The Centers for Disease Control and Prevention is considering relaxing its recommendations on how long people should self-isolate after testing positive for the coronavirus, another reflection of changing attitudes and norms as the pandemic subsides.
Under the proposed guidelines, Americans would no longer be advised to self-isolate for five days before returning to work or school. Instead, they may return to their routine if they have been fever-free for at least 24 hours without medication, the same pattern that applies to influenza and respiratory syncytial viruses.
The proposal would align the CDC’s advice with the revised isolation recommendations in Oregon and California. The change was reported earlier by the Washington Post but is still being considered, according to two people familiar with the discussions.
The CDC last changed its isolation policy in late 2021, when it reduced the recommended period to five days from 10. If adopted, the new approach would mean that Covid has taken a place alongside other common respiratory infections.
But by focusing on the isolation policy for Covid, the agency is wasting an opportunity to promote better public health policies, several experts said.
“From a long-term public health perspective, I think this really sets an unfortunate precedent,” said Dr. Syra Madad, senior director of the Special Pathogens Program at NYC Health and Hospitals.
He urged the CDC to “seize this opportunity to truly change the way we respond to deadly outbreaks and pandemics and support national, guaranteed paid sick and family leave rather than retreating to the easier option of eliminating the quarantine period.” .
Some researchers worried that Americans would interpret the new advisory to mean that Covid is no longer a threat. At its peak this winter, Covid claimed about 1,500 lives a week. In adults over 65, deaths from Covid were two to four times more common than those from the flu.
“There are still a lot of people getting sick from Covid and dying from Covid in the US,” said Dr. Boghuma Titanji, an infectious disease 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,” he said. Instead, he added, advice should be based on evidence.
Even people who have only a mild illness can go on to develop long-term Covid, for which there is still no cure, Dr Titanji added.
The proposed recommendations also appear 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’s School of Public Health.
Dr Nuzzo said she has an aunt with cancer who had contracted Covid twice in a health care facility. “I feel for the people who now feel even less protected,” he said.
At a minimum, the CDC should advise that people ending isolation after a day without fever also wear N95 masks or the equivalent when leaving their homes, he added.
“Let’s not pretend you’re suddenly not contagious” after a day, Dr. Nuzzo said. “We have to be very clear and transparent about that – to say we believe there is still a risk.”
Coverage remains a deeply controversial issue in the United States. But many people avoid masks only for fear of attracting attention or vitriol, said Dr. Jay Varma, chief medical officer at Siga Technologies and a former deputy health commissioner for New York City.
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 opposes the use of masks now, but this is not being corrected 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.
