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Dr. Rochelle Walensky, the director for the Centers for Disease Control and Prevention. Stefani Reynolds/The New York Times/Bloomberg via Getty Images

Dr. Rochelle Walensky is only 6 months into her job as director of the Centers for Disease and Control and Prevention (CDC).

In that time, the overwhelming majority of her efforts have been spent dealing with the vast array of issues surrounding the COVID-19 pandemic.

This week, Walensky announced the CDC is once again revising its recommendations on mask wearing, encouraging people who are vaccinated to cover up in indoor public spaces in high transmission regions.

In a question-and-answer session with Healthline, Walensky took time to defend her team and the diligent work being done at the CDC.

“What I will say is we have an extraordinary team and they are mission-focused, collaborative, and wanting to do right by the American people,” she said. “Do they wish we were in a different and better place? I think everyone does. Are they tired? Yes, but that does not change their mission-critical focus right now. Everyone is determined. They want to help.”

In a 15-minute interview with Healthline, Walensky also discussed a broad range of topics from mask wearing to vaccinations to booster shots to misinformation to school reopenings.

Here are excerpts from that conversation.

So what are the top line reasons that people should be willing to put masks back on?

Dr. Rochelle Walensky: There are three places we can drill down on. The first is, regardless of the new data we saw, we need to drill down on getting people vaccinated. Eighty percent of the counties that are in the highest amount of transmission right now are counties that have the lowest rate of vaccination. We knew that this was going to happen. We anticipated it happening. This virus will thrive in places that are not equipped to counter it and it is countered with vaccination. We are now currently seeing that play out.

What’s really heartening is we have seen upticks of vaccinations in those areas, upticks in first doses.

Thing two is: This is largely, I’ve said it before, a pandemic of the unvaccinated at this point. The amount of transmission right now is occurring by and large in those who are unvaccinated. We had anticipated the need to double down and say, ‘Until you are vaccinated, please, please wear your mask.’ This current Delta variant is unforgiving. If you are not masked, it will take the opportunity to transmit from one person to another quite readily, easily, and quite heavily. That message had to be sent in the absence of new data.

But the new data also needed to be shared: For those rare people who have gotten a breakthrough infection — and indeed they are rare and these vaccines are working well in terms of protecting people against severe disease and death — but for those rare people, we thought it was really important for those people to know that they are at risk of giving disease to someone else.

Part of that was about people who are around unvaccinated people [and] immunocompromised people. I came to this job from a clinical position and there if we have a vaccinated patient who has mild symptoms, we have a responsibility to say, ‘Don’t go home to your loved one who is a transplant patient.’

Do you have any concerns that new mask requirements could discourage people from getting vaccinated?

Walensky: We have done a lot of outreach to places where they’ve really seen this uptick and where it’s been challenging to get people vaccinated to talk about how best to walk the fine line in knowing we needed to do this but also recognizing that we absolutely did not want to deter their progress. So while this is the right thing to do from a public health standpoint, we share those concerns. We’ve been talking to states and local health officials to best find the way — in their community — to do this without deterring their efforts.

Schools are opening again soon and parents and staff are concerned and confused. What can be expected this fall? Will schools have mask mandates?

Walensky: The first thing to know from my vantage point is that we are now involved in numerous outbreak investigations in schools across the country where summer schools have not put in the proper mitigation strategies. In many of those places, they’ve had to close the schools.

“My primary goal is to make sure our children can safely get back to full-time, in-person learning and stay there for the school year.”

Dr. Rochelle Walensky, CDC Director

So, from that vantage point you can understand my primary goal is to make sure our children can safely get back to full-time, in-person learning and stay there for the school year. With that goal in mind, recognizing we don’t have a vaccine for 11 and under, that currently only about 31 percent of our 12 to 17-year-olds are vaccinated, and with that information from our summer school outbreak investigations, the majority of people in schools right now will not be vaccinated. That coupled with the fact that we have this new data that even vaccinated people can transmit, and our deep desire to keep our children in school. That is what led to our updated guidance to have masks in all schools this year.

Do you have anything you can share about the timeline for getting vaccines approved for those children 11 and under?

Walensky: It’s a great question. I have not seen the clinical trial data. My understanding is we are still targeting for the mid-fall, but that’s a question for the FDA [Food and Drug Administration].

The next surge is here. [Former CDC Director] Tom Frieden is estimating we could get to 200,000 new cases a day. Do you agree? And what are the main drivers of this surge?

Walensky: I’ve seen modeling data. Some of the modeling data do go up that high. Not all of them do. Do I think it’s possible? Yes, I think it’s possible. What I do want to reiterate, though, is a unified approach as a country would stop this [pandemic] in its tracks. We know what we need to do to stop this virus. It can fall short of many of the things we had to do last year. Do I think we all need to stay home right now? I do not. But if we are able to get the vast majority of people vaccinated and if, in the meantime until they are fully vaccinated, we had everybody wearing masks, we can stop this in its tracks and really be in a way better place in a relatively short period of time.

