Rising case count reignites debate over COVID-19 restrictions

Biden administration officials are discussing the potential for tougher guidelines to blunt the nationwide surge in COVID-19 cases, but the White House will have to weigh how new measures might affect its overall vaccination push.

The rise in infections around the country has sparked calls from some health experts to reimpose stricter masking guidance and other efforts designed to slow the spread of the virus. Doing so would likely set off criticism from conservatives and spark enforcement issues, as some Republican governors have vowed not to return to restrictions on businesses.

White House officials — wary of any appearance that they are politicizing health guidelines — have been adamant that the Centers for Disease Control and Prevention (CDC) will have the final say on whether new guidance is needed.

“It would be actually surprising and odd if our health and medical experts were not having an active discussion about how to best protect the American people. And there is of course an active discussion about a range of steps that can be taken, as there has been from the first day of this administration,” White House press secretary Jen Psaki said Monday.

“Certainly the surge in cases among the unvaccinated because of the delta variant prompts even more discussion about what actions can be taken,” Psaki added. “But we are going to — the CDC looks at data. They look at data across the country … and if they make an assessment, we will of course be here to follow their guidance.”

Anthony Fauci, President Biden’s top medical adviser on the pandemic, told CNN on Sunday that recommending vaccinated Americans resume wearing masks in some settings is “under active consideration.”

Fauci and other medical experts are part of those discussions, with Biden receiving regular briefings.

Asked Monday if the president supports restrictions for unvaccinated people in public settings such as restaurants and museums, Psaki reiterated that the White House will follow the CDC’s lead.

But some localities aren’t waiting to take their cues from Washington.

Los Angeles County and St. Louis recently announced new mask mandates, even for vaccinated individuals who are indoors. New Orleans issued an advisory encouraging the use of masks when indoors, and several other municipalities have gone similar routes.

The country’s seven-day average of new cases is a fraction of what it was during the January peak now that 188 million Americans have gotten at least one dose of the vaccine. But that same average has risen by almost 40,000 since earlier this month. Tens of millions of Americans have not gotten vaccinated, and health experts said the highly transmissible delta variant is likely to accelerate case counts.

The administration and some health officials have used the July spike to emphasize the importance of getting vaccinated, pointing to statistics that show nearly all hospitalizations involve unvaccinated individuals.

On Sunday, close to 500,000 people received their first vaccine dose, Psaki said, and a handful of states with low vaccination rates have seen their numbers pick up in recent days as fears of the delta variant prompt more Americans to roll up their sleeves.

Still, some health experts have called for stronger guidance from the CDC to avoid a full-blown wave of new cases while officials work to persuade a large swath of the population to get the shot.

“A number of months ago, the CDC recommended that people who are fully vaccinated didn’t have to mask or distance. At the time, I thought it was a catastrophic situation, and it’s proven to be catastrophic,” said Larry Gostin, a global health law professor at Georgetown University.

Leana Wen, a physician and visiting professor at George Washington University, argued in a Washington Post op-ed last week that the CDC should revise its guidance to say vaccinated individuals should wear masks unless they are surrounded only by others who are vaccinated.

Wen acknowledged areas with low vaccination rates are unlikely to heed new mask guidance or other restrictions.

“Still, leadership from the Biden administration can make a difference. There are many businesses and local jurisdictions that look to the federal government for direction,” she wrote.

The politics surrounding any update to masking guidance or capacity restrictions make it unlikely that major changes are imminent, however. Republicans are unlikely to comply with federal guidance that could cap large events or require masks indoors, particularly in states where governors are looking to remain popular with their conservative base ahead of 2024.

Additionally, if Americans are told to wear a mask indoors even if they’re vaccinated, many experts worry that it will take away a major incentive for some reluctant individuals to get the shot.

But the potential for 2020-style restrictions is likely to draw concerns from Democrats and Republicans alike. Leaders in both parties who are up for reelection next year may be hesitant to support any steps that hamper local economies.

“You are seeing some individuals in the Biden administration pushing for more restrictive measures again, and I think that is something that would make people feel better but not make a material difference,” said one former Trump administration health official.

The former official predicted the U.S. will soon see its daily case count climb toward 100,000 new infections as the highly delta variant spreads, particularly among unvaccinated populations. But they argued that cases aren’t the most important metric when deciding on new restrictions.

“What matters is health systems being overwhelmed,” the former official said. “If you go back to the beginning of the pandemic, the entire premise of mitigation measures was about making sure health systems didn’t get overrun. … If people focus on those, you shouldn’t see meaningful lockdowns going forward.”

Morgan Chalfant contributed to this report.