[sokoloff]

Fortunately, we’re not. In between, there was a vaccine developed and deployed and the science strongly (overwhelmingly is probably more precise) suggests that fully vaccinated people are at minimal risk to themselves and minimal risk to spread, which is of course the entire point of vaccines and entirely unsurprising given our understanding and long experience with other vaccines, which almost all exhibited the same disease control properties.

Getting vaccinated seems to me to be the exact opposite of throwing away all caution.

[ptaipale]

I quite agree, but I think the message from health authorities has also been problematic here: they repeated that "vaccinated individuals will still spread the infection".

That is true of course: some vaccinated individuals will still spread the infection because efficacy is not 100 %. But the public has, predictably, got this message wrong: I keep getting told that "vaccinated people will get the infection and spread it just the same".

No, not just the same. Vaccinated people are radically less likely to infect others. I do understand that the officials wanted to be careful and not encourage people to move around after being vaccinated, but perhaps they could have again worded their message differently, to be more honest and direct.

[cout]

Yes, that's the confusing bit.

In February, the CDC said that those with the vaccine can have asymptomatic infections (https://web.archive.org/web/20210209162120/https://www.cdc.g...). The NY Times used the term "silent spreaders".

Then in March the CDC's guidance was to continue wearing a mask after vaccination, except in situations where transmission risk was minimal (such as when everyone present has been vaccinated). They said we should do this while we're still learning about how vaccines affect the spread of the virus (https://web.archive.org/web/20210308164227/https://www.cdc.g...).

Now the CDC is saying fully vaccinated individuals do not need to wear a mask (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vac...), but no reason has been given for the change on that page. Were they wrong on asymptomatic infections in fully vaccinated individuals, or has the risk of spread simply been lowered because of the number of individuals who have received a vaccine?

Without knowing the reason behind the change in guidance (I'm sure there is one), I find it easy to be cynical and distrusting.

[_euac]

The changes can be explained by two simple factors, without the need for some grand nefarious conspiracy:

* The CDC's default position is caution * We know more now than we did in the past

In February, we realized vaccinated people could still get asymptomatic infections. Out of an abundance of caution, the CDC recommends vaccinated people keep wearing masks because the vast majority of the population isn't vaccinated.

As evidence accumulates in the intermediate time, we realize that vaccines also lower the percentage of people with asymptomatic Covid-19 [1]

With even more evidence, we realize vaccinated people overwhelmingly avoid hospitalization, which is the real issue we are trying to avoid [2]

With those two pieces of information, the CDC can now change their recommendation. Nothing nefarious going on, nothing 'unknowable' to anyone paying attention.

The problem is when people who are already predisposed to distrust the CDC - most likely due to their media diet - and put 0 effort in understanding the changing landscape see the CDC change the recommendation and assume it must be 'something political'. Those of us who were paying attention weren't that surprised about the announcement.

[1] https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...

[2] https://www.cdc.gov/media/releases/2021/p0428-vaccinated-adu...

[Gene_Parmesan]

I don't have a source for you, but my understanding is that the main reason for the change is that very recent studies have shown that people with vaccines and asymptomatic "breakthrough" infections carry a much lower viral load + viral shedding than previously thought. So even those vaccinated people who may have an asymptomatic infection are really at an extremely minimal chance to spread it to anyone else; they just aren't shedding enough virus particles to make the risk high.

[sokoloff]

I think many of us on HN object to imprecise messaging, sometimes to the point where it’s technically incorrect.

But I also have to admit that “Defund the Police”, “Flatten the Curve”, “I have a dream”, “Think Different” are more effective than a precise 2-page memo laying out a concrete plan.

Some people struggle with nuanced, complicated messaging. Others struggle when messages are over-simplified. I posit that the first group is a few orders of magnitude larger, at least in terms of effect of public comms.

[_euac]

There's almost a year between the time we originally went into lockdown to 'flatten the curve' and the time a significant part of the population got vaccinated. You can't pretend that not using a mask now - once someone is vaccinated - is the same as not using a mask back then.

[bwship]

I didn't wear one then, and don't wear one now.

[dguaraglia]

So basically what you are saying is that you drew your conclusion back then - who knows based on what data - and you are so set in your ways, there’s nothing that will change your mind.

Sounds like a super healthy way to approach life.

[blagie]

N95 masks ($2/day) + vaccines would almost certainly eliminate COVID19.

Wouldn't it be nice to eliminate COVID19?

Look at the heroics for WWI and WWII. And those caused fewer combat deaths.

You can't pretend Americans haven't grown selfish and lazy.

[sokoloff]

Once we achieve widespread (and seemingly very effective) vaccines, it’s not at all clear to me that spending trillions per year on masks for everyone and generating that additional amount of trash is the best use of those funds or “inconvenience points”.

[blagie]

Trillions?

That's the harm to the economy. That's not the cost of masks.

Providing everyone in the US with two high-quality N95-equivalent masks each week for a year would be at most $60 billion. ($2 per mask * 100 masks * 300 million people, at retail prices).

We didn't do that. Our kids have a half-year of learning loss. Small businesses around me closed, and a ton of people fell behind on mortgages. We're looking at pretty high inflation from how we've expended our money supply, eventually. Etc.

Part of the reason these things look like bad use of funds is that people don't do ROI calculations, and confuse millions, billions, and trillions. A trillion is a thousand times more than a billion, and a million times more than a million. But to everyone a MILLION dollars looks like a big number, as does a TRILLION dollars.

People also confuse the ridiculously high effectiveness of proper masks with the fairly low effectiveness of cloth masks.

[sokoloff]

> Providing everyone in the US

Can people not in the US harbor the virus? I assumed you were trying to eradicate it and to do so with your original figure of $2/day/person masks, it’s trillions per year worldwide. You later silently amended (not sure if in error or moving the goalpost) that figure to 2 masks/week in your $60B/yr estimate to cover most, not all, of the people in the US.

$2/day/person * 365 day/year * 7.5 B people/world -> over $5T/year/world

Thanks for the unneeded lesson on powers of 10, though.

[blagie]

sigh

* My comment was about the US. See the last line of my comment.

* In the US, the economic gains of having rolled out N95 and equivalent masks when they become widely available would have cost orders-of-magnitude less than the masks. Ending COVID19 sooner would still pay for a program like this today.

* Whether or not the vaccine will stop COVID19 is still TBD. We don't have good numbers on impact on spread, on ultimate vaccination rates, nor on mutations. It seems on-track, but still TBD.

* Yes, similar measures would need to be taken elsewhere to fully eradicate the virus, and that's assuming no animal stores. Doing math there brings up a million apples-to-oranges comparisons.

* Numbers in second post were was based on similar (successful) programs implemented in Taiwan and Korea, which did stop COVID19 (pre-vaccine) and allowed those economies to continue functioning, while ours imploded. Quotas were 2-3 per week, and everyone was required to use (and reuse) them. My second comment was more precise, if anything.