CDC considers ending 5-day isolation period for Covid

The Centers for Disease Control and Prevention is considering relaxing its recommendations for 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 recommended to isolate themselves for five days before returning to work or school. Instead, they could return to their routines if they have been fever-free for at least 24 hours without medication, the same standard that applies to influenza and respiratory syncytial viruses.

The proposal would align the CDC’s advice with revised isolation recommendations in Oregon and California. The change was previously reported by The Washington Post, but is still under consideration, according to two people with knowledge of the discussions.

The CDC last changed its isolation policy in late 2021, when it reduced the recommended period from 10 to five days. If adopted, the new approach would indicate that Covid has taken its place alongside other routine respiratory infections.

But by focusing on isolation policy for Covid, for example, the agency is squandering an opportunity to encourage better public health policies, several experts said.

“From a long-term public health perspective, I think this sets a really unfortunate precedent,” said Dr. Syra Madad, senior director of the special pathogens program at NYC Health + Hospitals.

He urged the CDC to “seize this opportunity to truly change the way we respond to deadly epidemics and pandemics and advocate for guaranteed paid sick and family leave nationwide rather than giving in to the easier option of eliminating the period.” of isolation.”

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 around 1,500 lives a day. In adults over 65, deaths from Covid have been two to four times more common than those from the flu.

“There are still many people contracting and dying from Covid in the United States,” said Dr. Boghuma Titanji, an infectious diseases doctor 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,” he said. Instead, he added, advice should be based on evidence.

Even people with only mild illness can develop long Covid, for which there is no treatment yet, Dr Titanji added.

The proposed recommendations also do not appear to take into account older Americans, or those who are immunocompromised or at risk of severe outcomes from Covid, said Jennifer Nuzzo, director of the Pandemic Center at the University’s School of Public Health. of Brown.

Dr. Nuzzo said she has an aunt with cancer who had contracted Covid twice in a healthcare facility. “I feel sorry for the people who now feel even less protected,” she said.

At a minimum, the CDC should recommend that people who end isolation after one day without fever also wear N95 masks or their equivalent when leaving their homes, he added.

“Let’s not pretend that you’re suddenly no longer contagious” after one day, Dr. Nuzzo said. “We have to be very clear and transparent about this: to say that we believe there is still a risk.”

Masking remains a deeply controversial issue in the United States. But many people avoid masks only because they fear drawing attention or vitriol, said Dr. Jay Varma, chief medical officer at Siga Technologies and former New York City deputy health commissioner.

Over time, sick people wearing masks could become the norm, like using condoms to prevent HIV infections or helmets to prevent head injuries, he said.

“A strong group of people oppose the use of masks now, but that will not be solved in time,” he added. “People change, people die, children 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.