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Emory’s associate chief medical officer responds to new CDC guidance on masks

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Emory’s associate chief medical officer responds to new CDC guidance on masks

Emory University Hospital Chief Medical Officer Dr. Colleen Kraft held a press conference on Tuesday, July 27, to discuss the COVID-19 delta variant and the updated CDC guidance related to masks. Photo by Zoe Seiler.
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Atlanta, GA — Emory University Hospital Associate Chief Medical Officer Dr. Colleen Kraft held a press conference on Tuesday, July 27, in response to the new recommendations from the Centers for Disease Control and Prevention.

The CDC recommended vaccinated individuals should resume wearing masks in public, indoor spaces and that everyone in K-12 schools should wear masks, regardless of vaccination status. Kraft agreed that these steps were necessary to stopping the spread of COVID-19.

“The recommendations for mask wearing for vaccinated [people] also feels maybe like a punishment,” Kraft said. “You got vaccinated, you’re following public health advice but in general we don’t want anybody to be infected, even if there’s a small chance for you to be infected and there’s a small chance for you to transmit it, this is just a way to sort of really stop that transmission at all times and make sure that it’s not going to persist and also mutate any further.”

She did not think that the CDC moved too quickly to lift the mask guidance a few months ago, as cases of the delta variant were lower at the time.

“Over 80% of people that get COVID today are getting the delta variant. That’s how quickly it’s spreading,” Kraft said. “So I think there was a time during the summer when we had such a low community prevalence and people sort of, whether they were mask wearing or not, the transmission was really low.”

She added the guidance was appropriate for what the country saw at that time.

“I don’t think any of us really want to be in this position or want to go back to masking,” Kraft said. “But again, we’re finding ourselves in the same place we were a year ago, July 2020, and I think instead of making nuanced guidance, I think trying to just make sure that everybody understands we’ve got to go back to stopping transmission is our most important part of this.”

RNA viruses, such as COVID-19, tend to mutate the longer they’re allowed to transmit, Kraft said. So the longer COVID-19 is allowed to transmit, the more likely it is going to mutate and the delta variant is more transmissible, probably needs less time to transmit and also probably causes more virus in the system to be replicated, she added.

Georgia has been through three surges of COVID-19 and this is the first surge that the state is seeing after a serious vaccine attempt “and I think that one of the things that we’re learning is that if we’re going to have low vaccine uptake, or we have a number of people who can’t be vaccinated yet, such as children, that we really need to go back to the stopping of transmission, which involves mask wearing,” Kraft said.

She added that people may feel like the community is sliding backward but thinks that in general, until more people get vaccinated or until transmission can be stopped, mask wearing is going to be the easiest fix, so officials can figure out how to stop the transmission so that people can get back to their daily lives.

During the CDC press conference, CDC Director Dr. Rochelle Walensky said that breakthrough cases can transmit the virus and have about the same viral load as cases in unvaccinated individuals. Kraft has seen the same in cases where people have the same amount of virus in their nose.

“When we see these breakthrough cases, these are people that are actually not producing enough immunity to fight against that variant, and it’s most likely going to be the variant in this case,” Kraft said. “That sort of setting up shop in your nose and making you symptomatic is going to produce enough virus to be able to transmit it to somebody else. But the benefit of having the vaccination is that you yourself should not be seriously ill and for sure not hospitalized due to that breakthrough infection.”

The transmission is why masks are being recommended again, Kraft said.

“So we know the Delta variant can’t get through masks, and so we need to go back to the things that worked, even though we were hoping with increasing uptake in vaccination that people could kind of be able to do their normal activities,” she said.

One question raised during the press conference was whether the U.S. has put too much faith in the vaccinations, especially since states have been unable to increase vaccination rates.

“I think that we needed to put our faith in something,” Kraft said. “I do think that if we had achieved sort of a high vaccination rate, we would have felt that we had been able to stop transmission before the delta variant could have gotten into our borders or come from our borders, whichever way it was transmitted.”

In regard to mandating vaccines, Kraft said the country is balancing how to support public health during a pandemic where there are extreme perceptions about COVID-19.

“So as somebody that wants to respect an individual and their decision to make a decision about their own health, I am a physician, I’m a clinician, I want to empower people,” Kraft said. “I think that we are probably going to be getting into the mandated aspects, at least for some groups of people.”

She added that it’s a balance of wanting people to feel like they have choice in what they can do. She also said that if vaccines are pushed harder, there may be some unintended consequences.

“I’m not saying that I wouldn’t advocate for a vaccine mandate, but I also want people to be educated, make their own good decisions as well,” Kraft said. “So I think to me, it’s that balance, and I’m not sure that we’re hitting that balance yet.”

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