The Centres for Disease Control and Prevention issued new guidance on Thursday. It reverses recommendations for social Isolation and quarantine following COVID-19 exposure. Also bringing the agency in line with how most Americans react.
“If the guidelines were to recommend quarantine for everyone with an exposure, and to think about how many people in the U.S. have been exposed to COVID in the past two or three months with the high levels of transmission that we’re having, we would be quarantining 10 to 15% of our population at any given time,” says Johns Hopkins epidemiologist David Dowdy. “That’s just not consistent, I think, with the risk of serious disease that we’re seeing at this time.”
The quarantine recommendations made the most noise among the changes announced by the CDC on Thursday. The CDC no longer recommends quarantining those who have been exposed to COVID-19 for 10 days. Instead, they recommend masking for 10 days, and getting tested five days after exposure. Also monitoring for infection symptoms such as fever, cough, shortness of breath, or other COVID-19 symptoms. If symptoms appear, they should be tested as soon as possible and isolated for at least five days, beginning immediately.
According to data from The New York Times, the United States sees approximately 100,000 new cases of COVID-19 each day. Also with 400-500 deaths. While these figures appear to be high, Dowdy points out that they are roughly comparable to the number of deaths seen during peak flu season each year.
Why is the CDC revising some of its COVID-19 recommendations?
Honestly, the CDC might attempt to catch up with what people are already doing. The primary recommendations for people with COVID-19 have not changed. However, the focus is now on those who have been exposed. The CDC wanted to ensure that they were not issuing guidance that was widely ignored.
However, it emphasizes the importance of vaccination, wearing masks when the transmission is high, isolating yourself if you have COVID-19, and wearing masks if you have been exposed. But it takes the requirement of quarantine if you’ve been exposed. Which, again, I believe is consistent with what most people in the country have been doing—and acknowledges that we don’t have to let this virus run our lives and our society right now. We want our response to be proportionate to the level of risk.
For many people, the decision to participate in an activity like shopping or attending a gathering required a risk assessment. What is the risk of being exposed to COVID-19, as well as the risk of spreading the virus to others? How should people consider their risk potential now that people with known COVID-19 exposures are no longer required to quarantine?
The approach you describe—that individual risk calculation of ‘how likely am I to be exposed and how likely am I to expose others who may be at risk?’. This is exactly what we should be doing, and I do not believe that this guidance changes that in any way. The advice for people, in terms of wearing masks and taking other protective measures. It still refers to community transmission levels, which are likely to be high in roughly half of the US population.
What else should people remember about the CDC’s advice and the current state of the pandemic?
We’ve reached a point where tracking case numbers is difficult because reporting and testing practices are so varied. Because so many people are testing at home and failing to report positive results, it’s difficult to use case numbers as a reliable indicator. But we do have other sources of information, such as hospitalizations and deaths. Also, things like test positivity, wastewater surveillance, and the fraction of ED visits with a COVID-19 diagnosis, and by tracking trends in these things, we can get a sense of where things are.
The number of people dying from COVID every day right now is comparable to the number of people dying from the flu during peak flu season. We have transmission levels that are as high now as they have been at any point in the pandemic. However, there have been the fewest deaths in the last four months since the pandemic began. As a result, the average case is becoming milder.
It is entirely possible that another wave of illness and death will occur. It’s also entirely possible that the same level of stability that we’ve seen in recent months will continue in the coming months.