostering and vaccinating is the way out of this pandemic. I would say the challenge for the White House - and this, you know, has become clearer as the pandemic has lingered just on and on - is that there is a subset of the population that refuses to get vaccinated. And President Biden telling people that it is their patriotic duty to be vaccinated is just not going to convince them.

I will say, in the last few weeks, we've also begun to hear more from the administration of a focus on testing and how they plan to make testing more available. In the new year, you'll be able to file insurance claims for those at-home rapid COVID tests that you can buy at drugstores. And the White House is also launching this online portal where you'll be able to order free tests to be mailed to your house. The White House has ordered half a billion of these tests. And the president has acknowledged that with hindsight he wished he would have done this sooner, maybe a couple months back.

NOGUCHI: And, you know, I will add to that, Ari, that testing is another area in which we've seen a lot of divergence between the public health message and the reality of life on the ground. You know, on the one hand, we know testing can greatly limit the spread of the virus. But as a practical matter, when you have millions of Americans unable to find tests or standing in huge, long lines to get them, that undermines the advocacy that a lot of epidemiologists want to see for testing.

SHAPIRO: And from testing to masks, some states and localities have mandates. Others are saying they won't implement that anymore. I mean, that seems like more reflection of politics than public health, right?

NOGUCHI: Yeah. I mean, you know, throughout this pandemic you've seen where politics has often been at odds with public health ideals. And what I hear more now is about how public health has to adapt to that environment - right? - because if people aren't listening or are actually hostile to the message or the mandate, then that can undermine public health. So, you know, I'll give you an example. I talked to Jeff Fortenbacher, who's the CEO of Access Health, a community health nonprofit in Muskegon, Mich., that serves low-income patients. His state does not have a mask mandate, and he doesn't require patients to mask up, either.

JEFF FORTENBACHER: If you require them to mask up, you aren't going to accomplish what you need to accomplish with them because you aren't going to engage because they're going to be so pissed off. It's really kind of just walking that line.

NOGUCHI: You know, so having a mask mandate, in other words, would alienate some patients, and that doesn't serve public health.

KHALID: You know, mandates, I will say, as a whole are just something that's been tricky for the White House. They have put in place a vaccine mandate for large workplaces and health workers, but those are tied up in the courts at the moment. And then, of course, there's this idea of travel mandates. There's currently a requirement for vaccine and testing if you're flying in from abroad, but there is no vaccine mandate for domestic travel. And White House medical advisers say it's not necessary at this point.

SHAPIRO: That's NPR White House correspondent Asma Khalid and consumer health correspondent Yuki Noguchi. Thank you both.

NOGUCHI: Thank you.

KHALID: Happy to do it. Transcript provided by NPR, Copyright NPR.

Asma Khalid is a White House correspondent for NPR. She also co-hosts The NPR Politics Podcast.
Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.