(CNN)Biden administration officials are increasingly urging governors and local officials to reinstate or avoid relaxing public health restrictions as coronavirus cases continue to rise and the US stares down the prospect of another surge.
What they're not doing is telling state and local officials which restrictions they should implement and when.
Unlike its school guidelines -- which tie varying degrees of in-person learning to case levels in a given district -- the Biden administration has declined to issue national public guidelines or criteria tying business closures, indoor dining restrictions and other capacity limits to the level of coronavirus circulating in a given community.
Biden administration officials say laying out across-the-board guidelines would do little to sway governors and could risk putting the White House in public conflict with governors at a time when they are trying to form common cause in accelerating vaccinations. They also want to avoid a scenario in which they issue guidance that is roundly ignored by governors across the country.
The result is that state and local officials are relying on a patchwork of self-determined criteria to determine when to reopen or limit the operations of businesses as they decide whether and how to heed the Biden administration's urging to "buckle down," as US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said earlier this week. And rather than leaning on leading indicators like case levels and test positivity rates, many governors often wait until hospitalizations increase to implement more restrictive measures.
"I think we've been pretty clear with regard to our guidance and strategies and setting specific strategies as to how people can remain safe in these settings, and we continue to articulate in these press conferences and others the importance of masking, distancing, not traveling and decreasing crowds," Walensky said Wednesday in response to CNN's question about why the administration has not issued this type of uniform criteria.
Dr. Anne Schuchat, the No. 2 official at the CDC, told CNN earlier this month that tying mitigation measures to case levels has also been complicated by rising numbers of vaccinations and that "some of the metrics that were being used three months ago may not perform the same now."
While the CDC is now publicizing weekly state reports initially crafted by the Trump White House's coronavirus coordinator Dr. Deborah Birx, the document no longer includes a cover page recommending specific mitigation measures that each state should consider implementing based on their level of coronavirus spread.
Last April, the Trump administration sought to tie sustained decreases in coronavirus cases to the reopening of certain businesses, issuing "gating criteria" that proposed three phases of reopening in an attempt to establish a national standard. While some states adopted the criteria, many ultimately did not stick to the criteria and President Donald Trump muddled his administration's messaging on the issue by pressuring a slew of Democratic governors to reopen their states a day later. Months of conflicting messaging ensued.
Biden administration officials did consider more prescriptive national guidelines during the transition. Dr. Vivek Murthy, who was sworn in this month as surgeon general and advised Biden during the transition, told NPR in November that the US needed a "national alert system that tells communities at what level to start implementing restrictions based on important indicators."
Instead of implementing that effort, Biden administration officials have focused on promoting clear, consistent, and science-based messaging about the state of the pandemic -- and delivering it with one voice, whether it is that of President Joe Biden or career health experts like Dr. Anthony Fauci.
Biden hasn't hesitated to call decisions by governors to loosen restrictions "mistakes," but beyond urging states to reimpose mask mandates, he has avoided issuing any prescriptive guidance to states. Amid loosened restrictions at the state level and widespread pandemic fatigue, travel is on the rise nationwide and adherence to public health guidelines such as mask-wearing is plummeting in some parts of the country.
Dr. Céline Gounder, an epidemiologist who served on the Biden transition's coronavirus advisory board, said issuing criteria tied to coronavirus transmission levels could help give some governors weighing coronavirus restrictions and economic considerations a nudge toward public health.
"I think it would be effective with Democratic governors and possibly some of the more moderate Republican governors," Gounder said. "It's not going to work across the country."
She said the administration is "walking this fine line of trying to be uniting and getting people vaccinated, but you don't want this backlash against a 'nanny state' approach."
Dr. Michael Osterholm, another epidemiologist who advised the Biden transition, said he believes federal criteria could help give some governors "cover" to impose new restrictions aimed at slowing the spread, but he fears it won't change the calculus for most governors.
"I'm not sure it will change anything and that's the part that is frustrating," he said.
White House officials say they are focused on hammering home public messaging and speaking with governors and state health officials multiple times a week, advising them privately rather than publicly pressuring them to adopt specific measures.
Andy Slavitt, a senior adviser on the White House's coronavirus response team, said the result is that governors know where the administration stands on the path forward.
"Three times a week for 10 weeks, Dr. Walensky has said, 'Wear a mask, avoid crowds, socially distance, and don't travel unless it's absolutely essential,' " Slavitt said. "Three times a week for 10 weeks, we repeat that in all our conversations with governors, in all our conversations with local officials, and we're not the only one saying it, public health officials from departments and agencies across the country make the same point, so that people who are in violation of that are choosing to do that. They are not confused about where we stand."
