The more than 28 million Americans fully vaccinated against the coronavirus will have to continue waiting for guidance from federal health officials for what they can and shouldn't do now.
The Biden administration said Friday that it's focused on getting the guidance right and accommodating emerging science, but the delays add to the uncertainty around bringing an end to the pandemic as the nation's virus fatigue grows.
"These are complex issues, and the science is rapidly evolving," Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said Friday. "We are making sure and taking time to get this right, and we will be releasing this guidance soon."
Such guidance would address a flood of questions from people who have been fully vaccinated: Do I still have to wear a mask? Can I go to a bar now? Can I finally see my grandchildren?
[CORONAVIRUS: Click here for our complete coverage » arkansasonline.com/coronavirus]
The need for guidance has slowly grown since January, when the first Americans began to complete the two-dose series of vaccinations then available. Now, more than half of people 65 and older have received at least one shot, said Andy Slavitt, a senior administration adviser on the pandemic.
In Washington state, Raul Espinoza Gomez has 22 grandchildren and great-grandchildren and an appointment today for his second dose.
By Easter, the 77-year-old's immune system will be ready to protect him from the virus. But how the family celebrates will depend on government advice, said Melissa Espinoza, 47, of Carnation, Wash., who plans to drive Gomez, her father-in-law, to get his second shot.
"We didn't gather together as a big family at Christmas," she said. "We go by what the state and federal guidelines recommend. We've had family members adversely affected by covid. We know the risks are severe."
[Video not showing up above? Click here to watch » https://www.youtube.com/watch?v=pgpEsbgUwTk]
OPENINGS CAUTION
Worried about persistently high caseloads and deaths, the Biden administration has condemned efforts to relax states' virus restrictions and pleaded with the public for several months more patience.
The caution has drawn critics, who point to the administration's own warnings that "fatigue is winning" as evidence that they need to be more optimistic about the path ahead to secure the cooperation of those who are yet to be vaccinated.
"I think it's going to be overly proscriptive and conservative, and that's the wrong message," former FDA Commissioner Scott Gottlieb told CNBC on Wednesday of the forthcoming CDC guidance.
"If we continue to be very proscriptive and not give people a realistic vision for what a better future is going to look like, they're going to start to ignore the public health guidance."
Dr. Jeremy Faust, an emergency physician at Brigham and Women's Hospital in the Division of Health Policy and Public Health, encouraged the CDC to be clearer about when and how it plans to produce the guidelines.
"Making the decision to go by the science is also making the decision that you're going to have to make a decision, which is really difficult when the science isn't settled," he said. "They're drinking from a fire hose of science, and sometimes it gets messy."
More than 55.5 million Americans have received at least one dose of vaccine, and slightly more than half of those -- 28.7 million -- have gotten the recommended two doses. The single-dose Johnson & Johnson shot soon will add a couple of million more Americans with questions about what new freedoms they can safely enjoy.
"I do hope I get to see my great-grandchildren more," said Rolando Solar, 92, who received his second dose in Miami on Wednesday. "But I know things will not go back to normal and, for an old man like me, this is as good as it will be."
Tami Katz-Freiman, 65, of Miami, got her second dose three weeks ago, and plans to watch the Miami Film Festival virtually Sunday at the home of unvaccinated friends. All will wear masks.
"We didn't have to discuss it with each other, because it's very clear to me that when there is a doubt and you don't have a CDC straightforward rule you better be on the safe side and take care for yourself," Katz-Freiman said.
Experts say it's understandable that the CDC has been cautious when many scientific questions remain, including how long vaccine-induced immunity lasts and whether vaccinated people are still able to transmit the virus to others. The answers are important when advising someone about what kind of risk they face in different settings, and how much of a risk they are to others.
"The vaccines at their best, in the clinical trials, were 95% effective. I didn't say 100%. And that's why we have to keep wearing masks most of the time," said Dr. William Schaffner, an infectious-diseases expert at Vanderbilt University.
[GALLERY: Click here for more photos » arkansasonline.com/36covid19/]
But the CDC has needed to come out with something more for vaccinated people than sticking with the same old mask-wearing, social-distancing guidance, he added.
"People are so eager to do something, and they want to see some tangible benefit from the vaccines. Americans are impatient. They want to get on with it," Schaffner said.
TEACHER NUMBERS
The national rush to vaccinate teachers in hopes of soon reopening pandemic-shuttered schools is running into one basic problem: It's not known how many teachers are getting the shots, or refusing to get them.
States and many districts have not been keeping track of school employee vaccinations, even as the U.S. prioritizes teachers nationwide. Vaccinations are not required for educators to return to school buildings, but the absence of data complicates efforts to address parents' concerns about health risk levels and some teachers unions' calls for widespread vaccinations as a condition of reopening schools.
The number of school staff members receiving vaccinations -- and refusal rates -- are unclear in several large districts where teachers were prioritized, including Las Vegas, Chicago and Louisville, Ky.
