There has been no shortage of anecdotal evidence that drinking increased during lockdown, but now a documented surge in alcohol-related gastrointestinal and liver disease consultations suggest to Brown University researchers that heavy drinking occurred during the pandemic.
Doctor visits dropped during lockdown while consultations for alcohol-related gastrointestinal issues and liver disease soared according to Dr. Waihong Chung, lead researcher of the study and a research fellow for the Division of Gastroenterology at the Warren Alpert Medical School of Brown University in Providence, Rhode Island.
Chung presented his team’s finding during a Thursday briefing hosted by Digestive Disease Week (DDW) 2021.
During the pandemic lockdown, the total number of gastrointestinal, or GI, consults was down 27% compared to the previous year.
“But, the proportion of consults for alcohol related GI and liver disease increased sharply — by about 60%,” he said. “In particular, we saw about a 53% increase in acute alcohol hepatitis, which is a very serious condition with a very high short term mortality.”
Alcohol-related GI liver disease includes conditions such as acute alcohol pancreatitis, alcoholic cirrhosis, alcoholic gastritis and alcoholic esophagitis.
Chung believes the study is an accurate reflection of what also happened in other urban and suburban areas across the U.S., because it involved nearly 1,300 records from a systemwide audit of the largest health system in Rhode Island.
During the reopening phase, the number of GI consults returned to pre-pandemic levels and consults for alcohol-related GI and liver diseases remained highly elevated by about 80%.
“More impressively, the relative volume of patients presenting with acute alcoholic hepatitis has more than doubled compared to the prior year,” Chung said. Case counts were up 127.2% compared to 2019.
The number of people needing inpatient endoscopic procedures was considerably higher, 34% compared to 12.8% in 2019. There also were worse outcomes from blood count liver function tests.
“In further analysis, we noted that during the lockdown phase, the majority of admissions for alcohol-related GI and liver diseases clustered around weeks five, six and seven of lockdown,” Chung said. “This timeframe mirrors the length of time it takes for symptoms to appear for these diseases, suggesting the start of the pandemic may have had an impact on patients’ alcohol consumption.”
Because many people who have alcohol-related diseases aren’t admitted to a hospital right away or at all, researchers believe health problems related to increased alcohol use may be even higher in the community.
Chung said alcohol use often is a manifestation of other problems such as mental health issues, anxiety or depression. He believes all doctors should talk with patients about alcohol use much like they routinely do blood pressure checks.
“And, identify people who might need help — sooner rather than later,” Chung said.
Patients diagnosed with post-COVID-19 syndrome, or so-called COVID-19 ‘long-haulers’, may experience symptoms such as mood disorders, fatigue and cognitive impairment that can make it difficult to return to normal life, according to a recent study.
The Mayo Clinic study, published Wednesday, found that fatigue was the most commonly reported symptom of patients being treated for post-COVID-19 syndrome. Of those studied, 80 per cent reported unusual fatigue, 59 per cent had respiratory complaints, and a similar percentage had neurologic complaints.
According to the study, which includes findings from the first 100 patients to participate in Mayo Clinic's COVID-19 Activity Rehabilitation program (CARP), which evaluates and treats post-COVID-19 syndrome, more than one-third of patients said it was difficult to perform basic daily tasks, and only one in three patients had resumed their usual duties at work.
“Most patients with whom we worked required physical therapy, occupational therapy or brain rehabilitation to address the perceived cognitive impairment," Greg Vanichkachorn, medical director of CARP and first author of the study, said in a press release.
"While many patients had fatigue, more than half also reported troubles with thinking, commonly known as 'brain fog.' And more than one-third of patients had trouble with basic activities of life. Many could not resume their normal work life for at least several months."
The patients involved in the study were evaluated and treated between June 1 and Dec. 31, 2020 and were evaluated an average of 93 days after they were infected with COVID-19. The average age of the participants was 45.
