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WASHINGTON — The White House is meeting with outside health experts to plan an exit strategy from the pandemic and transitioning to the “new normal,” but behind-the-scenes efforts hit a very public reality: A string of blue-state governors abruptly gave up their mask mandates to get ahead of President Biden.

Two of the administration’s top doctors – the president’s chief pandemic medical adviser, Dr. Anthony S. Fauci and director of the Centers for Disease Control and Prevention, Dr. Rochelle P. Walensky on Wednesday both expressed their qualified optimism on Wednesday. direction of the pandemic. Dr. If cases continue to drop and no new variants emerge, the country “may be heading towards what we would consider more normal,” Fauci said in an interview.

However, Dr. Fauci warned that the situation is “still unpredictable” and said any transition from the current crisis will be gradual. And Dr. Significantly, Walensky said that while his agency is working on new guidance for states, it is too early for all Americans to remove their masks in closed public places.

“Our hospitalizations are still high, our death rates are still high,” the White House Covid response team said during a news briefing. “So, we’re not there yet as we’re working towards it and encouraged by current trends.”

The governor’s frenzy to drop mask orders is emerging as the White House Covid response coordinator Jeffrey D. Zients and the government’s top doctors seek advice from a wide range of public health experts, including some former Biden advisers. very publicly encouraged The president will change course. Citing brief Wednesday’s hearings, Mr. Zients said the White House had reached out to governors and local public health officials to talk about “the steps we need to take to keep the country moving forward.”

According to multiple participants, the talks aim to prepare a new playbook for the delicate next phase of the pandemic, where the threat of coronavirus will likely recede but the possibility of a new variant and another deadly surge is very real. They address a range of issues beyond masking and mitigation, from how to get new antivirals to people who test positive for the virus, to whether to upgrade ventilation systems in schools.

But slow negotiations within both the CDC and Mr. Zients’ team are putting the White House in a difficult position. While officials study the science and chart a careful course, governors risk making the Biden administration irrelevant as they move forward on their own.

A former Baltimore health commissioner and a frequent critic of the administration, Dr. “Management should read the room and see nearly all elected leaders act without them,” Leana Wen said, adding: The CDC says everyone should go unmasked right now. What they’re looking for is clear metrics of when restrictions can be lifted and when they might need to come back.”

The governors themselves said this. Last week, after a bipartisan group of governors met with Mr. Biden, Republican Arkansas Governor Asa Hutchinson told reporters that he stressed the nation’s need to “get away from the epidemic” and gave him “clear guidelines on how we can return to a greater state of normality.”

It is now clear that states have decided not to wait. On Wednesday, the governors new YorkRhode Island, Massachusetts and Illinois joined a growing list of Democrats. either a general statewide unmasked a mission or a mission that applies to schools.

Asked about the moves, White House press secretary Jen Psaki said the president was determined to deliver on his campaign promise of listening to scientists and tracking data.

“This is not moving at the speed of politics,” he added. “It moves at data rate.”

The domestic controversy comes as the recent surge of Covid-19 fueled by the highly contagious Omicron variant has waned in much of the country. The seven-day average number of new cases fell from an average of 800,000 in mid-January to about 253,000 on Wednesday. New York Times database. Hospitalizations are also falling, but deaths, a lagging indicator, continue to rise.

If the decline in cases and hospitalizations continues, as many experts expect, Mr. Biden himself will soon make some difficult decisions: Should he declare the end of the national emergency, his predecessor, President Donald J. Trump, said. Announced in March 2020? Should Mr. Biden lift his mask requirement for travel on planes, trains and buses?

Mr. Biden must be careful to avoid a “mission accomplished” moment. With cases falling in June of last year, his advisers began predicting a “joyful summer”, and Mr Biden announced on July 4 that the United States was “closer than ever to declaring our independence from a deadly virus.” Then the Delta variant soared across the country. The emergence of an even more infectious variant of Omicron in late autumn also caught management off guard.

