— It recommends wearing a mask for 10 days and getting tested on day 5 or later.
Instead of quarantining if exposed to COVID-19, wear a high-quality mask for 10 days and get tested on day 5 or later, regardless of vaccination status, the CDC suggested in revised COVID guidelines issued Thursday.
"In light of the high levels of population seroprevalence against SARS-CoV-2, and to limit social and economic impacts, quarantine of exposed individuals is no longer recommended, regardless of vaccination status," said Greta Massetti, PhD, of the CDC COVID-19 Emergency Response Team and colleagues in the Morbidity and Mortality Weekly Report .
Furthermore, “the CDC now recommends case investigation and contact tracing only in healthcare settings and certain high-risk congregate settings,” the authors wrote. The updated guidelines no longer mention the previously recommended “test and stay” strategy for students who had potential exposure.
The agency developed the revised guidance because "high levels of vaccine- and infection-induced immunity and the availability of effective treatments and prevention tools have substantially reduced the risk of medically significant illness from COVID-19 (severe acute illness and post-COVID-19 conditions) and associated hospitalization and death," Massetti and co-authors said.
"These circumstances now allow public health efforts to minimize the impacts of COVID-19 on individual and social health by focusing on sustainable measures to further reduce medically significant illnesses, as well as to minimize strain on the health care system, while reducing social, educational, and economic barriers," they added.
“The CDC’s public health recommendations change in response to evolving science, the availability of biomedical and public health tools, and changes in context, such as population immunity levels and currently circulating variants,” the authors continued. “The CDC recommends a strategic approach to minimizing the impact of COVID-19 on health and society that is based on vaccination and therapy to prevent severe illness; the use of multi-component prevention measures when feasible; and a particular emphasis on protecting people at high risk of severe illness.”
However, the agency reiterated in a press release that people should isolate themselves from others if they have COVID-19, and that they “should also isolate themselves if they are sick and suspect they have COVID-19 but do not yet have test results.” Once test results come back, if they are positive, patients must adhere to full isolation recommendations; if the results are negative, patients can end their isolation.
"COVID-19 remains a constant threat to public health; however, high levels of vaccine- and infection-induced immunity and the availability of medical and non-pharmaceutical interventions have substantially reduced the risk of medically significant illness, hospitalization, and death from COVID-19," the authors wrote.
“As SARS-CoV-2 transmission continues, the current focus on reducing medically significant illness, death, and strain on the healthcare system are appropriate and achievable goals that are supported by the widespread availability of the current set of effective public health tools,” they added.
Updated recommendations for those who test positive include:
- Stay home for at least 5 days and isolate yourself from others in your household. You are likely to be most infectious during these first 5 days.
- Wear a high-quality mask when you must be around other people at home and in public.
- If, after 5 days, you have no fever for 24 hours without the use of medication and your symptoms are improving or you never had symptoms, you can end isolation after day 5.
- Regardless of when isolation ends, avoid being around people who are more likely to become seriously ill from COVID-19 until at least day 11.
- Use a high-quality mask until day 10.
- If you had a moderate illness (if you experienced shortness of breath or difficulty breathing) or a severe illness (you were hospitalized) due to COVID-19 or if you have a weakened immune system, you should self-isolate until day 10.
Daniel McQuillen, MD, president of the Infectious Diseases Society of America, applauded the revised guidelines in a statement, calling them "a positive sign that advances in vaccines and treatments have significantly reduced the risk of severe illness, hospitalization, and death."
However, "with much of the country experiencing transmission rates above 20%, we cannot let our guard down" and must continue to self-isolate and wear masks when appropriate, McQuillen added.
The CDC recommendations come just over a week after a study published in JAMA Network Open found that a substantial proportion of COVID-19 patients who continue to test positive on a rapid antigen test after 5 days may still be infectious. Of 17 patients who underwent viral culture testing on day 6, 12 still had a positive antigen test, and six of these patients had culturable virus, an indicator of infectivity, reported Lisa Cosimi, MD, of Brigham and Women's Hospital in Boston, and colleagues.
On Thursday, the FDA recommended that people using rapid antigen tests for COVID-19 get a repeat test to avoid a false negative result. “At-home COVID-19 antigen tests are less likely to detect the SARS-CoV-2 virus than molecular tests, such as polymerase chain reaction (PCR) tests,” the agency noted. “Today, the FDA is highlighting the continued need for repeat or serial testing when people get a negative result with an at-home COVID-19 antigen test, including recommending additional testing over a longer period of time.”
“Throughout the course of the COVID-19 pandemic, public health scientists have continued to learn about the SARS-CoV-2 virus and the impact of variants on diagnostic tests that detect SARS-CoV-2,” the FDA said. “Today’s recommendations are based on the latest Omicron study results of people with probable infection showing that repeat testing after a negative at-home COVID-19 antigen test result increases the likelihood of obtaining an accurate result.”