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CDC issues new covid-19 guidelines at a time of protests and rallies

Anthony S. Fauci, the nation’s top infectious-disease expert, said Friday that it is a “danger” and “risky” for people to be gathering in large groups. (Jabin Botsford/The Washington Post)

The Centers for Disease Control and Prevention released new coronavirus guidelines Friday to help Americans navigate a changed country, as they face mass protests, spiking cases in many states and President Trump’s plans to return to holding big rallies.

The CDC guidance includes a recommendation that organizers of large events that involve shouting, chanting or singing “strongly encourage” the use of cloth face coverings. That is complicated by a push to reopen the country even as more than 2 million Americans have now been infected by the coronavirus.

Federal health officials on Friday said their guidance was aimed at keeping people safe as states reopen and communities plan and hold gatherings, such as concerts, festivals, conferences, parades, weddings and sporting events. Jay Butler, the CDC’s deputy director of infectious diseases, sidestepped questions about whether the agency’s new guidance for large gatherings applies to campaign rallies, saying the recommendations speak for themselves.

“They are not regulations. They are not commands,” Butler, who is helping lead the agency’s coronavirus response, told reporters during the first full CDC briefing in more than three months. “But they are recommendations or even suggestions [on] how you can have a gathering that will keep people as safe as possible.”

The CDC guidance comes after more than two weeks of national protests where many demonstrators wore masks but others did not. It also coincides with Trump’s plans to hit the campaign trail next week and to accept his party’s nomination at a packed convention in Jacksonville, Fla., in August.

Anthony S. Fauci, the nation’s top infectious-disease expert, said Friday that it is a “danger” and “risky” for people to be gathering in large groups — whether at a Trump rally or a protest. Speaking on ABC News’s “Powerhouse Politics” podcast, Fauci said that if the gatherings take place, people should “make sure” to wear a mask.

Trump has repeatedly refused to wear a face covering in public, and recently moved the main part of his party’s nominating convention from North Carolina to Florida after North Carolina Gov. Roy Cooper (D) declined to promise he could speak to a packed arena. Trump has indicated he does not want to require participants to wear masks for his acceptance speech.

The dissonance comes as fears of a new wave of coronavirus surging in several regions, with a number of states reaching record-high cases in recent days.

In Oregon, Gov. Kate Brown (D) imposed a one-week pause on the state’s reopening process, pointing to evidence that coronavirus infections are rising in both urban and rural parts of the state.

The move is intended to give public health experts time to determine why the virus is spreading and whether the state needs to modify its reopening plan, Brown told reporters. She said she planned to work with those experts to decide whether to extend the pause, lift it early or take other action to stem the spread.

“This is essentially a statewide yellow light,” she said, a day after the state recorded 178 infections, its highest number since the outbreak began.

Other states, including Florida, where the governor publicly lobbied for the Republican convention by promising relatively few restrictions, have also seen record infections in recent days. The spike has come in the wake of a broad push to reopen businesses and relax social distancing restrictions.

Public health experts say they are seeing a “new wave” of states experiencing a surge of cases, including Arizona, California, North Carolina and Texas.

At the CDC, Butler said that while the number of new cases each day has “relatively plateaued over a prolonged period of time” nationwide, communities are experiencing variable levels of transmission as they ease mitigation efforts.

In coming weeks, states could see cases increase as they reopen and as more people participate in mass gatherings, Butler said. He warned about “additional potential challenges” in the fall and winter when covid-19, the disease caused by the coronavirus, begins circulating alongside the seasonal flu.

If cases start to increase dramatically, officials may need to consider reimposing the kinds of measures states used in March, such as stay-at-home orders, Butler said, adding that local officials will be the ones making the ultimate decisions.

While Trump and his top administration officials have asserted that future economic shutdowns are off the table even if cases spike, growing hospitalizations in some areas could force local officials’ hands.

Several coastal counties in Florida are experiencing a rise in cases and high occupancy in intensive care units, according to a briefing received by the Federal Emergency Management Agency, said a FEMA official who spoke on the condition of anonymity to describe the private conversation.

