The Health 202: Obama’s CDC director says three feet of distancing in schools is fine, if people wear masks

“Look, 100 feet is safer than six feet, which is safer than three feet,” Frieden said during a Washington Post Live interview with me yesterday. “Is three feet okay for most schools? Absolutely, if they mask, if they repeatedly identify cases and isolate and quarantine.”

“Should students returning to school this fall be kept six feet apart? Or is three feet sufficient? And is it even feasible to keep children, particularly young ones, socially distant?

“Where schools land on those questions will determine their capacity for giving kids in-person instruction during an uncertain fall semester. States in the South and West are struggling with a renewed surge of covid-19 patients, setting new hospitalization records daily and forcing medical workers to add new intensive care beds and special air-flow systems.”

About one-third of school districts — serving millions of schoolchildren — have offered virtual-only instruction for much of the academic year. Those decisions stem partly from the six-feet recommendation.

Yet the widely acknowledged consequences of keeping kids at home for months on end, as well as a growing body of research showing that many schools have opened with little coronavirus spread, have prompted a heated debate over whether the CDC guidelines were too conservative and whether they should be modified.

“You have to be practical about what’s needed because it’s really important that our kids get back to school learning and in person,” Frieden told me. “We need to do that as soon as possible.”

Ashish Jha, dean of the Brown University School of Public Health, told the New York Times he wishes the CDC would “just come out and say” that keeping students six feet apart isn’t a major issue.

“It never struck me that six feet was particularly sensical in the context of mitigation,” Jha said.

Asked by a reporter whether he’s “frustrated” by the possibility of the CDC needing to do a “course correction” on its guidance, Cardona replied “not at all.”

“I recognize it may change,” he said.  “And if it does, we’re going to be able to adapt and work with [schools]…we recognize that partnership is what’s going to lead to our schools being open as quickly as possible.”

Earlier in the week, CDC Director Rochelle Walensky had acknowledged how hard it is for schools with limited space to keep students six feet apart, saying the agency is reviewing the Massachusetts study.

“We are looking at these data carefully,” Walensky told reporters Monday. “The question actually prompted more studies to be done, so we know more are forthcoming. We’re taking all of these data carefully and revisiting our guidances in that context.”

And Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, hinted an openness to revising the guidance to three feet in a Sunday interview with CNN.

“When the data shows that there is an ability to be three feet, [the CDC] will act accordingly,” Fauci said. “The CDC is very well aware that data are accumulating making it look more like three feet are okay under certain circumstances.”

The agency has said studies show in-person schooling isn’t a major driver of coronavirus spread. Yet its guidance still says six feet of distance is “required” in places with substantial or high transmission of the virus. Under the agency’s rubric, that includes the vast majority of the country, my colleague Karin Brulliard pointed out.

Furthermore, the World Health Organization recommends about three feet (one meter, it says), while the American Academy of Pediatrics recommends a range of three to six feet. Those guidelines have been in place since last summer.

Teachers are now starting to return to classrooms as they receive coronavirus vaccines. 

But many large districts — including in Chicago, Los Angeles and Northern Virginia — are still splitting classes in half. That means just two days of in-person instruction for each group — a direct result of following the six-feet guidance. In Chicago, the majority of public elementary and middle schools will be less than half full. 

Yet a new study in Massachusetts found schools with three feet of distancing had no more coronavirus spread than those with six feet of distancing.

The study compared 251 school districts adhering to different distancing minimums and found little difference in case rates among students and staff members. The authors concluded that schools with mask mandates can reduce distancing “without negatively impacting student or staff safety.”

It’s hardly the only evidence. Ever since August, we’ve written multiple editions of The Health 202 detailing new research finding that opening schools was safe and contributed little or not at all to spread of the virus.

Becerra is expected to narrowly win confirmation. Yesterday the chamber voted 50 to 49 to end debate and move forward to the final vote, with Sen. Susan Collins of Maine as the sole Republican to join Democrats in voting to advance Becerra’s nomination. 

While Democrats have sought to underscore the urgency of getting the nation’s top health official in place amid a pandemic, the majority of Republicans have opposed Becerra. GOP critics cite his support for abortion rights and his lack of medical experience. Sen. John Cornyn (R-Tex.) called Becerra a “partisan warrior.”

The Senate Health, Education, Labor and Pensions Committee voted Wednesday to advance the nominations of Vivek Murthy for surgeon general and Rachel Levine for assistant health secretary. All 11 Democrats on the committee, as well as Republican Sens. Lisa Murkowski (Alaska) and Susan Collins (Maine), voted to advance both nominations. Murthy also counted support from Republican Sens. Mitt Romney (Utah), Bill Cassidy (La.) and Roger Marshall (Kan.).

“Three months after vaccinations were made available to all members of Congress, about 1 in 4 members of the House have not received the shots to inoculate themselves against the deadly coronavirus, disregarding the advice of their own physician and missing an opportunity to promote public acceptance of the drugs,” The Post’s Marianna Sotomayor and Paul Kane report.

There is no public list of which lawmakers have received a vaccine, but The Post contacted 44 congressional offices to ask if the members had been vaccinated. Of the 23 that responded, nine Republican representatives said that they had not received the shot. None of the 15 Democrats contacted acknowledged not being vaccinated.

