If the scientists at the US Centers for Disease Control and Prevention had their way, to curb the spread of Covid-19 right now, nearly every US school would cancel football, wrestling, band, and loads of other mainstay school activities.
In another piece of guidance, the CDC tells people who’ve recovered from Covid-19 that they can leave their homes after five days — and while they are out and about for the next five days, they should avoid being around more than 80% of the US public.
Dr. William Schaffner, an adviser to the CDC for four decades and an infectious disease expert at Vanderbilt University Medical Center, said it’s “unlikely, unreasonable, and unrealistic” to think Americans will follow either of the agency’s suggestions.
“Making public health recommendations — they are not a platonic ideal,” Schaffner added. “They have to work in the real world. As we say in Tennessee, that dog won’t hunt.”
Such out-of-touch advice has been a hallmark of many CDC recommendations long before the pandemic began, and the agency needs to do better, said current and former health officials and physicians who have worked with the CDC on health guidance.
Over the past few weeks, the agency has faced criticism for issuing guidance that was confusing or seemed counterintuitive. In this case, the criticism is different; the concern is that CDC staffers, while hardworking, smart, and well-intentioned, don’t always consider whether Americans will — or even can — follow their advice.
In a statement, CDC Director Dr. Rochelle Walensky said the agency “prioritized academics over athletics because of the increased risks involved in some extracurricular sports. When followed, our school guidance has been incredibly effective. In the fall, 99 percent of schools were able to remain open during the intense delta wave of COVID.”
CDC’s school guidance
As part of its guidance last updated on January 6, the CDC advised schools to “cancel or hold high-risk sports and extra-curricular activities virtually” any time a community has a “high” Covid-19 transmission rate.
The guidance links to a CDC map that indicates more than 99% of US counties are
currently experiencing high transmission.
The CDC gives football and wrestling as examples of high-risk sports and says that “high-risk extracurricular activities are those in which increased exhalation occurs, such as activities that involve singing, shouting, band, or exercise, especially when conducted indoors.”
Paul Imhoff, president of The School Superintendents Association, told CNN while schools have gone to great lengths to curb the spread of Covid-19, he doesn’t know of any schools that have canceled activities such as football or band or choir. Such activities, he said, are “important to students’ mental health.”
In her statement to CNN, Walensky said the CDC “developed our school guidance knowing school administrators, teachers and parents were looking to us at CDC to get their children back in the enriching environment of the classroom and it was a priority to get our children back to school safely,” adding that “vaccines are available for school-aged children, which adds another layer of protection and enhances the school guidance.”
At a January 7 media briefing, Greta Massetti, chief of the CDC’s Field Epidemiology and Prevention Branch, said the guidance was “intended to really protect that critical in-person learning time.” She added that the guidance “is really one piece of a layered prevention strategy that schools can use. CDC continues to recommend layered prevention, including universal masking, including screening, testing, and a variety of other strategies.”
CDC’s isolation guidance
In its isolation and quarantine guidance, which was last updated on January 9, the agency tells people that if they have Covid-19, they should isolate themselves for five days following the onset of symptoms or a positive test. After that, they can end isolation if they’re fever-free without the use of medication and other symptoms have improved.
That advice links to a CDC page that lists conditions that make people more likely to become severely ill with Covid-19. Many of the conditions are very common, such as being overweight or suffering from depression, certain heart conditions, or cancer.
The Computational Epidemiology Lab at Boston Children’s Hospital estimates that more than 80% of Americans have at least one of the conditions on the CDC’s list, according to an analysis the group did for CNN.
When asked about the advice at the briefing, Walensky said the agency was asking people to “avoid your family members or others who might be immunocompromised, avoid visiting grandma or a nursing home.”