Lack of Scientific Evidence for COVID-19 Rules Raises Concerns

Questioning the Six-Foot Rule: Was There Ever Science Behind It?

by Faruk Imamovic
Lack of Scientific Evidence for COVID-19 Rules Raises Concerns
© Getty Images

During the pandemic, one recommendation became a fixture in public life: maintain six feet of distance from others. This guideline, promoted by the Centers for Disease Control and Prevention (CDC), shaped many aspects of daily living and business operations. However, as the nation now reflects on the pandemic, questions arise about the scientific basis for this measure.

The Emergence of the Six-Foot Rule

In a congressional hearing, Dr. Anthony S. Fauci, a key figure in the fight against COVID-19, characterized the six-foot distancing rule as “an empiric decision that wasn’t based on data.” This admission has prompted scrutiny over how such a significant guideline could dominate public health policy without robust scientific backing.

Elinore McCance-Katz, the Trump administration’s assistant secretary for mental health and substance use, had long been skeptical of the six-foot rule. Throughout 2020, she repeatedly asked the CDC to provide the scientific justification for this recommendation. McCance-Katz argued that the guideline, while intended to prevent COVID-19 transmission, was causing significant harm to mental health, businesses, and overall well-being. In a June 2020 memo to the CDC, she urged the agency to revisit the decision or present stronger evidence supporting the rule.

Despite these internal concerns, the six-foot recommendation remained in effect until August 2022, albeit with some modifications as vaccination rates increased and schools began to reopen. As McCance-Katz's memos reveal, there was an ongoing debate within the health agencies about the necessity and efficacy of this guideline.

Lack of Evidence and Broader Implications

The persistence of the six-foot rule, despite its tenuous scientific basis, has left lasting reminders. Cities across the country still display signs urging people to keep their distance. According to experts, social distancing did play a role in saving lives, especially early in the pandemic when vaccines were not yet available. A paper by the Brookings Institution credits behavior changes, including social distancing, with preventing approximately 800,000 deaths.

Lack of Scientific Evidence for COVID-19 Rules Raises Concerns
Lack of Scientific Evidence for COVID-19 Rules Raises Concerns© Getty Images/Christopher Furlong

However, the lack of concrete evidence supporting the specific six-foot measure has been a point of contention. Andrew Atkeson, a UCLA economist and co-author of the Brookings paper, expressed frustration over the absence of rigorous studies on what distance would be most effective. He warned that public skepticism towards such unverified guidelines could undermine trust in future public health directives.

Notably, the World Health Organization recommended a shorter distance of one meter (about three feet), which some experts believed would have been equally effective and less disruptive, particularly in school settings. Scott Gottlieb, former Food and Drug Administration commissioner, described the six-foot rule as “probably the single most costly intervention the CDC recommended” throughout the pandemic.

Impact on Schools and Businesses

The most profound impact of the six-foot rule was perhaps felt in the education sector. Many schools found it impossible to maintain such a distance between students, leading to prolonged closures and a reliance on virtual learning. Joseph Allen, a Harvard University expert in environmental health, criticized the rule, stating that it was based on a misunderstanding of how particles travel through indoor spaces. He advocated for a three-foot distance, particularly in schools, coupled with improved ventilation and filtration.

Businesses, too, struggled with the implementation of the six-foot guideline. Jeff Bezos, founder of Amazon, questioned the scientific validity of the rule and its practicality. In March 2020, Bezos contacted senior Trump administration officials to discuss alternative measures. Despite these concerns, Amazon adhered to the six-foot rule, implementing various technologies to enforce it across their global operations.

The six-foot rule's origins remain somewhat obscure. The CDC has credited a team of experts who based their recommendations on research, including a 1955 study on respiratory droplets. In his book "Uncontrolled Spread," Gottlieb noted that the CDC initially proposed a ten-foot distance, which was reduced under pressure from the Trump White House due to concerns over feasibility.

Rethinking Public Health Measures

The debate over the six-foot rule highlights the challenges in creating public health policies during an unprecedented crisis. Initially, the CDC and other health agencies believed that the coronavirus was primarily spread through droplets, which could travel several feet from an infected person. This led to the adoption of the six-foot rule, despite later evidence suggesting the virus was airborne and could spread beyond six feet in enclosed spaces.

Dr. Robert R. Redfield, CDC director during the Trump administration, admitted in a congressional hearing that the six-foot rule was based on historical practices for other respiratory pathogens, rather than specific studies on COVID-19. This acknowledgment has led to a reevaluation of how public health guidelines are formulated and communicated.

Efforts to challenge the six-foot rule faced political hurdles. Rochelle Walensky, who later became CDC director under President Joe Biden, initially supported the six-foot guideline but worked to revise it. In March 2021, she announced that elementary school students could sit three feet apart if masked, reflecting a shift towards more flexible and evidence-based measures.

The experience of the pandemic underscores the need for rigorous scientific research to inform public health recommendations. As the world prepares for potential future crises, it is crucial to balance precautionary measures with practical considerations and ensure that policies are grounded in solid evidence.