Most patients in the study had no pre-existing conditions prior to contracting COVID-19, and many did not experience COVID-19 symptoms that were serious enough to require hospitalization.
"Most of the patients had normal or non-diagnostic lab and imaging results, despite having debilitating symptoms. That's among the challenges of diagnosing [post-COVID-19 syndrome] in a timely way and then responding effectively,” said Vanichkachorn.
So-called COVID-19 long-haulers have been speaking out about the long-term health effects of the disease since the early days of the pandemic, and a growing body of research points towards just how impactful post-COVID-19 symptoms can be on patients.
A review of nine long-term studies published in the journal Nature Medicine in March looked at the frequency of symptoms among long-haulers, the most common of which included fatigue, shortness of breath, anxiety, depression, and post-traumatic stress disorder.
Three studies from France, Britain and China showed that between 25 and 30 per cent of patients reported sleep disturbances weeks after recovering from COVID-19. And in a cohort of 402 survivors in Italy who had been hospitalized due to COVID-19, 56 per cent tested positive for at least one psychiatric condition such as PTSD, depression or anxiety.
Some COVID-19 long-haulers have reported improved symptoms after being vaccinated, but researchers are still calling for more research to be done into the long-term effects of the disease.
"As the pandemic continues, we expect to see more patients who experience symptoms long after infection, and health care providers need to prepare for this, know what to look for, and know how to best provide for their patients' needs," said Vanichkachorn.
COVID-19vaccines approved by the United States like Pfizer, Moderna, and Johnson and Johnson have effectiveness against the B1617 variant of the virus that is predominant in India, which is experiencing one of the worst outbreaks of the pandemic, a top American health official said.
The observation is based on the latest data about the variant and the three major vaccines approved by the United States, said Dr Francis Collins, Director of the National Institute of Science.
“The data is coming in, and it looks very encouraging that the US-approved vaccines, the Pfizer, the Moderna, the J&J, do have effectiveness against this variant called B1617,” Collins told the media.
“It's a little less effective in that case than some of the others, but it looks like it ought to be good enough to make Americans protected. And that's really a good thing to hear,” he said in response to a question.
Early this week, the World Health Organization classified the B1617 SARS-CoV-2 variant, which was first detected in India, as a variant of concern. The WHO said that evidence showed B1617 was more transmissible.
The state of Michigan is following suit with federal health officials, lifting requirements for fully vaccinated people to wear masks in most situations.
The new rules from the Michigan Department of Health and Human Services go into effect at 9 a.m. Saturday.
The announcement from Gov. Gretchen Whitmer’s office came Friday morning, the day after the U.S. Centers for Disease Control and Prevention issued updated mask guidance. If you’re fully vaccinated, you won’t have to wear a mask in most situations — though the CDC still wants you to wear one in a hospital, on public transport or aboard an airplane.
You’ll also still have to follow any rules set by your local government, your workplace (the Michigan Occupational Safety and Health Administration has yet to issue updated guidance) or instituted by a business.
Meijer, for example, said in a Friday statement that it will keep requiring masks at all its stores, citing its desire to keep workers and shoppers alike safe.
“While we are aware of new CDC guidance, many state or local orders in the Meijer footprint remain in effect regarding masks. In order to help ensure the continued health and safety of all its team members and customers, Meijer continues to require face coverings by anyone entering a Meijer store or Meijer Express station at all locations, except where medical conditions prevent them from wearing one.“
People who are not fully vaccinated — that is, are not two weeks past their final dose — must still wear their masks indoors.
“The safe and effective COVID-19 vaccine and all the hard work that Michiganders have done allows us to take a big step in returning to normal,” MDHHS Director Elizabeth Hertel said in a statement. “This updated order keeps Michigan in alignment with CDC guidance that is based on the knowledge of health experts. I urge our residents to continue to be respectful of each other as we move forward.”
Clay Wilms, a customer at the Meijer on West Main Street west of Kalamazoo, said that even though he is fully vaccinated, he will keep wearing his mask for now even if a business decides to not require it.
