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CDC Lifts 5-Day Isolation Guidance

The updated guidance for COVID-19 isolation now aligns with other respiratory viruses like the flu or RSV.

On March 1, the Centers for Disease Control and Prevention (CDC) updated its Respiratory Virus Guidance for COVID-19, dropping the five-day isolation period in favor of a shorter time frame.

The new guidance says that people with COVID-19 can return to their typical daily activities if they feel better overall and have not had a fever within the past day of isolation or 24 hours. However, the person should not have used fever-reducing medications during this isolation period.

The CDC says that for five days after returning to their usual activities, people should still take precautions like wearing masks and distancing themselves from others when indoors. If a fever recurs or an individual starts to feel ill again, the CDC recommends repeating the 24-hour isolation recommendations.

The updated guidance aligns with recommendations for other respiratory viruses like influenza and respiratory syncytial virus (RSV).

According to the CDC, the new guidance is based on data suggesting most SARS-CoV-2 transmission primarily occurs early in the disease, and most people are no longer infectious after eight to 10 days. Though COVID-19 remains a threat to public health, it impacts people much like the flu or RSV and is no longer considered an emergency.

The CDC notes that complications from COVID-19, like multisystem inflammatory syndrome in children (MIS-C), are less common, and cases of long COVID appear to be decreasing.

Moreover, more than 98% of people in the United States have antibodies to SARS-CoV-2 through prior infection, vaccination, or a mix of both, and death rates from COVID-19 have fallen over the past four years. Meanwhile, deaths from influenza have remained consistent except for a drop during the COVID-19 pandemic.

CDC data also shows that interest in COVID-19 vaccines is waning. During the 2023-2024 respiratory virus season, about 22% of adults and 42% of older adults received the COVID-19 vaccine. The vaccine effectiveness hovers around 50%.

Will the new COVID isolation guidance lead to more illnesses?

States in the U.S. and other countries that have already recommended shortened isolation periods have not observed an increase in COVID-related hospitalizations or deaths. Still, the CDC acknowledges that COVID-19 carries risks of post-COVID-19 conditions, unlike other respiratory viruses.

Maria Ruiz M.D., an associate professor of medicine and an infectious disease expert at the George Washington University School of Medicine and Health Sciences tells Healthnews that while COVID is still a more serious illness than influenza, its mode of transmission is similar.

"[The] CDC opted to have a unifying and more easy to follow isolation guidance. I believe this will increase compliance," Ruiz says.

Ruiz notes that, in the U.S., isolation was never enforced and was left to individual practice except in clinical settings.

"We are seeing less illness now with the current isolation guidance, but there is also less testing," Ruiz explains. "I think many people don't test due to fear of having to isolate. It is likely that there are people that don't even know they have COVID that are not isolating."

According to a CBS report, the U.S. Government is dropping other COVID-related efforts due to the downturn in viral activity and other factors. On March 8, the United States Postal Service (USPS) will no longer distribute free COVID-19 tests, and pharmacies will stop dispensing supplies of the antiviral medication Paxlovid.

These actions reflect a shift from the emergency response phase initiated at the start of the pandemic four years ago to the pandemic recovery and maintenance phases. During recovery and maintenance, COVID-19 is handled in conjunction with other threats to public health.

Moving forward, Ruiz says people can continue to protect themselves from COVID-19 by washing their hands often and avoiding touching the face and nose.

"If you are immunocompromised or have a big deadline and cannot afford to get sick, wear a mask in crowded settings," Ruiz adds. "Get vaccinated. Test and isolate as appropriate. Practice cough courtesy and wear a mask if coughing or getting over an illness and ask those around you to do the same."

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