On March 1, the U.S. Centers for Disease Control and Prevention made a major change to its COVID-19 isolation guidelines. Individuals who test positive for COVID no longer have to isolate for at least five days before returning to work or school. Under the new guidance — which applies to all respiratory infections including COVID — infected individuals can resume normal daily activities as long as their symptoms are improving, and they have been free from fever for more than 24 hours without the use of fever-reducing medications. The CDC notes however that people can still be contagious beyond their ‘stay at home’ period and therefore should continue to use extra precautions for an additional five days after returning to activities. Those precautions include wearing a mask, keeping distance from people, maintaining good hand hygiene, keeping areas well ventilated, and getting tested for respiratory viruses to clarify their illness if necessary. Yale School of Public Health Associate Professor of Public Health (Health Policy) Dr. Jason L. Schwartz, PhD, recently took a moment to explain the new guidelines and why they were implemented.
Why did the CDC decide to change its COVID-19 isolation guidelines at this time?
We are now in the fifth year since the emergence of COVID. Along the way, our understanding of the virus has grown enormously. We have developed and implemented effective strategies for its prevention and treatment—from masks to tests to vaccines to antiviral drugs, and we have seen many iterations of guidelines and recommendations from the CDC and other public health agencies. This latest change from the CDC — like those that preceded it — attempts to reflect the latest assessment of the current threat posed by COVID as well as the value of crafting clear, easy-to-understand, and easy-to-implement recommendations for the public. This revision to isolation guidelines is part of an ongoing, long-term effort by the CDC to harmonize its recommendations regarding COVID with those for other respiratory viruses, particularly influenza and RSV, that likewise cause substantial numbers of illnesses, hospitalizations, and deaths, particularly among older and other high-risk populations.
What are some of the concerns experts have about the shorter isolation period?
Some people with COVID or other respiratory viruses will remain contagious after the newly modified isolation period ends, a fact that the CDC acknowledges in its revised guidance. This has prompted concern among some experts regarding the potential for further transmission of the virus and a resulting increase in community risk for COVID and its more severe outcomes, especially in older Americans, immunocompromised individuals, and others with underlying medical conditions. In response, the CDC has noted that the guidelines advise individuals recovering from respiratory illnesses to continue to take precautions for several days after the recommended isolation period ends, including mask-wearing, enhanced hygiene, and limiting proximity to others. It is worth emphasizing that these updated guidelines — both the isolation period and the subsequent additional precautions — are intended to apply to individuals experiencing any respiratory illness, an important detail at a time when far fewer individuals are testing for COVID than did so during the peak pandemic period.
Is COVID-19 still a major health threat and should people still get tested and vaccinated to avoid it?
Yes! COVID unquestionably remains a serious health threat, considerably more so than other respiratory viruses currently, even though public attention to the virus has declined precipitously over the past year (or longer). The numbers of illnesses, hospitalizations, and deaths that continue to be caused by COVID make that fact emphatically clear, even though they thankfully reflect large declines from earlier stages of the pandemic. Testing, masks, vaccines, and antiviral medications led to those declines, and they remain valuable tools. Vaccines, in particular, continue to be highly effective in preventing COVID’s most severe health outcomes. Remaining up to date with COVID vaccination — as well as influenza and RSV vaccines, all based on CDC recommendations — is an effective, common-sense strategy for sustained protection, especially for older individuals and others at increased risk of severe illness, hospitalization, and death from COVID and other respiratory viruses.