“I think everybody going to have to make a decision and some people are going to go one way and some people are going to go the other,” Wilms said.
Small retailers like The Spirit of Kalamazoo are often aligning their policies with state requirements, according to boutique co-owner Kathleen Widner.
“We will have a sign on the door that says if you’re fully vaccinated, you do not have to wear a mask but that staff at The Spirit of Kalamazoo will continue to wear their masks and we are fully vaccinated,” Widner said.
The store plans to revisit the employee requirement after a week and follow rules set by MIOSHA once they are released.
Stacy Skartsiaris, the owner of Theo and Stacy’s restaurant in downtown Kalamazoo, said the entire staff is vaccinated but it may keep the mask requirement for employees a bit longer. Server Kristen Bowers said she does not mind having to wear a mask.
“The customers might still be uneasy at first. I think that over time they might get more comfortable with it but at first it’s something that you probably want to ease into,” Bowers said.
Marsha Mansaray, the deputy administrative health officer for Ottawa County, said county health departments could choose to implement their own masking rules but that hers has no plans to do so.
“I think most businesses that serve the public will probably minimize their requirements for masking unless they serve a public that’s compromised, their health is at risk,” Mansaray said.
No one, vaccinated or not vaccinated, has to wear a mask outdoors. That means, the Detroit Tigers tweeted, that you don’t have to wear a mask at Comerica Park as of Saturday.
In light of the new guidance issued Thursday by the U.S. Centers for Disease Control and Prevention, and in accordance with state and local health officials, effective May 15, guests will not be required to wear masks at outdoor locations/seating areas within Comerica Park.
After July 1, the indoor mask mandate will run out for everyone regardless of vaccination status.
—News 8 reporter Kyle Mitchell contributed.
WHITMER CONTINUES TO URGE VACCINATIONS
Michigan’s first mask order was issued by the governor 385 days ago, on April 24, 2020.
“Throughout this entire pandemic, our north star has been data and science from the CDC and our public health professionals, and we are going to continue to listen and trust the experts,” Whitmer said in a video posted to social media. “And after months of getting out the damn vaccines, the data is clear: The COVID-19 vaccines are a miracle of modern science and they work to keep people safe from this deadly virus.”
We’ve trusted scientists and experts to keep us safe during the pandemic, and it’s worked. With millions of Michiganders fully vaccinated, we can now safely take the next step to get back to normal. Vaccines protect you and your loved ones, if you haven’t already, sign up today. pic.twitter.com/zjXoKeSQDW
— Governor Gretchen Whitmer (@GovWhitmer) May 14, 2021
Whitmer, who is now more than two weeks out from her second dose, said she was “excited to get back to the things that we all know and love.”
But she also warned that “this doesn’t mean that the COVID-19 pandemic is over,” and she called on people who haven’t been vaccinated to do so.
As the guidance was coming out of Lansing, Lt. Gov. Garlin Gilchrist was in Grand Rapids visiting a local vaccine clinic. He said Whitmer’s administration was still looking at how the new mask guidance would affect her “MI Vacc to Normal Challenge” that ties restrictions — like the loosening of capacity restrictions that are still in effect — to vaccination benchmarks.
“We’re taking a look at that; obviously, this is new context,” he said. “But I think that we should find what happened yesterday as really an unambiguously positive thing. It perhaps might be the biggest incentive for people to make the choice to get vaccinated because we’ve been living in this reality where we’ve had to wear mask and social distance for a year. We have this tool that works better that we could ever imagined. These vaccines are so safe, so effective. They stop people from (getting the virus) or make it very difficult to transmit, get sick, go to the hospital or pass away. So now you can get vaccinated, get fully inoculated and then you can take your mask off. You can get back to doing the things that you miss and the way that you miss them. That’s encouraging.”
There is no indication what, if any, changes to the metric targets may be forthcoming.