St. Lucie, Fla., has reached 100 percent ICU bed occupancy, the official said. Hospitals in Arizona have also sounded the alarm about a sharp decline in available ICU bed space, as case numbers there have surged since late May.

In Tulsa, where Trump plans to hold his first rally in months next week, officials reported 71 new cases Friday, the city’s second-highest daily total. Oklahoma overall is seeing cases climb to new highs.

CDC Director Robert Redfield began Friday’s briefing by saying he recognizes that Americans are eager to return to normal activities, but he added that it’s important to remember that “this situation is unprecedented and that the pandemic has not ended.”

Officials said the guidance released Friday is intended to help people stay as safe as possible as the country heads into the summer months and Americans seek to reconnect with family and friends.

Protests over the death of George Floyd when a Minneapolis police officer knelt on his neck have dwindled in size after erupting into mass demonstrations in major cities across the country. While many protesters wore masks, public health experts have expressed fears that the lack of social distancing at the events may have accelerated the spread of the coronavirus. Many police officers present at the marches also were not wearing face coverings.

Some Trump allies saw the mass gatherings as a signal for the president to restart his political rallies, which have often involved long lines and arenas packed with thousands of supporters. Trump’s last rally was in February, and his campaign manager Brad Parscale said Friday that more than 200,000 people have requested tickets for the Tulsa rally.

But top health officials in the Trump administration continue to warn against mass gatherings, adding to an ongoing sense of tension between the president and his own advisers.

A similar recommendation for using cloth face coverings in settings that involve shouting, chanting or singing, including choirs, was removed from the CDC’s guidance for reopening houses of worship last month after weeks of debate between the White House and the CDC.

Republican National Committee chairwoman Ronna McDaniel told Fox News on Friday that the party will have a “packed arena” at its national convention in Jacksonville, while also putting “safety checks” in place to keep attendees safe.

Some public health officials have complained that inconsistencies in the federal government’s guidance for the pandemic, as well as the CDC’s relatively low profile, has left many Americans unsure how to respond. The last full CDC briefing was March 9.

“If the guidance isn’t clear from the top, from our political leaders and public health leaders, people will be confused,” said Tom ­Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health.

“I am really concerned about some of the things that I hear about this virus being behind us or ‘we aren’t planning on issuing any more directives or communicating about this,’ ” he said. “I think it’s going to be really important from the top of government . . . to be communicating about risks.”

On large gatherings, the new guidance says event planners should consider several strategies, including broadcasting regular announcements about steps attendees could take to reduce the virus’s spread; limiting attendance or seating capacity to allow for social distancing; and reconfiguring parking lots to limit congregation points.

It also suggests limiting attendance to people who live in the area and working with local officials to identify how to separate people with covid-19-like symptoms or those who have tested positive for the virus but do not have symptoms.

Separately, officials laid out recommendations to help individuals reduce their own risk for infection as they resume daily activities, including using drive-through services and taking the stairs rather than a crowded elevator.

Officials also released a report showing Americans strongly supported stay-at-home orders in early to mid-May, with most adults reporting they would not feel safe if those orders were lifted. Most also said they often or always wore face coverings.

Several new studies published this month support wearing masks to curb the transmission of the virus. The broadest, a review funded by the World Health Organization and published in the journal Lancet, concluded that data from 172 studies indicate wearing face masks reduces the risk of coronavirus infection.

“Our findings suggest, in multiple ways, that the use of masks is highly protective in health-care and community settings,” said the author of the review, Holger Schünemann, an epidemiologist and physician at McMaster University in Ontario. He cautioned that the studies collected in the Lancet article were observational, not randomized trials, limiting the conclusiveness of the results.

Werner Ernst Bischoff, a professor of infectious diseases at Wake Forest University known for his studies on respiratory transmission of viruses, said masks are critical because the simple act of breathing releases potentially infected particles.

Loud talking, yelling and singing release even more, he said.

“You want to create a seal,” said Bischoff, who said he sees masks as the “critical element” in preventing transmission — even more than hand-washing or disinfecting surfaces.

Isaac Stanley-Becker, Jacqueline Dupree and Ben Guarino contributed to this report.