Any new strategy must take this into account, said Michael T. Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

“One has to acknowledge that we are entering a new phase of transmission in our communities, keeping in mind forever that we were in exactly the same place a year ago today, where cases were declining from the peak in January, where vaccines were flowing,” he said. aforementioned. “And look what that gave us.”

The CDC’s masking decisions are particularly worrying: Experts say it’s difficult to publish a one-size-fits-all prescription for an expanding and diverse country like the United States.

Infectious disease specialist, who recently joined Kaiser Health News as editor-in-chief, Dr. “It’s a tough situation, because of course people are really worried about returning to some sense of normalcy,” said Celine Gounder. “It’s highly variable across the country – how much transmission there is, what the vaccine intake has been – but the CDC provides guidance for the entire country, so it makes sense to be cautious.”

Masking has become one of the most controversial issues of the pandemic. Many Republican governors gave up their mask mandates a long time ago. Some, like Florida Governor Ron DeSantis, have already been banned. mask powers and threatened to punish school officials who disobeyed them. The actions drew fierce criticism from Mr Biden, who directed the education secretary to introduce federal civil rights actions to discourage states from banning masking in classrooms.

But White House officials did not criticize their fellow Democrats for ending masking rules. Ms Psaki said there was a distinct difference between “stopping on the road like Ron DeSantis did” and “let local school districts choose, as many of these states do”.

Public health experts agree that school mask guidelines shouldn’t last forever, but divided About whether it’s time to let them go. CDCs current masking recommendations Advise state and local authorities to enact closed masking policies in high-contamination areas of the country.

A color-coded map on the agency’s website shows the entire country in red; 99 percent of all counties are in a high transmission zone – Dr. A point that Walensky underlined on Wednesday.

The public was understandably confused. A few weeks ago, with the rise of Omicron infections, the CDC clarified his stance About the various types of masks, acknowledging that cloth masks often worn by Americans do not offer as much protection as surgical or respiratory masks. A few days later, Mr. Biden announced that his administration would distribute 400 million free high-quality N95 masks to the public.

Now several experts said the agency needed to quickly find metrics for when masking and other mitigation measures should be relaxed and when reinstated. Dr. Wen spoke of an “offramp” and “on ramp” for mitigation measures, and said two factors are critical: whether hospitals and intensive care units have adequate capacity, and whether vaccines and boosters are well protected against serious illness.

“Rejecting restrictions should be their top priority, because that’s what individuals, businesses, state and local officials think about every day,” he said.

Dr. Wen, Gounder, and Osterholm are on a long list of experts the White House has recently consulted. None of the participants believed that the participating management officials – general surgeon Dr. Vivek H. Murthy; Dr. Fauci; and the science advisor of the Covid response, Dr. David A. Kessler – listened more than talked.

Meetings with outside experts seem to have been triggered by a tripartite article published in the Journal of the American Medical Association in January, in which six former Biden transition advisers urged management to take a longer view and produce a pandemic tactics book aimed at: “the new normal.”

The oncologist and medical ethicist who advised former President Barack Obama, Dr. Ezekiel Emanuel led the way. In the first article, University of Minnesota epidemiologist Dr. Emmanuel, Dr. Gounder and Dr. Osterholm wrote that the United States should avoid being stuck in a “permanent state of emergency.”

They recommended that management set targets and specific criteria, including how many hospitalizations and deaths from respiratory viruses, including influenza and Covid-19, to better prepare for inevitable outbreaks, including novel coronavirus variants. amount.

Mr. Biden is already signaling that he is past the pandemic. In His statements at a press conference in mid-January, “It is advancing towards a time when Covid-19 will not interrupt our daily lives, when Covid-19 will not be a crisis, but something to be protected from,” he said of the nation. But the president also said “we’re not there yet”.

Adel Hassan Contributing reports from Boston and Amelia Nierenberg from New York.