It took Whitmer’s administration nearly 20 hours to respond after the CDC’s update, but Gilchrist said he wasn’t surprised by federal health officials’ move.
“I think it’s encouraging and I don’t think that anyone should look at it as out of nowhere because it’s responsive to the overwhelming and evolving evidence from scientific research,” Gilchrist said. “The CDC has been transparent about that from day one, putting forth the smartest research that they have. So this has been a building for some time now so we weren’t surprised. We were encouraged by it.”
Michigan is aiming to vaccinate 70% of the population over the age of 16. Demand has plummeted recently — the percentage crept up only a tenth of a percent Friday to 55.7%. Most people eager to get the shots have already been able to do so. Health officials must now focus on reaching those who are willing to get the shots but want it to be convenient or those who are hesitant for any number of reasons.
“It’s critical that eligible Michigan residents who have not yet been vaccinated schedule their appointments as soon as they can,” Dr. Joneigh Khaldun, the state’s chief medical executive, said in a statement accompanying the governor’s release about masks. “Getting shots in arms is the best way to end the pandemic. If you have not yet been vaccinated, it is important to continue to mask up to protect yourself and others from COVID-19.”
Some health experts are questioning whether federal officials moved too fast in relaxing mask recommendations that would allow for people fully vaccinated against COVID-19 to shed face covering in most indoor and outdoor settings. And they are suggesting California and local leaders move a bit more cautiously in easing mask mandates.
Dr. John Swartzberg, a clinical professor emeritus of the UC Berkeley School of Public Health’s infectious diseases division, said, “There is good science to support changing our policy. On the other hand, I’m surprised they came out with it this soon. I would’ve liked to have had another month under my belt of seeing the numbers continue to come down.”
If California does begin allowing fully vaccinated people to be maskless in stores, who would be checking to see if those without masks were really vaccinated? Will supermarkets really be interested in checking vaccine cards at the entrance?
“I can’t see grocery stores confirming that you’re vaccinated. It just won’t happen,” Swartzberg said.
The United Food and Commercial Workers union, which represents 1.3 million essential food and retail workers, also questioned the CDC’s move.
“While we all share the desire to return to a mask-free normal, today’s CDC guidance is confusing and fails to consider how it will impact essential workers who face frequent exposure to individuals who are not vaccinated and refuse to wear masks,” Marc Perrone, the union’s international president, said in a statement. “Essential workers are still forced to play mask police for shoppers. … Are they now supposed to become the vaccination police?”
Grocery stores, however, could opt to simply retain a no-mask, no-service policy.
Dr. Kirsten Bibbins-Domingo, chair of the UC San Francisco department of epidemiology and biostatistics, tweeted that the science used in the CDC’s recommendation is sound, “but who bears the brunt in policy implementation?” Some of the people less likely to be vaccinated in America, she said, are working-class people who have been too busy working or caring for family to get the vaccine. “Are we failing essential workers yet again?” she asked.
Some fear that the CDC’s move will backfire and end up normalizing not wearing masks — without requiring vaccinations. That could end up hurting anyone more likely to remain unvaccinated, such as lower income residents and those who are Black and Latino, some of whom want to get vaccinated but haven’t been able to do so because of factors like feeling they might miss work due to vaccine side effects or not being able to get the vaccine from a trusted place — reasons mentioned in a recent Kaiser Family Foundation survey.
Other experts thought the CDC made a good call and think the new guidance will entice people to get vaccinated as long as they can see the benefits of getting vaccinated. “I know many on Twitter are saying the unvaccinated will simply say they were vaxed. Some will, but many won’t want to, they’ll now view vaccination as something with more value and seek it out,” tweeted Dr. Scott Gottlieb, former commissioner of the U.S. Food and Drug Administration.
Swartzberg has criticized state officials for reopening the economy too quickly twice last year, which were both followed by surges. The question is whether lifting mask mandates too quickly will cause California “to be burned a third time.” It’s probably not likely, but it cannot be ruled out, he said.
