Biden and his health officials left watching states move on without them as pandemic guidance deliberations drag on

Sources told CNN the administration’s top health officials are assessing in real time how to handle federal guidance on mitigation steps like masking and there is an internal recognition that the US is entering a new phase.

A key component of the discussions has been what metrics will now determine when communities need to implement safety measures, like masking, and when. In previous phases of the pandemic, the focus has been on case numbers, but now hospital capacity, hospitalization rates and death rates are all considered major factors. One administration official described this as a “significant undertaking,” given that officials are identifying a new national framework for public health guidance.

“We want to be deliberate about it and ensure we both implement right decisions but also can communicate it clearly to a diverse country, where one state may look different than another,” the official said.

But while this work drags on, states and localities around the country are making moves that put them in conflict with the Biden administration and federal public health guidance. The starkest evidence of this growing impatience is the moves by Democratic governors normally in sync with the administration who stepped away from the federal guidance this week by preparing to lift rules for masking indoors and at school. The decisions came after state leaders had pressed Biden for clearer guidelines at the White House last week.

The sudden changes on the local and state levels, coming without the explicit green light from the White House or the US Centers for Disease Control and Prevention, are creating pressure on Biden to catch up. And in some cases, they have has led to confusion about whose guidelines to follow.

Biden acknowledged the confusion in an interview with NBC News that aired on Thursday, saying the discrepancy between recommendations from the CDC and local governments on indoor mask mandates is “confusing” for Americans. But the President said he is focused on giving people the tools they need to protect themselves against Covid-19.

“It is confusing, it’s worrisome to people. They’re trying to figure out — but what I’ve tried to do, I’ve tried to make sure we have all the vaccines needed, all the boosters needed, all the masks that are needed, all the protection that’s needed,” Biden told NBC’s Lester Holt.

Perhaps the most complicated guidance for the President is masking. For Biden, the question of masks — when to wear them, when it’s OK not to and who gets to decide — is tied up in the emotions and politics of the pandemic.

Last May, he announced with great enthusiasm in the White House Rose Garden an end to mask recommendations for fully vaccinated people, calling it a “great day.” He was forced to reverse himself two months later, making clear at the time his frustration at having to mask up again.

Now, Biden and his aides appear reluctant to offer new guidelines on wearing masks indoors, even as cases of Covid-19 decline rapidly in most areas of the country despite transmission in many areas remaining high and daily case counts average about 209,000 per day over the last seven days, according to Johns Hopkins University data.

At the White House, Biden and his top aides continue to wear masks indoors unless they are sitting alone in an office. Meeting with electric utility executives Wednesday, the President removed his mask to speak — but was seated at least 10 feet from his visitors.

The pandemic-era optics have frustrated Biden in the past, and he has voiced a desire to get back to normal, too. Yet for a White House intent on following the guidance of federal health officials, the rules appear unmovable until the CDC changes its recommendations.

While they are considering updates to guidelines and consulting a range of experts on how to move forward, administration officials on Wednesday suggested the rules were still necessary amid a still-ongoing pandemic.

“We are working on that guidance. We are working on, you know, following the trends for the moment,” CDC Director Dr. Rochelle Walensky said. “Our hospitalizations are still high; our death rates are still high. So as we work towards that and as we are encouraged by the current trends, we are not there yet.”

A time of transition

The hesitance to change federal guidelines has led to a patchwork of local and state rules that are changing by the day as individual governors take matters into their own hands.

The Democratic governors of Connecticut, New Jersey and Delaware, as well as Oregon’s health department, have set timelines for the end of their states’ school mask mandates in a sign of the receding wave of Covid-19 and the country’s move toward a “new normal.”

Biden was understanding of governors who are moving ahead with lifting mask mandates, saying that it is a “tough call” on whether now is the time. He also said that some governors lifting mandates are not removing them right away but in the weeks or months ahead.

“I’ve committed that I would follow the science. The science that is put forward by the CDC, and … the federal people, and I think is probably premature, but it’s, you know, it’s a tough call,” Biden said when Holt asked if it was too soon to lift indoor mask mandates.

