CDC Considers Dropping Five-Day Covid Isolation Guideline

While no official decision has been made, symptomatic patients might be able to stop isolating if they are fever-free for 24 hours and are beginning to feel better under the proposed change

People sitting on a train, one with a mask on
The proposed changes to isolation guidelines would bring the CDC's approach to Covid-19 closer to California's and Oregon's. Both states amended their isolation guidance within the last year. Spencer Platt / Getty Images

The Centers for Disease Control and Prevention (CDC) is planning to revise its Covid-19 isolation policies, writes Lena H. Sun for the Washington Post, which first reported the news. Under the proposed recommendations, people who have tested positive for Covid could end their isolation if they have mild and improving symptoms and have been fever-free for 24 hours, without medication.

Currently, the CDC guidelines state that symptomatic patients who have tested positive should isolate for at least five full days following symptom onset. Beyond that point, patients should continue isolating until they are fever-free without medication for 24 hours and their symptoms are improving. Asymptomatic people should isolate for five full days following a positive test, and everyone who has tested positive should wear a mask around others through day ten.

Discussions regarding changes to the guidelines are in the early stages, however, and no definitive decisions have been made yet, an official at the Department of Health and Human Services says to NBC News’ Erika Edwards and Berkeley Lovelace Jr.

“It’s way too preliminary,” the source tells the publication. There’s “lots more consultation to be had.”

Some experts say the planned changes are appropriate and signal that Covid will be treated more like other infectious diseases, such as the flu, while others express concern about community health.

“Given the increased amount of immunity to Covid-19 in the population, access to treatment for Covid-19 and reductions in hospitalizations and deaths, it seems reasonable for the CDC to adapt our national strategies,” Clay Marsh, West Virginia University’s chief health officer, tells CNN’s Jamie Gumbrecht and Brenda Goodman.

“From a long-term public health perspective, I think this sets really an unfortunate precedent,” Syra Madad, senior director of the special pathogens program at NYC Health and Hospitals, tells the New York Times’ Apoorva Mandavilli. The CDC should “seize this opportunity to truly change how we respond to deadly epidemics and pandemics and advocate for national, guaranteed paid sick and family leave instead of caving into the easier option of eliminating the isolation period.”

In January, California changed its Covid isolation guidelines—now, residents can end isolation if they are fever-free for 24 hours without medication and have improving symptoms, and asymptomatic people who test positive do not need to isolate. Oregon made a similar change last May.

Covid-19 hospitalizations and deaths are only a fraction of what they were at the peak of the pandemic. But more than 2,000 Americans died from Covid-19 each week in the first half of January, and close to 30,000 people were hospitalized with Covid-19 at the start of the year. Wastewater monitoring, which can help track and predict cases, indicates that viral activity is high nationally, per the CDC.

Any changes to isolation guidelines don’t mean Covid-19 is less contagious, Jennifer Nuzzo, an epidemiologist at Brown University, says to NPR’s Pien Huang. “The science of Covid has not changed,” she tells the publication.

The planned changes seem to not take into account vulnerable groups like older Americans or people who are immunocompromised, Nuzzo tells the New York Times.

Many people continue to suffer from long Covid, the wide range of symptoms that can last for months or years after infection. A National Health Interview Survey published last fall found that by 2022, 7 percent of all U.S. adults had experienced long Covid at some point.

“This could actually increase Covid and long Covid cases and, to a certain extent, probably illness among high-risk individuals and thus hospitalizations and deaths,” Anand Parekh, chief medical adviser at the Bipartisan Policy Center, tells NPR.

However, some experts and health officials have argued that more practical guidelines are needed now, since many people are no longer following the current ones.

“Public health has to be realistic,” Michael T. Osterholm, an infectious disease expert at the University of Minnesota, tells the Washington Post. “In making recommendations to the public today, we have to try to get the most out of what people are willing to do. … You can be absolutely right in the science and yet accomplish nothing because no one will listen to you.”

On the other hand, Jessica Malaty Rivera, an epidemiologist and communications adviser to the de Beaumont Foundation, tells NPR that people’s actions shouldn’t be shaping the government’s advice.

“It’s like saying, well, people aren’t really wearing a seat belt, so I guess we can say seat belts don’t matter,” she tells the publication. “That kind of defeats the purpose of providing evidence-based information—that’s still the responsibility of public health to do that.”

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