Swartzberg said he preferred an idea floated by Gov. Gavin Newsom earlier this week, who proposed two different ideas about how to ease mask mandates in California. His second idea, mentioned on Wednesday, suggesting eliminating outdoor mask mandates next month but perhaps retaining indoor mask mandates for a bit longer.
“Instead of taking giant steps, like I think the CDC took today, I think we should be taking small steps toward the same goal,” Swartzberg said. “We ultimately will get there. But I think we’ll get there more safely if we’re more cautious.”
UC San Francisco infectious disease specialist Dr. Monica Gandhi has been among experts who have urged the CDC to move faster to lift mask guidelines and was surprised at how fast federal officials acted Thursday. She welcomed the news and said science backs up the new recommendations.
She said lifting mask guidance for fully vaccinated people will provide an incentive for those who may have put off getting the shot.
“People need incentives now,” Gandhi said. “I think this is going to help people who are on the fence to go and get vaccinated.”
One complicating issue for local governments is that the CDC seemed to make its announcement without offering much of a hint of what was coming, and the result is that state and local officials are left with the difficult task of how to address the difficult problem of who is responsible to determine who is vaccinated and who, as a result, can be unmasked.
L.A. County officials were caught off guard by the details of the CDC announcement, and it took nine hours before the governor’s office issued a statement about the new guidelines, saying in a tweet Thursday night that it was reviewing the guidance and continues to “encourage all eligible Californians to get vaccinated as we look to fully reopen on June 15.”
“We still have millions of people that are not vaccinated — that haven’t even gotten one dose,” L.A. County Public Health Director Barbara Ferrer said Thursday. “And every day, the numbers may be small, but every day there are people who are getting infected.”
As a result, it would be prudent, Ferrer said, to take time to ensure rules are in place to keep people as safe is possible. Questions officials need to answer include what it would mean for employees working at a location who, for whatever reason, may not be able to get vaccinated. The solution, Ferrer said, shouldn’t be to create more risk of virus spread between unvaccinated people at a time L.A. County is trying to keep case counts low and continue reopening businesses and expand capacity.
The goal is to find rules “so that everyone can feel pretty comfortable that we’re not having a lot of exposures that would be unnecessary,” Ferrer said. She added that, at least in the near future, “it may not be possible to lift all of the restrictions everywhere.”
On CNN, Dr. Leana Wen, a former health commissioner for Baltimore, worried that the CDC’s move makes it easy for people who never wanted to get vaccinated or wear masks to now enter stores without face coverings — increasing the risk for people who cannot be vaccinated, like children too young to be inoculated, or immune compromised people who are not fully protected by the vaccine. “We’re now putting them at risk, and I think bringing us actually even further from reaching herd immunity,” Wen said.
Here are the basics of the CDC mask guidance:
Anyone who is fully vaccinated can participate in indoor and outdoor activities, large or small, without wearing a mask or physical distancing.
Unvaccinated people or partially vaccinated people are still asked to wear masks in virtually all indoor settings and most outdoor settings when interacting with people from outside their household who may not be vaccinated. (Members of a single household of unvaccinated people can be maskless indoors if everyone else is vaccinated.)
Masks are still required for everyone traveling on public transportation, including buses and trains, and in airports and stations.
The rules also apply for hospitals, prisons, homeless facilities and other institutional settings.
Local and state rules may be stricter and will remain in force.
Unvaccinated people should still wear masks and get vaccinated right away.
After a year of frightening headlines, widespread concern, and countless retweets that the virus that causes Covid-19 may attack the heart more aggressively than any other viral illness, the verdict is in: It doesn’t.
A report published last week in the journal JACC: Cardiovascular Imaging made that verdict blatantly clear.
It’s time to set the record straight on Covid-19 and the heart, and to consider the lessons for how science is communicated to the public.
