CDC studies reducing covid isolation time
The Centers for Disease Control and Prevention is considering loosening its recommendations regarding how long people should isolate after testing positive for the coronavirus, another reflection of changing attitudes and norms as the pandemic recedes.
Under the proposed guidelines, Americans would no longer be advised to isolate for five days before returning to work or school. Instead, they might return to their routines if they have been fever-free for at least 24 hours without medication, the same standard applied to the influenza and respiratory syncytial viruses.
The proposal would align the CDC’s advice with revised isolation recommendations in Oregon and California. The shift was reported earlier by The Washington Post, but it is still under consideration, according to two people with knowledge of the discussions.
The CDC last changed its policy on isolation in late 2021, when it scaled down the recommended period to five days from 10. If adopted, the new approach would signal that covid has taken a place alongside other routine respiratory infections.
But by focusing on the isolation policy for covid, for example, the agency is squandering an opportunity to foster better public health policies, several experts said.
“From a long-term public health perspective, I think this sets really an unfortunate precedent,” said Dr. Syra Madad, senior director of the special pathogens program at NYC Health + Hospitals.
She urged the CDC to “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.”
Some researchers worried that Americans would interpret the new advice to mean that covid was no longer a threat. At its peak this winter, covid claimed about 1,500 lives a day. In adults older than 65, deaths from covid have been two to four times as common as those from the flu.
“There’s still a lot of people getting covid and dying from covid in the U.S.,” said Dr. Boghuma Titanji, an infectious diseases physician at Emory University in Atlanta.
“When you make a public health recommendation, it’s not supposed to be based on what people are already doing,” she said. Instead, she added, the advice must be grounded in evidence.
Even people who have only a mild illness may go on to develop long covid, for which there is no treatment yet, Titanji added.
The proposed recommendations also seem not to take into account older Americans or those who are immunocompromised or otherwise at risk of severe outcomes from covid, said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health.
Nuzzo said she has an aunt with cancer who had twice contracted covid in a health care facility. “I do feel for people who now feel even less protected,” she said.
At the very least, the CDC should advise that people who end isolation after one fever-free day also wear N95 masks or the equivalent when leaving their homes, she added.
“Let’s not pretend you’re suddenly not contagious” after one day, Nuzzo said. “We have to be very clear and transparent about that — to say that we think that there still is a risk.”
Masking remains a deeply controversial issue in the United States. But many people eschew masks only because they fear drawing attention or vitriol, said Dr. Jay Varma, chief medical officer at Siga Technologies and a former deputy commissioner of health for New York City.
Over time, sick people wearing masks could become the norm, like wearing condoms to prevent HIV infections or helmets to prevent head injuries, he said.
“A strong group of people oppose wearing masks now, but that’s not fixed in time,” he added. “People change. People die off. Kids become adults.”
CDC officials declined to discuss the proposed changes. “We will continue to make decisions based on the best evidence and science to keep communities healthy and safe,” the agency said in a statement.