I'm Wondering If You Should've Waited A Bit Longer

The author of the article you linked wrote:

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The Centers for Disease Control and Prevention cited an unpublished study from India to justify its recommendation Tuesday that fully vaccinated people "wear a mask in public indoor settings in areas of substantial or high transmission" of COVID-19.

But I believe that this is misleading. Here's why...

On July 27th, the CDC released a Science Brief that, in part, discussed "Breakthrough Infections." In the comments in this section, the CDC writes (among other things):

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The proportions of VOCs observed among breakthrough cases has been similar to that observed in CDC’s national genomic surveillance,(160) but interpretation of these data is challenging because of local variation and changes in variant proportions over time. An Israeli study of VOC infections in adults fully vaccinated with Pfizer-BioNTech compared with unvaccinated matched controls, during a time when Alpha was the dominant strain and Beta was detected in <1% of all specimens, found a higher proportion of Beta in fully vaccinated cases (matched odds ratio = 8.0) and a higher proportion of Alpha in partially vaccinated cases (matched odds ratio = 2.6), though small sample sizes, especially for Beta, were noted as a limitation.(161) A study from Houston, Texas observed that Delta caused a significantly higher rate of breakthrough infections in fully vaccinated people compared with infections from other variants, but noted that only 6.5% of all COVID-19 cases occurred in fully vaccinated individuals.(162) Studies from India with vaccines not authorized for use in the United States have noted relatively high viral loads and larger cluster sizes associated with infections with Delta, regardless of vaccination status.(96) These early data suggest that breakthrough Delta infections are transmissible. Unpublished data are consistent with this, and additional data collection and studies are underway to understand the level and duration of transmissibility from Delta vaccine breakthrough infections in the United States and other settings.

The India study that I believe the CDC referenced is (I think) the same study that the author cited in his article. One of the key takeaways from this study, though, is that:

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In an analysis of vaccine breakthrough in over 100 healthcare workers across three centres in India, the Delta variant not only dominates vaccine-breakthrough infections with higher respiratory viral loads compared to non-delta infections (Ct value of 16.5 versus 19), but also generates greater transmission between HCW as compared to B.1.1.7 or B.1.617.1 (p=0.02).

In essence, the study found that, not only did the delta variant of Covid "breakthrough" the vaccine, but those infected had such high viral loads that they were more efficient in transmitting the virus to other vaccinated people (than the original version and other variants).

OK, well...from my vantage point, there are a couple of things of interest about this particular study: A) As you noted, it hasn't been peer-reviewed yet; B ) it only involved approx. 100 vaccinated people; and, maybe most importantly, C) the vaccine that the delta variant broke through in India hasn't been authorized for use in the United States (Astra Zeneca). Factors I would acknowledge likely shouldn't be the sole justification of the CDC's mask recommendation this week.

But this is where I believe the author (intentionally or not) may have misled his readers. The CDC didn't use the India study as it's sole justification. If you go back to the July 27th Science Brief information listed above, it clearly states, "Unpublished data are consistent with this..."

So, it would appear that, in addition to the India study, CDC had in its possession other information it had yet to release.

Here is what I believe is that additional information that the author couldn't wait for before publishing an article that (again) concluded:

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The Centers for Disease Control and Prevention cited an unpublished study from India to justify its recommendation Tuesday that fully vaccinated people "wear a mask in public indoor settings in areas of substantial or high transmission" of COVID-19.

A couple of notes about this outbreak in Provincetown: 1) At the time of this document's writing, it mentions 469 infections. It's now over 900 cases (74% of them involving vaccinated people); 2) Because the outbreak occurred on US soil, most (if not all) of those infected received an FDA-approved vaccine (i.e. Pfizer, Moderna, or J&J); and, 3) CDC is still looking into the matter and hasn't drawn any conclusions yet.

But taking these factors as a whole, what's occurring in Provincetown seems to be tracking closely with the findings in India (as it relates to the delta variant).

Now, you can def argue that CDC shouldn't base ANY recommendations off of non peer-reviewed or unpublished information. But I believe that, based upon their training and experience, these correlating events caused them concern - especially considering the numbers and US-approved vaccines involved.

But I think it was disingenuous for the author to suggest that the mask recommendation was based solely off of the India study.

To his credit, he said that he contacted CDC for a response (but didn't get one). But I'm wondering if it might not have been prudent to wait a tad longer for the additional info to come out. It looks like he told only half of the story.

BTW...the saving grace of all of this is that the vaccines are doing their job as only 7 people connected to the Provincetown outbreak have had to be hospitalized (with no reported deaths). Though not foolproof, the vaccines are safe and very effective at keeping people out of the hospital. This is something we should ALL be happy about and help to promote their use.