The concern emerges
An early report that set in motion fears of a Covid-heart disease connection was published in JAMA Cardiology on July 27, 2020. German researchers claimed that 78% of recently recovered Covid-19 patients had “abnormal” signs on their cardiac magnetic resonance scans and 60% showed signs of inflamed heart muscle, a condition known as myocarditis. Those astonishing numbers were covered in nearly 400 news outlets. The report has so far received been viewed more than 900,000 times — a rarity for academic papers.
Soon after its publication, however, the paper was criticized for statistical and methodologic errors. It eventually underwent a long but much quieter correction that indicated that many of the abnormalities were only marginally more common among those recovering from Covid-19 than among similar control individuals who had not had Covid-19.
A few weeks later, on Sept. 11, 2020, a study out of Ohio State University showed that 15% of competitive athletes who had recovered from Covid-19 had abnormalities on cardiac magnetic resonance scans. This study, of just 26 athletes, was entirely lacking in controls. What’s more, earlier and contemporary studies had found similar abnormalities among elite athletes without Covid-19. But the news coverage and social media posts continued at a frenzied pace. College sports nearly stopped. And people with mild or even asymptomatic disease sought out cardiac magnetic resonance scans, and some physicians even recommended having them.
The outsized attention spurred a group of concerned medical professionals, led by University of Michigan cardiologist Venkatesh Murthy, to issue a letter of concern to medical organizations asking that these scans be performed only as part of careful research studies with appropriate control groups. All three of us signed this letter because of our concern about overdiagnosis.
The signal of cardiac harm isn’t replicated
The question raised by the two reports wasn’t whether SARS-CoV-2 could cause myocarditis. Doctors have long known that viruses can cause heart inflammation and sometimes even lead to congestive heart failure and sudden cardiac death. The concern was that SARS-CoV-2 had some special proclivity to harm the heart.
Over the ensuing months, numerous research groups published studies that refuted the early concerns and provided reassuring evidence that SARS-CoV-2 had no extra toxicity to the heart — though they did little to dispel the public idea that it did.
In January 2021, University of Wisconsin researchers studied 145 student athletes who had Covid-19 and found myocarditis in only 1.4% of them, none of whom required hospitalization. In March, a group of sports cardiologists reported on nearly 800 professional athletes who had tested positive for Covid-19. Less than 1% of these athletes had abnormal findings on cardiac magnetic resonance scans or stress echocardiography. None of these athletes had cardiovascular trouble when they returned to play.
In April, another group of authors published a series of 19,000 athletes who were tested for Covid-19. About 3,000 tested positive for SARS-CoV-2, most of whom then underwent basic cardiac testing. Reassuringly, less than 1% of these work-ups yielded abnormal findings. And just 21 of the 3,000 had definite, probable, or possible cardiac involvement based on lab testing and cardiac imaging. Five (0.2%) of the athletes required hospitalization for non-cardiac complications of Covid-19 and one (0.03%) had a successfully resuscitated cardiac arrest that was deemed not related to Covid-19 because a heart scan done as part of the evaluation showed no evidence of myocarditis.
In a stronger study published last week, an international team compared two groups of health care workers: one with Covid-19 and the other without it. There were absolutely no differences in biomarkers of heart function or heart scans using echocardiography or magnetic resonance.
These three studies enrolled young people with mild symptoms. But even in the sickest of the sick, Covid-19’s effect on the heart appears to be modest. A London-based team reported on a series of 148 patients who had recovered from severe Covid-19. Cardiac magnetic resonance scans done during convalescence showed that nearly half of the individuals had no major heart abnormalities, and 9 out of 10 had normal heart function. These researchers coined a new phrase for myocarditis seen on cardiac magnetic resonance scans: they called it a myocarditis-like pattern because “we do not know what is causing this.”
To sum up: The issue of Covid-19 induced cardiac problems was massively overblown.