In the past, the White House has criticized state leaders — all Republicans — for banning mask mandates. But it has adopted a milder approach for these Democratic governors easing restrictions ahead of CDC guidelines, saying the decisions will be made at the local level.

At a meeting last week at the White House, many of the same governors pressed Biden for clearer guidelines for states looking to emerge from the pandemic and return to a semblance of normalcy.

New Jersey Gov. Phil Murphy said after meeting Biden that there was a “lot of good discussion about what does the road from pandemic to endemic look like.”

But Murphy decided against waiting for an answer. He announced Monday the state’s mask mandate in schools and childcare settings will end on March 7. Citing the decline in Covid cases, increased vaccinations and the lower severity of the Omicron variant of the coronavirus, he called the move “a huge step back to normalcy for our kids.”

In response, the White House and CDC have continued to emphasize that federal guidance is masks should be worn in schools. That’s led some state officials to suggest the Biden administration’s guidance is out of touch.

“It doesn’t match where the American people are at this moment. A lot of states feel we need to move from pandemic and endemic status,” one senior state official in a state that is relaxing its mask mandate in schools told CNN on Wednesday. “It certainly doesn’t match public sentiment and what’s happening on the ground.”

Asked Wednesday whether parents, students and teachers who live in a state where the mask mandate in schools has been relaxed should still follow the CDC’s recommendation, White House press secretary Jen Psaki responded: “Yes.”

Walensky, meanwhile, said, “Those decisions can be made at the local level.”

The senior state official said their own recommendation to parents in their state would simply be: “Make the decision that’s best for you and your child.”

State officials growing frustrated

One California Democrat said that from their vantage point, there were “frequent inconsistencies between the administration’s messaging and the CDC’s guidance” layered on top of a patchwork of state and local regulations. That’s left many Americans “not trusting anyone and ultimately making their own decisions entirely,” the California Democrat said.

Two officials stressed the difference in states easing mask requirements and the CDC updating its mask recommendations because the states are making decisions based on their specific situations rather than the entire nation. Some officials within the administration have also been hesitant to make drastic changes, concerned about another troublesome variant catching them by surprise.

Biden’s team has been meeting for weeks with outside health experts to plot a path forward as case counts fall rapidly, but the “return to normal” plans are still emerging. The planning is complicated by difficult memories of previous moments when the end of the pandemic appeared imminent, only for that hope to be spoiled by the emergence of virulent new strains of the virus.

Some of the President’s top advisers have also been offering advice to individual states that are working to update their statewide recommendations.

New York Gov. Kathy Hochul, who announced on Wednesday that her state would lift its statewide mask-or-vaccination requirement for indoor businesses — though not for schools — on Thursday said she had consulted with Dr. Anthony Fauci, Biden’s top medical adviser, in recent days.

“He said, ‘Are you also looking at the infection, the hospital ratio?'” Hochul said of their conversation.

Not all governors have coordinated the lifting of their mask mandates with the White House, prompting some internal frustration. But White House Covid-19 response coordinator Jeff Zients often speaks multiple times a week with the leadership of the National Governors Association, Arkansas Gov. Asa Hutchinson and Murphy, according to one official.

Tensions over mask recommendations between the White House and the CDC have emerged at previous points in the pandemic, including when the agency was forced to reverse its position on indoor mask wearing over the summer.

Officials said the administration was considering changes to some of the metrics it has used to dtermine mask guidelines. Currently, the CDC says areas of “high” or “substantial” transmission should require masks indoors — a category that includes nearly the entire country.

Yet public health experts, including within the administration, have recently begun moving away from caseloads as the key barometer for the pandemic, focusing instead on hospitalization and death rates to measure the severity of the crisis.

With cases and hospitalizations trending downward, Zients said Wednesday that fighting the Omicron surge remains “priority number one” but indicated that there has been some outreach to governors and other public health officials on the next steps.

“We’re moving toward a time when Covid won’t disrupt our daily lives — a time when Covid won’t be a constant crisis — so we’re no longer fearing lockdowns and shutdowns but getting back to safely doing what we all love. In doing so, we will rely on the powerful set of tools that have been developed: the vaccines, the booster shots, treatments and testing,” Zients told reporters.

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By Betty C. Giordano

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