“If we are able to get the vast majority of people vaccinated and if, in the meantime until they are fully vaccinated, we had everybody wearing masks, we can stop this in its tracks.”

Dr. Rochelle Walensky, CDC Director

That said, we know that this Delta variant is really transmissible, one of the most transmissible respiratory viruses that we know of, in fact. It will continue to thrive. It will continue to find our weakest points and it will continue in places that are not doing their part to try and stop it. That’s one of the biggest issues in terms of why it’s doing so well against us now.

Are other measures beyond masking on the table to stop this surge? Are there any measures that are completely off the table?

Walensky: I’ve been humbled enough by this pandemic and by this ever-changing landscape to never say never. But what I will say is we are working really closely with states. We are trying hard to engage and ask what is the help you need from us? Is it outbreak investigation? Is it vaccine confidence? Is it multilingual resources? Is it teams on the ground in order to assist? Is it more creative vaccination sites? We’re entirely here to help.

In fact, we’re having these conversations recognizing that not all of the states want to hear this from the federal government or want to announce they are receiving support from the federal government. We’re happy to do it quietly.

Where are we at with booster shots and what are your feelings on those who are preemptively getting them? Is it time for people to think about this? When might we hear news on this?

Walensky: Thank you for that question. One thing I want [to make sure people are aware of] is there is misreporting out there that is claiming that CDC is not following people who [have tested positive] and are not hospitalized and have not died. We have numerous ways of following vaccine effectiveness. And the passive reporting we get from hospitalizations and deaths is only one such mechanism and, in fact, not the epidemiological best mechanism because relying on passive reporting is not the most comprehensive way to do it. It’s one way and informative but not the best.

What we are doing is we have numerous cohorts scattered around the country that are collecting data on tens of thousands of people, cohorts of people in long-term care facilities, who are essential workers, who are healthcare workers who present to urgent care centers. We follow and look at this data each week as they come in. Those are the best epidemiologic designs in order to follow vaccine effectiveness over time.

We have not yet seen evidence that we need to take action on boosters. However, we are watching it carefully and we as a government are working together to ensure that when we see data that demonstrates waning immunity, we will be ready to act.

There are, of course, some people who did not respond well to the first two doses, such as the severely immune suppressed, and we’re also taking action to make sure they have access to a third dose.

One thing I really want to emphasize is [when] people take these questions into their own hands and get their own [additional] doses, we don’t have as much of the capacity to monitor safety. We have a huge amount of data now for the over 160 million Americans who have been fully vaccinated, but we don’t have a lot of data on people who got more doses than two and I believe that would be important to collect.

Vaccine misinformation. Is there a solution?

Walensky: Certainly we know that misinformation is propagated 70 percent more often than true information and what I think is our job is to be out there frequently, early, and often to combat it and to have that come from trusted sources. We’re working really hard to be louder than the misinformation that’s out there. It’s been quite unfortunately a real stain on our efforts, it really has because, yeah, I’ll just say there: It’s been a real stain on our efforts.

“We’re working really hard to be louder than the misinformation that’s out there. It’s been quite unfortunately a real stain on our efforts.”

Dr. Rochelle Walensky, CDC Director

Talk to us about trust and the CDC. What are you doing to fight the mistrust that boils up out there. Is there anything you can do?

Walensky: I don’t think the misinformation challenge is pointed directly at the CDC. One of the things I’m working hard at is being out there and giving the public information as we get it. We received the information upon which we made this change of recommendations less than a week ago. There was a lot of work and action that needed to happen, but I thought it was important for the American people to hear. I am doing my best to be out there, to demonstrate the science that is leading to guidance updates, and to really be forthcoming, vocal, and very transparent about where we are.

Certainly, we’ve had a hard pandemic. All of us have had a hard pandemic. I think the people in the agency have had a hard couple of years as well, not just because of the pandemic but because of the perception of the CDC. It’s hard for me to say from the inside, but I do think that latter part is getting better and I think the pride is returning to the work that we are doing. They’ve always been smart, proud, brilliant people who, I will just say, work tirelessly without credit, without individual credit, to make sure that America is safe. No one will ever know the person who stayed up all night to update the guidance so we could deliver it for you. No one will ever know the person there working all weekend making calls to state health officials making sure that vaccine did not suffer as we updated guidance. Those names will never be known to anyone. We’re doing that so America will be safe.

Any last message you want to give the American public right now?

Walensky: You know, any time I have an opportunity to answer that question, what I usually say is: Get vaccinated. What I will add to double down is: we at CDC — and I am not here to convince you to get vaccinated — I am here to answer your questions and give you the information you need to have you see the perspective that I have seen. And I think that if you do, you will be asking to get vaccinated.