The broader lessons — science messaging
The flawed German report that sparked the hyperbolic messaging was tweeted by more than 19,000 accounts and covered by nearly 400 news outlets. An opinion piece in the New York Times by cardiologist Haider Warraich, titled “Covid-19 Is Creating a Wave of Heart Disease,” was published shortly after the paper. If not for public critical appraisal from Mayo Clinic cardiologist Michael Ackerman, the 2020 college football season might not have happened.
We can only speculate on the reasons for this failure of science communication. Fear is likely a contributor. As doctors who care for people with serious illness, the three of us have witnessed firsthand the way fear shreds rational decision-making.
The pandemic injected fear in big doses. It stems from more than the virus’s high death rate in older people or its ability to spread rapidly and collapse health care systems. The most fear-inducing aspect of Covid-19 is its unpredictability. Many of us wonder: could I fall ill tomorrow?
Lax scientific review might also have played a role. Two of us (J.M. and A.F.) tried to shed light on this issue. Our first study, conducted with several colleagues, showed that the timeline from receipt to publication of studies was eight times faster during the pandemic than the year before. Of course, speedier publication isn’t a problem in and of itself: normal peer review may simply be too slow. But in our systematic follow-up study comparing top-cited papers during the pandemic with those published before it, Covid-19 related articles were of significantly lower scientific rigor. Scientific publication moved faster during the pandemic, but the quality of the work was poorer.
We take away two lessons from the Covid-19 myocarditis story. One is that SARS-CoV-2 can sometimes, though rarely, cause heart inflammation — just as many other viruses do. Clinicians, therefore, can appeal to sound medicine; further testing can be decided on an individual basis. Screening low-risk patients with MRI and other fancy tests is neither necessary nor wise.
The broader lesson is that science communication in times of crisis must keep a level head. The public, and decision-makers, need properly controlled studies instead of early sensational reports. In a world where success is measured by clicks, the idea that even mild cases of Covid-19 could pose a new and unprecedented threat to the heart took off. That fear has largely been unsubstantiated, though news of it won’t spread nearly as quickly.
The story of “Covid heart” is not over. Future studies will undoubtedly provide more information. But people who have recovered from Covid-19 have no special reason to worry about their hearts. Instead, we should all worry about the incentives in the modern media world, and why we got so far ahead of ourselves.
John Mandrola is a Kentucky-based cardiologist and electrophysiologist. Andrew Foy is a cardiologist and assistant professor of medicine at Penn State University. Vinay Prasad is a hematologist-oncologist and associate professor of epidemiology and biostatistics at the University of California, San Francisco.
New York state's mask mandate will remain in effect as state health officials review new federal guidance to allow vaccinated people to ditch face coverings under most conditions, Gov. Andrew Cuomo said late Thursday.
The statement came shortly after the CDC on Thursday recommended fully vaccinated Americans can discard masks and the need for social distancing outdoors and in most indoors settings.
"In New York, we have always relied on the facts and the science to guide us throughout the worst of this pandemic and in our successful reopening," Cuomo said in a statement.
The governor's office is reviewing revised CDC guidance in consultation with state Health Commissioner Dr. Howard Zucker "and our partners and health experts in surrounding states," Cuomo added.
New Jersey Gov. Phil Murphy's administration issued similar comments Thursday, saying the state is reviewing the CDC rules before taking action to remove its mask mandate.
The new mask wearing guidelines announced by Dr. Rochelle Walensky, the CDC director, represented a major step toward a return to normalcy for a nation battered and at times divided by a pandemic that has lasted more than a year.
"Anyone who is fully vaccinated can participate in indoor and outdoor activities, large or small, without wearing a mask or physical distancing,'' Walensky said.
"If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic.''
A person is considered fully vaccinated against the coronavirus two weeks after getting the second Pfizer or Moderna shot or the same length of time after receiving the one-dose Johnson & Johnson vaccine.
The new guidance still calls for wearing masks in crowded indoor settings such as buses, planes, hospitals, prisons and homeless shelters but could ease restrictions for reopening workplaces and schools.
