Things are always a’changin.’ That includes CDC guidance for COVID-19 isolation.
A Feb. 13 article from the Washington Post outlines the coming changes and the reasoning behind them. The current recommendations are from December 2021. In January 2021, 26,000 people were dying from COVID weekly, and about 115,000 were being hospitalized. Now, weekly, about 20,000 are going to the hospital and around 2,300 are dying from it. That is still a lot.
In December 2021, the recommended isolation time from the first positive test was 10 days. To better align with infection trends, the change then was made to stay home and isolate in your house for five days from the last positive test or until you had no fever for 24 hours without medicine.
The article says CDC officials have acknowledged the internal discussions of how the COVID landscape has changed in four years. It went from killing 1.2 million people to a population where most folks have a level of immunity from prior infection or vaccination or both.
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This warrants a more realistic adaption since few people are following the old guidelines, which are still to isolate for five days. The new recommendations are slated to be that COVID positive individuals stay home until they have been fever-free without medicine for 24 hours and their symptoms are mild and improving. This was according to three agency officials who wished to remain anonymous. The current recommendations would not change for more vulnerable groups or hospitals, etc. The revised advice should be out around April.
This work has been going on since last August but was put on hold when COVID reared its ugly genes to cause a new wave. That seems to be subsiding, but it is still active as seen in the analysis of public wastewater for COVID evidence. The prevalent variant J.N1 has made quite an impact. The dominant groups being infected knowingly are the elderly and immune compromised. Persistent difficulties after an infection called long COVID still may include fatigue, difficulty breathing, brain fog, joint pains and loss of taste or/and smell.
Not everyone agrees over such liberalization of isolation. One person quoted in the article said, “Doing so sweeps this serious illness under the rug,” and that public health officials should treat COVID differently from other respiratory viruses because it is deadlier than influenza and can have long term complications. She is a clinical instructor at Harvard Medical School and a member of the People’s CDC, a coalition of health care workers, scientists and advocates focused on reducing the harmful effects of COVID-19.
Oregon and California have already made similar changes. The concept behind the change is go give people symptom-based guidance, like flu recommendations. It is a way to prioritize those most at risk and balance the potential for disruptive impacts on schools and workplaces. Oregon says it hasn’t observed any disproportionate increases in community transmission or severity shown by the data from last month.
California is still recommending COVID infected folks wear masks indoors when around others for 10 days after having a positive test. You can take it off sooner if you have two sequential negative tests. It isn’t clear what the CDC will say about mask wearing.
To frame this discussion in more practical terms, you can get sick with any of the respiratory infections now in our communities. At first it’s hard to tell COVID, flu or RSV apart, because their initial symptoms are about the same. The best way to protect people around you is to mask up and avoid unnecessary trips from home. You probably shouldn’t go shopping and spread your germs all over the store. Now I am starting to sound like my mom.
Dr. Frank Bures, a semi-retired dermatologist, has worked in Winona, La Crosse, Viroqua and Red Wing since 1978. He also plays clarinet in the Winona Municipal Band and a couple Dixieland groups.
