What should people do if they are exposed to the required quarantine end? How long should they isolate if they become infected? What is the reason for making the changes? And are there exceptions: who should take precautions beyond the new recommendations?
CNN: Did the CDC really end the quarantine? That seems like a big step.
dr. Leana Wen: It has effectively ended quarantine for people exposed to Covid-19. I agree, this is a big change in the recommendations.
CNN: Can you remind us of the difference between quarantine and isolation?
female: Quarantine applies to someone who has been in close contact with a person infected with the coronavirus. Close contact, according to the CDC, means being within 6 feet of someone with Covid-19 for a total of 15 minutes or more over a 24-hour period. Earlier in the pandemic, recommendations were that those exposed to Covid-19 should self-quarantine and not be out in public. That’s how someone in need of “quarantine” was defined – as someone who hasn’t been diagnosed with Covid-19, but who does have significant exposure.
Now someone with known exposure no longer needs to go into quarantine, but they do have to mask a 10-day period.
On the other hand, a person should be in isolation if they are diagnosed with Covid-19. Isolation is defined as being physically separated from others to prevent transmission of the virus during the contagious period.
CNN: Are there still people who, despite the guidelines abolishing quarantine, still have to take extra precautions?
female: Yes. The CDC says those with exposure should take extra precautions around people who are more likely to become very ill from Covid-19. What I mean by this is that you need to be extra careful when visiting an elderly grandparent, for example.
If your partner currently has the virus and you and your children do not, you can still go to work and your children to school in a mask, but consider delaying travel to medically vulnerable relatives until after the 10-year period. to dawn. If you live in a home with vulnerable individuals, keep your distance for the 10-day period following your exposure and make sure everyone indoors masks around each other.
CNN: What should people know about insulation now?
female: Here the new CDC guideline is a bit complicated.
If you have no symptoms, or if you have symptoms and they improve and you remain fever-free for at least 24 hours, you can end the isolation after five days. For the next five days, you will still have to mask yourself in public places. So you can go to work, but keep masking at work, and make sure you mask on the train or bus there.
There are some caveats here. First, the CDC guideline says that if you had moderate illness, defined as shortness of breath or difficulty breathing, or if you required hospitalization, or if you are immunocompromised, you should isolate until day 10. This makes sense, because a more serious illness or compromised immune system suggests that you could have had a higher viral load that takes longer to clear.
Second, CDC once again emphasizes caution around people who are likely to become very ill from Covid-19. If you have just had Covid-19, you should wait at least until after day 10 to visit medically vulnerable family or friends. I would also add that you should test negative with a rapid antigen test before seeing vulnerable individuals indoors. This isn’t something the CDC recommends, but I think the negative test gives more reassurance to protect those at high risk.
Third, speaking of testing, the new guideline also says you can end your 10 days of masking early if you do two quick tests 48 hours apart. Let’s say on day five your rapid test is negative. You can take another test on day seven, and if it’s negative, you don’t need to mask after that.
I think this makes sense, and would actually like the CDC to be even more explicit with its recommendation to lift test-based isolation. There are some individuals who still test positive on day 11. Here I am only referring to the rapid home antigen test, as the PCR test could remain positive for much longer. I think it would be even safer to say that you should test negative before being around vulnerable people, even if it’s been 12 or 13 days for example.
female: Good question, and yes it is. This “rebound” phenomenon is often associated with taking the antiviral Paxlovid, but can occur in people who are not on treatments. The CDC guideline says that if someone tests positive again, the clock resets, and the day they test positive, the second time is day zero. That means they have to go through another five days of isolation and masking until after day 10, just like the first time.
CNN: Why were these changes made? Has Science Changed or Is the CDC Responding to Public Pressure?
female: I think there are two factors. One is the recognition that Covid-19 is here to stay. We will probably live our entire lives and the lives of our children and beyond with this virus. Given that, the focus should be on getting back to business as usual, which means avoiding policies that disrupt everyday life.
The other factor is that public health must respond to where the public is. Most Americans have returned to many aspects of pre-pandemic life. The CDC guidelines seem to meet people where they already are — and for some, they don’t go far enough — for example, they still recommend masks in high-transmission areas, even though most people don’t. In order for public health to be trusted, it must be considered relevant, and if the CDC’s guidelines are too far removed from people’s everyday behavior, they will not be trusted.
The implicit here is that there is no new research leading to the change. Quarantine will not be removed as Covid-19 has become less contagious. However, circumstances have changed, including the fact that we have many more tools that reduce the chance of serious illness from the coronavirus.
All in all, I think the CDC made the right decision. Easing restrictions now will preserve the credibility of public health officials later, if stricter guidelines are needed due to a new, more dangerous variant.