Several Republicans told The Post that they had already had coronavirus and intended to rely on natural immunity to avoid infection. Other Republicans, including House Minority Whip Steve Scalise (La.), said that they did not want to jump the line of Americans trying to get a shot.

Last week, Scalise cited the fact that 75 percent of members have received a vaccine as a reason to end the practice of remote voting and virtual committee hearings. But Democratic leaders have pushed back against that suggestion. House Majority Leader Steny H. Hoyer (D-Md.) told Scalise that he should urge more Republican members to get shots.

A Biden administration official told Bloomberg News that Mexico and Canada are at the top of Biden’s list to eventually receive vaccine exports from the United States.

The United States has so far spurned requests for vaccine sharing from other countries, even as it sits on millions of doses of AstraZeneca that have yet to be authorized for use in the country. Mexico made another request this week for the United States to share these untapped doses, Bloomberg News’s Josh Wingrove reports.

The Biden administration has said that the United States will not share vaccine doses until it has enough to vaccinate all Americans. 

“At this time, there have been requests around the world, of course, from a number of countries who have requested doses from the United States, and we have not provided doses from the U.S. government to anyone,” White House press secretary Jen Psaki said last week.

“For nearly the entire year, the COVID epicenter was not in China, where the pathogen originated, or in corners of South Asia or sub-Saharan Africa, where limited state capacity and medical infrastructure seemed, at the outset, especially concerning, but either in Europe or the United States — places that were rated just one year ago the best prepared in the world to combat infectious disease,” New York magazine’s David Wallace-Wells writes.

Many different explanations have been proffered for why some regions have done better than others: the random nature of superspreader events, the portion of the population that is elderly, the obesity rate, residential density, climate and humidity. The list goes on.

David adds another theory: Countries in East Asia and Oceania endeavored to eradicate the virus. “Mostly, they succeeded,” he writes. “When it mattered most, no nation in what was once grandly called ‘the West’ even really bothered to try.”

Countries in Europe and the Americas took a reactive approach to the virus, waiting for it to spread within their borders before implementing harsh shutdowns. The goal from public health officials was to reduce the spread of the virus, but the countries never leveraged the widespread testing, contact tracing and containment measures at the start of the pandemic that would have contained it.

There’s another corollary to this: U.S. commentators often focused on the many failures of the government response, led by a president who routinely made false statements about the virus. “But the problem with assigning Donald Trump all, or even most of, the blame for America’s suffering is that the country’s failure isn’t unique. In fact, before the arrival of vaccines, the American experience of the coronavirus was not exceptional but typical — at least among those European nations it typically considers its peers,” David writes.

• The CDC released new guidance recommending weekly coronavirus testing in workplaces. The agency also recommended broad screening at colleges and universities, detention centers and homeless shelters, The Post’s Ben Guarino reports.
   
• The European Union proposed creating joint vaccine passports for its more than 440 million residents in an effort to boost summer travel, The Post’s Rick Noack and Quentin Ariès report. But vaccinations are on pause across swaths of Europe after several countries temporarily halted the use of the AstraZeneca vaccine over concerns that it could lead to blood clots. It’s a decision that many scientists fear will contribute to spiraling infections.
   
• Democratic lawmakers have linked a massacre in Atlanta that left eight people dead to anti-Asian rhetoric during the pandemic. Six of the victims were women of Asian descent. While the motive of the killing is not yet known, Democrats say it comes amid a rise in anti-Asian animus and hate crimes, fueled in part, they argue, by rhetoric from President Donald Trump, who repeatedly called the coronavirus the “China virus” or “kung flu,” The Post’s Cleve R. Wootson Jr. and Marianna Sotomayor report.

Rahul Gupta, the top health official at maternal and child health advocacy group March of Dimes, is Biden’s likely pick to lead the Office of National Drug Control Policy, four people familiar with the selection process told The Post on the condition of anonymity to discuss confidential deliberations, The Post’s Dan Diamond, Matt Viser and Lenny Bernstein report.

Gupta previously served as West Virginia’s health commissioner and has a close working relationship with the state’s Democratic senator, Joe Manchin III, who has emerged as a key swing vote in the Senate.

But Biden is unlikely to elevate the drug czar to a Cabinet-level position, despite pressure from advocates who argue the role should have increased prominence amid a substance-abuse crisis that has only worsened during the pandemic.

Some anti-addiction advocates have raised concerns about Gupta, arguing that he did not do enough to support needle exchanges in West Virginia during a 2017 HIV outbreak there. The National Alliance for Medication Assisted Recovery has also asked Biden to probe Gupta’s role in a moratorium on new opioid treatment programs in West Virginia, according to a letter obtained by The Post. Other candidates being considered for the role include Santa Clara University professor H. Westley Clark and Regina LaBelle, the office’s acting director.

“Federal Medicaid officials on Wednesday sent letters to Arkansas and New Hampshire officials, informing them that the administration had formally scrapped the federal government’s permission for the states to mandate that some enrollees work, volunteer or attend school as a condition of coverage,” Politico’s Rachel Roubein reports.

The Biden administration’s push to unwind the Trump-era programs was long expected. The administration has indicated that it has serious concerns about the requirements and does not see them as consistent with the goals of the Medicaid program.  

Work requirements have been approved in at least a dozen states, but only Arkansas and New Hampshire received letters revoking their programs on Wednesday. The timing may be tied to a Supreme Court case aimed at reviewing lower-court decisions against work requirements in those two states.