The latest guidelines from the Centers for Disease Control and Prevention (CDC) say fully vaccinated Americans do not need to wear face masks or practice physical distancing except when business policy or government regulation requires them to do so. But "despite the new guidelines," The New York Times says in a story about the loosening of that city's COVID-19 restrictions, "many experts still suggest wearing a mask indoors when not eating or drinking. People should maintain social distance when possible. And they should try to choose outdoors over indoors."
Just to be clear: This is the advice that the "many experts" cited by the Times are giving to people who have been fully vaccinated. Although they may have naively assumed those shots protected them against COVID-19, the Times is saying, they should not let down their guard just yet. But that position seems absurdly cautious in light of the evidence showing how remarkably effective the vaccines are.
"People who are vaccinated can do much more with less risk than those who are not," the Times concedes. "But vaccines do not offer 100 percent protection, and only about half of people in the region are fully vaccinated. As a result, some epidemiologists continue to recommend following the golden rules of coronavirus safety."
The fact that the Times describes COVID-19 safeguards as "golden rules," analogous to a timeless ethical principle, suggests that its advice is based on something other than rational, context-dependent concerns about virus transmission. Mask wearing and physical distancing, once presented as temporary responses to the pandemic that would no longer be necessary after the danger had passed, have been transformed into rituals that signify membership in a COVID-19 cult of caution.
As Reason's Robby Soave notes, that cult has strong partisan overtones. "The mask was supposed to be a temporary public health intervention," he writes, "and it's regrettable that for many people these little bands of cloth have become Team Blue's version of the Make America Great Again hat."
That conclusion is hard to deny given the comments of some dedicated mask wearers and the weak scientific basis for urging vaccinated people to act as if they never got their shots. "Vaccines do not offer 100 percent protection," the Times warns. But they come pretty damned close.
A randomized, placebo-controlled clinical trial reported in The New England Journal of Medicine found that the Pfizer vaccine "conferred 95% protection against Covid-19 in persons 16 years of age or older." Contrary to a common misunderstanding, that does not mean fully inoculated subjects had a 5 percent chance of getting COVID-19. It means their risk was 95 percent lower than the control group's.
The 43,448 subjects, who were evenly divided between the treatment and control groups, received their second shots 21 days after their first shots. "There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive [the vaccine] and 162 cases among those assigned to placebo," the researchers reported.
In other words, the risk of confirmed infection was about 0.75 percent in the control group and about 0.037 percent in the treatment group. There were nine cases of "severe Covid-19" among subjects who received the placebo and one among the subjects who received the vaccine, making the risks 0.041 percent and 0.0046 percent, respectively. That's an 89 percent reduction.
Follow-up studies have confirmed that COVID-19 vaccines are highly effective. A study published in the CDC's Morbidity and Mortality Weekly Report found that people 65 or older who had received the Pfizer or Moderna vaccine were 94 percent less likely to be hospitalized with COVID-19. A prospective study of nearly 4,000 "essential and frontline workers" in the United States, reported in the same journal, found that receiving the Pfizer or Moderna vaccine was associated with a 90 percent reduction in COVID-19 infections, including asymptomatic as well as symptomatic cases. Among fully vaccinated subjects, there were 0.04 confirmed infections per 1,000 person-days, compared to 1.38 among unvaccinated subjects.
A retrospective Israeli study of 6,710 health care workers who were screened for COVID-19, reported in The Journal of the American Medical Association, yielded similar results. It found that the incidence of symptomatic infection was 0.047 per 1,000 person-days among subjects who had received the Pfizer vaccine, compared to about 1.5 among unvaccinated workers. For asymptomatic infection, the incidence was 0.11 and 0.67 per 1,000 person-days, respectively. In other words, vaccination was associated with a 97 percent reduction in symptomatic infection and an 83 percent reduction in asymptomatic infection.
Even in the rare cases of infection among vaccinated individuals, CDC Director Rochelle Walensky noted last week, they tend to have shorter infections and a lower viral load. That means they are less likely to transmit the virus.
The Times summarizes results like these by saying vaccinated people face "less risk" than unvaccinated people. To call that an understatement would be an understatement.
If anything, the tiny risks of infection measured in these studies would be even smaller now that more Americans are immune to COVID-19 as a result of vaccination or prior infection. Yet the Times, unlike the CDC, is advising fully vaccinated people to continue wearing masks, continue following the six-foot rule, avoid exercising in gyms ("outdoors remains safer"!), and carefully choose restaurants based on factors such as "airflow," "cleaning and other protocols," and "space between tables."
In theory, such continued caution could make sense, depending on one's tastes and preferences. But when your anxiety about minuscule risks makes you even more timid than the notoriously hypervigilant CDC, it might be time to rethink your priorities.