Some state agencies and districts have said privacy concerns prevent them from tracking or publishing teacher vaccination data. Others say vaccine administration sites are not tracking recipients' occupations, and they are not in position to survey employees themselves.
No states are publicly reporting the percentage of teachers and school staff members that have been vaccinated, according to a Johns Hopkins University analysis published Thursday.
Education leaders are missing out on an opportunity to address hesitancy about when it's safe to go back, said Megan Collins, co-director of the Johns Hopkins Consortium for School-Based Health Solutions. Increased transparency could influence back-to-school decision making, she said, and would likely make teachers and students more willing to return to classrooms.
"We're seeing a substantial disconnect. There are states not prioritizing teachers for vaccine that are fully open for in-person instruction, and others that are prioritizing teachers for vaccines but aren't open at all," Collins said. "If states are going to use teacher vaccinations as a part of the process for safely returning to classrooms, it's very important then to be able to communicate that information so people know that teachers are actually getting vaccines."
More than a dozen states had yet to prioritize teachers for vaccines before President Joe Biden this week directed all state governments to administer at least one vaccination to every teacher, school employee and child-care worker by the end of March. Biden has promised to have most K-8 schools open by the end of his first 100 days in office, or the end of April.
The CDC did not include vaccinating teachers in its guidelines for schools to consider when to get students back to classrooms, but vaccines have been a sticking point in reopening debates.
BACK TO SCHOOL
Oregon Gov. Kate Brown said Friday that she will issue an executive order mandating that all K-12 public schools provide universal access to in-person learning by month's end for students up to fifth grade and by mid-April for older students.
The state's case numbers have fallen sharply in recent weeks. Oregon put teachers ahead of older residents in line for the vaccine -- a decision that angered many people 65 and older. As teachers get vaccinated, Brown has been under pressure from parents and local officials in many counties to reopen schools.
Many teachers' unions nationally have balked at a return to in-person learning, putting them at odds with Democratic governors like Brown in some states.
In neighboring Washington state, Gov. Jay Inslee has implored educators to return to the classroom, but most students there are in online classes, and the Seattle teachers' union is defying a district plan to return special education students to schools. In Chicago, the teachers' union last month agreed to return to class with expanded access to vaccinations and metrics that will lead to school closures again if case numbers spike.
In a letter to Oregon's Health Authority, Brown said the "science was clear" and that she was "relieved" that she could get children back to class.
"I feel so much hope for Oregon's kids, their parents and their schools, as we continue to navigate this pandemic," she said. "Our kids are our future, and we need to do everything we can to make up for the losses of 2020."
Many parents reacted with relief and said the past year had been extremely difficult for their children.
"It's very positive and definitively a step in the right direction -- and frankly, it's about time. Clearly, it's been hard for districts to figure out what's going to be best for their students, and it's taken a long time," said Katie Chrisman, who has a child each in elementary school, middle school and high school in the Portland suburbs.
Her children "haven't had a ton of suffering, but they're definitely not thriving -- and for me, that's been the biggest concern," she said.
STATES' PUSH
California Gov. Gavin Newsom, under threat of recall, is pushing for young students' return to classrooms. Nevada, with 11 straight months of declining gambling revenue, wants to scrap most virus-related restrictions. Alabama, with one of the lowest covid-19 vaccination rates among U.S. states, is saying goodbye to masks next month.
Governors loosening coronavirus restrictions -- or, like Texas and Mississippi, lifting them entirely -- are counting on Johnson & Johnson's new vaccine to usher in a return to prepandemic life. Health experts say their surrender to tantalizing normality, amid a death toll of 522,000 and climbing, is courting a potential fourth U.S. surge.
Coast to coast, deaths have slowed and cases have fallen, but the latter figure has plateaued. By month's end, the supercontagious U.K. variant of covid-19 will dominate among American cases, according to the CDC.
"We're now dealing with a virus that's better at its job than the one we were dealing with a few months ago, so it makes it even more irresponsible to open up," said Robert Wachter, chairman of the department of medicine at the University of California, San Francisco.
In the U.S., no elected officials have moved more boldly against pandemic safety precautions than Republican Govs. Greg Abbott of Texas and Tate Reeves of Mississippi, who Wednesday lifted mask rules and rescinded other orders intended to slow the virus's spread.
Abbott and Reeves have said they have to reopen for the sake of the economy, but some of their Republican peers are being more cautious.
Gov. Jim Justice of West Virginia, which has one of the nation's leading vaccination rates, in a CNN interview called unmasking "almost a macho thing."
Information for this article was contributed by Carla K. Johnson, Mike Stobbe, Zeke Miller, Kelli Kennedy, Casey Smith, Jocelyn Gecker, Sophia Tareen, Sara Cline, Anna Liz Nichols and Gillian Flaccus of The Associated Press; and by Elise Young and Josh Saul of Bloomberg News (WPNS).
