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What's your risk of getting COVID? The CDC recently changed the answer

SARAH MCCAMMON, HOST:

What is your risk of getting COVID-19? That's been the question hanging over daily decisions for two years now, and it seems to have changed again recently. The Centers for Disease Control and Prevention came out with a new way of measuring COVID levels in a given area, signaling a shift in how the U.S. plans to navigate the pandemic. But as NPR's Will Stone reports, some people are questioning how useful that tool is.

WILL STONE, BYLINE: It was like the CDC was painting its COVID map with an entirely new palette. Gone were the huge patches of bright red, indicating high levels across much of the U.S. Instead, there was an inviting mix of green and yellow - a sign of low or medium COVID levels.

Madison County, Iowa, underwent this transformation from red to green that left Cindy Watson totally confused. She's 61 and a professor of math and science.

CINDY WATSON: And if I'm confused, holy cow, everybody else has got to be really confused.

STONE: The change in color came with a change in guidance. Americans in low and medium counties could now shed their masks.

WATSON: And all of a sudden, the CDC said, hey, you can unmask. OK, based on what?

STONE: Cindy Watson is right to be confused, says Jessica Malaty Rivera, who's an epidemiologist at the Pandemic Prevention Institute.

JESSICA MALATY RIVERA: That is a perfect example of a situation that is not actually low risk.

STONE: This is what happened - the CDC adjusted how it calculates the level of COVID in different communities. Before, counties were ranked by the number of infections. Now it's mostly tied to hospital admissions and how many beds are filled with COVID-19 patients. Cases do get factored in, but the CDC has raised the threshold substantially. A county can be green if it has under 200 cases per 100,000 people in the past week, which is a lot higher than it was before. Here's Rivera again.

MALATY RIVERA: It's honestly shocking. What it looks like is quite literally a changing of thresholds in order to justify a policy that I think assumes way too much risk.

STONE: But the CDC says there's good reason to shift the focus to severe disease and keeping hospitals from being overwhelmed. After all, cases don't mean what they did two years ago. Vaccines and immunity from prior infections are keeping many people who catch the virus out of the hospital. And there's another goal to make things simple and clear for Americans.

(SOUNDBITE OF VIDEO)

GRETA MASSETTI: Knowing the COVID-19 community level in your area...

STONE: That's a CDC scientist pitching the new map in a recent informational video, but some experts say this is not the best way for an individual to gauge their risk of catching the virus.

JEFF DUCHIN: CDC is putting a lot of weight on preventing hospitalizations, and that's really important.

STONE: Dr. Jeff Duchin, the health officer for Seattle and King County.

DUCHIN: However, different individuals may put more weight than CDC did on simply preventing infection.

STONE: This is why Duchin thinks the CDC guidance is better suited for public health agencies like his, not the average person who's just trying to figure out, how worried should I be going to the grocery store or the gym? For that, cases do matter a lot, and hospital numbers aren't a real-time reflection of disease. They tend to trail infections by about a week.

Josh Salomon is an infectious disease modeler at Stanford. He says it could take a while for a county to move into the high-red category.

JOSH SALOMON: What I worry about is that this switch is going to be too late to prevent a lot of illness and death.

STONE: Because it's only in the red that the CDC tells people to take meaningful action, like wearing a face mask. Up to that point, people who are at high risk, like the immunocompromised, have to decide for themselves whether to take extra precautions.

SALOMON: It really does continue to shift the emphasis of protection as being an individual-level response as opposed to a collective responsibility.

STONE: But Dr. Jay Varma at the Weill Cornell Center for Pandemic Prevention and Response says this kind of transition happens all the time in public health.

JAY VARMA: I am OK with the decision to shift from a primarily collective responsibility to an individual one, as long as government continues to do its part.

STONE: Meaning people who do want to be cautious need resources, like tests, high-quality masks and clear messaging.

Will Stone, NPR News.

(SOUNDBITE OF NICK BOX'S "THOUGHTS") Transcript provided by NPR, Copyright NPR.

Will Stone
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