By Christopher Cheney
New Centers for Disease Control and Prevention (CDC) COVID-19 guidance on quarantine and isolation is “confusing” and risks spreading the virus, the president of the American Medical Association (AMA) says.
CDC guidance on quarantine and isolation for those who have been exposed to someone with COVID-19 or people who test positive for COVID-19 has changed several times since the beginning of the pandemic. Under certain circumstances, the new guidance reduces the amount of time that people must quarantine or isolate themselves from 10 days to five days.
The new CDC guidance was last updated on Jan. 4.
In a prepared statement released on Jan. 5, AMA President Gerald Harmon, MD, expressed disappointment over the new CDC guidance. “Nearly two years into this pandemic, with omicron cases surging across the country, the American people should be able to count on the Centers for Disease Control and Prevention for timely, accurate, clear guidance to protect themselves, their loved ones, and their communities. Instead, the new recommendations on quarantine and isolation are not only confusing, but are risking further spread of the virus,” he said.
The new CDC guidance that reduces the time for isolation is misguided, Harmon said.
“According to the CDC’s own rationale for shortened isolation periods for the general public, an estimated 31% of people remain infectious five days after a positive COVID-19 test. With hundreds of thousands of new cases daily and more than a million positive reported cases on January 3, tens of thousands—potentially hundreds of thousands of people—could return to work and school infectious if they follow the CDC’s new guidance on ending isolation after five days without a negative test. Physicians are concerned that these recommendations put our patients at risk and could further overwhelm our healthcare system,” he said.
A negative test should be required for ending isolation after someone tests positive for COVID-19, Harmon said. “Test availability remains a challenge in many parts of the country, including in hospitals, and we urge the administration to pull all available levers to ramp up production and distribution of tests. But a dearth of tests at the moment does not justify omitting a testing requirement to exit a now shortened isolation.”
New CDC isolation guidance highlights
The CDC says isolation should be used to separate people with suspected or confirmed COVID-19 from people who have not been infected.
The CDC has the following guidance for isolation. “At home, anyone sick or infected should separate from others, or wear a well-fitting mask when they need to be around others. People in isolation should stay in a specific ‘sick room’ or area and use a separate bathroom if available. Everyone who has presumed or confirmed COVID-19 should stay home and isolate from other people for at least 5 full days (day 0 is the first day of symptoms or the date of the day of the positive viral test for asymptomatic persons). They should wear a mask when around others at home and in public for an additional 5 days.”
If someone has COVID-19 and has symptoms, they should isolate for at least five days, the CDC says. For these people there are six recommendations for ending isolation, the CDC says.
- Isolation can be ended after five full days if you are fever-free for 24 hours without using a fever-reducing medication and other symptoms have improved.
- After ending the five-day isolation period, people should wear a well-fitting mask around others at home and in public for an additional five days.
- If fever persists and other symptoms do not improve after five days of isolation, you should not end your isolation until you are fever-free for 24 hours without the use of fever-reducing medication and other symptoms have improved.
- After ending isolation, travel should be avoided until a full 10 days after the first day of symptoms. If you must travel on days six through 10 after your first day of symptoms, you should wear a well-fitting mask when you are around others while traveling.
- You should not frequent places where you cannot wear a mask such as restaurants and avoid eating around others at home and work until a full 10 days after your first day of symptoms.
- Toward the end of the five-day isolation period, there is no requirement to get testing, but the “best approach” is to take an antigen test if the test is available and the person wants to test. The test should be conducted only if you are fever-free for 24 hours without the use of fever-reducing medication and other symptoms have improved. “If your test result is positive, you should continue to isolate until day 10. If your test result is negative, you can end isolation but continue to wear a well-fitting mask around others at home and in public until day 10,” the CDC says.
Christopher Cheney is the senior clinical care editor at HealthLeaders.