The Centers for Disease Control and Prevention (CDC) have no plans to change their recommendation that all U.S. schools require students to wear masks, according to an audio recording of a closed-door House Energy and Commerce committee briefing obtained by Reason.
"The CDC provides guidance," CDC Director Rochelle Walensky can be heard saying on the recording. "Our guidance currently is that masking should happen in all schools right now."
The Energy and Commerce subcommittee on Oversight and Investigations hosted the briefing, which took place virtually on Tuesday and was attended by Walensky, White House COVID-19 adviser Anthony Fauci, and Assistant Secretary for Preparedness and Response within the U.S. Department of Health and Human Services Dawn O'Connell.
Walensky faced criticism—from members in both parties—that the CDC's guidance is confusing and out of step with human behavior at this stage of the pandemic. Rep. Cathy McMorris Rodgers (R–Wash.), the committee's ranking Republican member, challenged Walensky on the science behind school mask mandates, noting that the Arizona study oft-cited by the CDC in support of masking kids has been thoroughly debunked by The Atlantic.
"What we see in the U.S. is an outlier as it relates to the mask mandate for our children to go to school," said McMorris Rodgers. "[The World Health Organization and UNICEF] have both recommended against masking for kids under the age of five because it's going to do more harm than good. For children ages 6 to 11, they think that we should be considering other factors like learning and social development. My question today, my one question, is Dr. Walensky, will you commit to update your guidance by Friday to allow children in person without the burden of masks?"
Walensky made no such commitment to a timetable for abolishing school mask mandates. She acknowledged the "limitations" of the Arizona study, as well as other studies the CDC has relied upon to inform their guidance, but rejected any near-term changes on masking in schools.
"They all have limitations, and that's important to recognize because we are not randomizing schools," she said. "We have to control for whether there are windows, ventilation, and other activities happening outside of these schools. So all of these studies have limitations. But they are for the most part uniformly pointing to that when there's a lot of disease out there, the masks are preventing that disease and preventing that transmission and because of that we are able to keep our schools open."
Rep. Gary Palmer (R–Ala.) also asked Walensky how she could justify the agency's school masking guidance.
"Explain why we need to keep allowing school districts to impose a mask mandate on kids," he asked.
In response, Walensky defended the agency's current guidance, but also noted—perhaps with some frustration—that local jurisdictions were free to disregard it.
"I will also say that guidance is just guidance, and all of these decisions, we've continued to say, have to be made at the local level," she said. "As cases come down dramatically, we have deferred our guidance to the local jurisdictions."
Given that many coronavirus-cautious jurisdictions are seemingly waiting for the CDC's permission to relax masking requirements—in schools, especially—this answer prompted some outrage.
"That's not acceptable," said Palmer.
It wasn't just the Republicans; Rep. Anna Eshoo (D–Calif.) expressed considerable bafflement that the CDC was incapable of being clearer about what levels of caution were still appropriate.
"You hear the word confusion over and over again," said Eshoo. "But here's another one for you: masking. You know where I live in the Bay Area, the peninsula in the heart of Silicon Valley? Schools, cities, towns, counties: you're saying one thing, and they're doing something else. And this is a highly educated area, too. I trust our public health officials here. So my first question and my second point to you, Dr. Walensky, why do we have to be on two different tracks? Isn't there some kind of public health consensus about this?"
Walensky replied by citing the national figures—170,000 cases per day, 2,200 deaths per day, etc.—and was immediately cut off by Eshoo.
"When you use the national figures, that's not a snapshot of where we are, so can you take that into consideration as you're giving me an answer?" said Eshoo.
"Absolutely," said Walensky. "We know that all of these decisions have to be made at the jurisdictional level. So not only do we report the national data, but we have to report them at the jurisdictional level, because we know that we ask the jurisdictions to look at their local context, to look at their local cases, to look at how their hospitals are doing, to look at their local death rates. And that is exactly what I think is happening across the country in a phased way. Many different policies are rolling out. Some are saying they're removing masks. Now some are saying they're removing masks at the end of the month. Some say we're removing masks at the end of the month, but not yet for schools. And so this is really happening at the jurisdictional level. And what we're recommending is that given right now, where we are for cases, that the masks should still stay on."
Eshoo responded with skepticism that people were checking the CDC website to figure out which policies were merited based on their local jurisdictions' numbers.
"I think that's confusing, and I do think that it puts a dent in CDC credibility," said Eshoo. "Credibility is everything in this. Who are you going to pay attention to? So, I mean, it goes to that and I think it's troubling. They're making it sound as if, you know, all of these local entities, public health directors, whatever, are not paying attention to the CDC. That's the way it looks to me. All right? That's the way it looks. That's the way it sounds. So I don't know. What should I tell my constituents? Oh, look at their website. I don't think that's a good answer, honestly."
The three government health advisors fielded questions from Democratic and Republican committee members on a variety of other subjects as well, including the approval of fourth booster shots, the availability of therapeutics, and the possibility that COVID-19 emerged from a lab. Republicans grilled Fauci about the National Institute for Health (NIH) grant that funded coronavirus research in Wuhan with the same vigor that they demonstrate in public. Rep. John Joyce (R–Penn.) asked Walensky about the CDC's refusal to recognize immunity acquired from a previous infection as legitimately protective. He noted that given recent findings, so-called natural immunity should count as satisfying the federal vaccine requirement for health care workers.
"During the delta surge, case rates for those who had previous infection and no vaccination were substantially lower, four- to fivefold lower, than those who were only vaccinated," said Joyce. "Hospital rates followed a similar pattern. Given these findings, will the CDC commit to updating the guidance to recognize the value of natural immunity? And will you advocate to alter the [Centers for Medicare and Medicaid Services] vaccine mandate for health workers, which you pointed out right now are gravely affected by COVID-19, so that natural immunity will be recognized as satisfying the requirement in order to ease the pressure on health care staffing throughout the United States?"
Walensky gave no indication that she would support that change.
"Thank you for that question and for recognizing our work and trying to understand the importance of infection and immunity," she said. "We published that report in [Morbidity and Mortality Weekly Report] and actually late last year, we also published a scientific proof that demonstrated a review of dozens of papers on the importance and the and the impact of infection-induced immunity. Two key limitations from that report were that they were done during the delta surge. All of these data were collected during the delta surge and did not reflect omicron, which we now know requires a higher level of immunity. And secondly, that they did not reflect the period of time when boosters were available. People were not necessarily up to date with their vaccines, and the vaccines had actually likely been waning."
Walensky did not specifically mention school masking in her public remarks at the White House the following day, though she did signal that the CDC intends to issue more flexible guidance on masking in general. So far, however, she has given no indication that any update to the guidance would apply to kids in schools—and even behind closed doors, she has reiterated the agency's position that all schools should have mask mandates.