Nation hears mixed messages on pandemic

Americans are hearing mixed messages on the pandemic as the country moves into a new phase of a more than two-year battle against the coronavirus.

The United States is clearly in an improved position, with hospitalizations at their lowest point of the pandemic and deaths falling. But with cases ticking up, there is disagreement among health experts about how much risk remains and how far people need to go to deal with it. 

President Biden’s chief medical adviser, Anthony Fauci, made headlines on Tuesday when he said on PBS that the U.S. is “out of the pandemic phase” of the virus, but on Wednesday he then sought to clarify his statement by telling The Washington Post the country is out of the “full-blown explosive” pandemic phase. 

The Biden administration was also put in an awkward position last week when a federal judge struck down the mask mandate for public transportation, with officials deliberating over whether to appeal amid a split among experts on whether the order was still needed. The administration ended up appealing to preserve its authority in case of a future variant, but did not seek to immediately reimpose the order.  

Illustrating the complex risk calculations at play, debate is swirling about the White House Correspondents’ Association dinner, for which hundreds of people will gather in a ballroom, on Saturday. Biden plans to attend, but Fauci is pulling out, citing his personal risk calculations. Vice President Harris’s office said Tuesday that she had tested positive for COVID-19.

“This messaging is tricky, and I’m afraid of giving people the wrong message and telling them, ‘Don’t worry; it’s over,’” said Eric Toner, a senior scholar at the Johns Hopkins Center for Health Security.  

“It doesn’t fit well in a seven-second soundbite,” he added. “I’m glad I don’t have Tony Fauci’s job trying to explain this.” 

Part of the challenge is that much of the response has shifted from broad measures like mask mandates to encouraging people to make individualized choices for themselves based on their personal level of risk and risk tolerance. 

Vaccines and booster shots, as well as newly available treatments like the Pfizer pill Paxlovid, have greatly reduced the risk of severe disease compared to earlier in the pandemic. 

But risks are still not zero, including for lingering symptoms like “long COVID.”

“It’s a difficult terrain to navigate … it makes it difficult to have one single message out there,” said Josh Michaud, associate director for global health policy at the Kaiser Family Foundation. “It’s basically up to everyone to decide what they want to do.” 

Whether to go to the White House correspondents’ dinner, he added, is “just is a symbol” for the many decisions people are making every day based on their personal risk. “It’s going to be an individual level decision,” he said.  

White House press secretary Jen Psaki stressed individual decisionmaking on Wednesday when asked about Biden’s and Fauci’s differing decisions on the dinner.  

“Every individual will make their own decisions about whether they attend this event, other events, whether they wear a mask at it or not,” Psaki said, while noting Biden would skip the “eating portion” of the event.  

She noted that the administration has put forward a plan to return to more normal routines, but “in that, that requires making risk assessments and decisions about what you’re going to do and what you’re going to attend and be a part of, as we all do every day.” 

Jonathan Reiner, a professor of medicine at George Washington University, tweeted that Biden should skip the dinner.  

“The WH [White House] has been walking a tightrope,” he wrote on Twitter. “They’re trying to portray that we’re in a much better place w/ COVID and the risk is low. But the virus is surging in a lot of places and we’re nearing 1 million dead and they’re trying to protect POTUS without having everyone at the WH mask.” 

Some experts still stress widespread masking as an important tool for people in crowded places and on airplanes. Others say the focus has shifted from preventing cases to preventing severe disease and hospitals from being overwhelmed.

The Centers for Disease Control and Prevention moved toward that view in late February, when it eased mask guidance for much of the country, based in large part on hospital capacity metrics.  

Critics of the shift away from masks point to immunocompromised people, children under 5 and other vulnerable groups, while others note that wearing a high-quality mask still offers protection to the wearer even if others do not wear one, in addition to vaccines, boosters and treatments that have changed the equation.  

Ashish Jha, the new White House COVID-19 response coordinator, put the emphasis on preventing severe disease, not trying to prevent all cases, at a press briefing on Tuesday. 

“We have a very, very contagious variant out there,” he said. “It is going to be hard to ensure that no one gets COVID in America. That’s not even a policy goal. The goal of our policies should be, obviously, minimize infections whenever possible, but to make sure people don’t get seriously ill.”

He pointed to Harris’s COVID-19 case as an example, noting that she is vaccinated and twice boosted, giving her strong protection from severe disease. She has reported suffering no symptoms so far.  

While the White House touts the tools that are now available to blunt the effects of COVID-19, some experts note it is important to do more to make them available. 

Some patients have reported trouble accessing Paxlovid, the highly effective treatment pills from Pfizer, which the White House acknowledged this week when it announced new steps to make the pills more widely available.  

And about half of eligible adults have not received a booster shot.

“There are lots of unboosted people still out there,” Kaiser’s Michaud said, calling for the administration to make greater efforts to reach more people with the shots.  

The main threat to the current, improved situation is the development of a new variant that further evades vaccines. The White House warns that it needs new funding from Congress to be able to purchase updated vaccines if they are needed.  

“There still is a fair amount of COVID around, and no one knows for sure what’s going to happen two, four, six, eight, 10 weeks down the road,” Toner, the Johns Hopkins senior scholar, said.