CDC recommends shorter COVID isolation, quarantine for all

U.S. health officials on Monday cut isolation restrictions for asymptomatic Americans who catch the coronavirus from 10 to five days, and similarly shortened the time that close contacts need to quarantine.

Centers for Disease Control and Prevention officials said the guidance is in keeping with growing evidence that people with the coronavirus are most infectious in the two days before and three days after symptoms develop.

"I’m not surprised," said Dr. Jill Foster, the University of Minnesota’s director of pediatric infectious diseases, of the new guidelines "I think it’s a reasonable thing to do."

Dr. Foster told 5 EYEWITNESS NEWS it will be critical that people stayed masked for the recommended five days after isolation or quarantine ends.

"We’re not totally saying ‘After five days, you’re great’," she said. "Ten days for the first five days, stay isolated. For the second five days, be really careful wearing a mask and that means even with your household family members."

According to Dr. Foster, those with COVID should continue to be careful of who they interact with for the full 10 days.

"They’re probably less likely to be contagious [during the remaining five days] but they still might be," she said. "Especially stay away from folks that are unvaccinated and stay away from folks that have a problem with their immune system."

The new guidelines come as millions of Americans travel to see loved ones during the holiday week.

"There’s no question that this is something the airlines have wanted," said Kyle Potter the executive editor of Minnesota-based travel and flight deal website Thrifty Travel. "A handful of the country’s largest airlines have been begging for more than a week for this so I do think that this will certainly help."

Delta Airlines, JetBlue Airways and Airlines for America, which lobbies on behalf of U.S. airlines, have all recently asked the CDC to reduce the isolation period for fully vaccinated individuals. The companies have cited COVID-19 as a source of staffing problems.

The Christmas travel weekend was marked by cancellations across the country.

"Airlines on a really good day with no weather, with no software problems, with no Omicron variant leaving them short staffed, are stretched really thin right now," said Potter. "What we’re seeing right now is not just one thing going wron or two things going wrong, but a lot of things going wrong all at once and it really is this perfect storm that’s becoming a pretty big nightmare for people who are trying to get somewhere this week and into the new year."

Despite increased travel numbers, the industry has experienced challenges throughout 2021.

"We have seen these issues with airlines again and again, through the summer and fall," said Potter. "They just don’t have enough staff and when things go wrong, they don’t have the people to catch up without having mass cancellations."

The variant has also caused some travelers to rethink flights and change their plans.

"I think this is going to be a short term gut punch for travel, especially for the travelers out there who are affected by some of the cancellations that we’ve seen, as well as feeling like they need to call off their travel plans in the near term future because of what we’re seeing right now with COVID cases," said Potter. "But what we’ve seen is that with every wave of COVID cases, the drop in travel interest gets a little bit shallower and it doesn’t last quite as long. You’ll have to ask me again in a couple of weeks, or probably a couple of months even, but I think what we’ll see is the same thing will be true in this case with Omicron."

The decision also was driven by a recent surge in COVID-19 cases, propelled by the omicron variant.

Early research suggests omicron may cause milder illnesses than earlier versions of the coronavirus. But the sheer number of people becoming infected — and therefore having to isolate or quarantine — threatens to crush the ability of hospitals, airlines and other businesses to stay open, experts say.

CDC Director Rochelle Walensky said the country is about to see a lot of omicron cases.

"Not all of those cases are going to be severe. In fact many are going to be asymptomatic,” she told The Associated Press on Monday. “We want to make sure there is a mechanism by which we can safely continue to keep society functioning while following the science."

Last week, the agency loosened rules that previously called on health care workers to stay out of work for 10 days if they test positive. The new recommendations said workers could go back to work after seven days if they test negative and don’t have symptoms. And the agency said isolation time could be cut to five days, or even fewer, if there are severe staffing shortages.

Now, the CDC is changing the isolation and quarantine guidance for the general public to be even less stringent.

The guidance is not a mandate; it’s a recommendation to employers and state and local officials. Last week, New York state said it would expand on the CDC’s guidance for health-care workers to include employees who have other critical jobs that are facing a severe staffing shortage.

It’s possible other states will seek to shorten their isolation and quarantine policies, and CDC is trying to get out ahead of the shift. “It would be helpful to have uniform CDC guidance” that others could draw from, rather than a mishmash of policies, Walensky said.

The CDC’s guidance on isolation and quarantine has seemed confusing to the public, and the new recommendations are “happening at a time when more people are testing positive for the first time and looking for guidance,” said Lindsay Wiley, an American University public health law expert.

Nevertheless, the guidance continues to be complex.

ISOLATION

The isolation rules are for people who are infected. They are the same for people who are unvaccinated, partly vaccinated, fully vaccinated or boosted.

They say:

—The clock starts the day you test positive.

—An infected person should go into isolations for five days, instead of the previously recommended 10.

—At the end of five days, if you have no symptoms, you can return to normal activities but must wear a mask everywhere — even at home around others — for at least five more days.

—If you still have symptoms after isolating for five days, stay home until you feel better and then start your five days of wearing a mask at all times.

QUARANTINE

The quarantine rules are for people who were in close contact with an infected person but not infected themselves.

For quarantine, the clock starts the day someone is alerted to they may have been exposed to the virus.

Previously, the CDC said people who were not fully vaccinated and who came in close contact with an infected person should stay home for at least 10 days.

Now the agency is saying only people who got booster shots can skip quarantine if they wear masks in all settings for at least 10 days.

That’s a change. Previously, people who were fully vaccinated — which the CDC has defined as having two doses of the Pfizer or Moderna vaccines, or one dose of the Johnson & Johnson vaccine — could be exempt from quarantine.

Now, people who got their initial shots but not boosters are in the same situation as those who are partly vaccinated or are not vaccinated at all: They can stop quarantine after five days if they wear masks in all settings for five days afterward.

FIVE DAYS

Suspending both isolation and quarantine after five days is not without risk.

A lot of people get tested when they first feel symptoms, but many Americans get tested for others reasons, like to see if they can visit family or for work. That means a positive test result may not reveal exactly when a person was infected or give a clear picture of when they are most contagious, experts say.

When people get infected, the risk of spread drops substantially after five days, but it does not disappear for everyone, said Dr. Aaron Glatt, a New York physician who is a spokesman for the Infectious Diseases Society of America.

“If you decrease it to five days, you’re still going to small but significant number of people who are contagious,” he said.

That’s why wearing masks is a critical part of the CDC guidance, Walensky said.