The US Centers for Disease Control and Prevention (CDC) is considering relaxing its recommendations on how long people should isolate themselves after being diagnosed positive for the coronavirus, another reflection of changing attitudes and norms as the pandemic wanes. .
Under the proposed guidelines, Americans would no longer be advised to self-isolate for five days before returning to work or school. Instead, they could resume their routines if they were fever-free for at least 24 hours, without the use of medication — the same pattern applied to influenza and respiratory syncytial viruses.
The proposal would align CDC advice with revised isolation recommendations in Oregon and California. The move was previously reported by The Washington Post but is still under consideration, according to two people with knowledge of the discussions.
The CDC last changed its isolation policy in late 2021, when it shortened the recommended period to five days instead of 10. If adopted, the new approach would signal that Covid has taken its place alongside other routine respiratory infections.
But by focusing on Covid isolation policy, for example, the agency is wasting an opportunity to promote better public health policies, several experts said.
“From a long-term public health perspective, I think this sets a very unfortunate precedent,” says Syra Madad, senior director of the special pathogens program at NYC Health + Hospitals.
She urged the CDC to “seize this opportunity to truly change how we respond to deadly epidemics and pandemics and advocate for guaranteed national paid family and medical leave rather than giving in to the easier option of eliminating the isolation period.”
Some researchers are concerned that Americans will interpret the possible new guidance as indicating that Covid is no longer a threat. During the American winter, the disease caused around 1,500 deaths per day. In adults over 65, deaths were two to four times more common than those caused by the flu.
“There are still too many people catching Covid and dying from Covid in the US,” says Boghuma Titanji, an infectious disease doctor at Emory University in Atlanta.
“When you make a public health recommendation, it shouldn’t be based on what people are already doing,” she says. Instead, she adds, advice should be grounded in evidence.
Even people who only have a mild illness can develop long Covid, for which there is still no treatment, Titanji adds.
The proposed recommendations also appear not to take into account older people, those who are immunocompromised or at risk for serious complications, says Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health.
At a minimum, the CDC should advise that people who end isolation after a fever-free day also wear N95 or equivalent masks when leaving home, Nuzzo adds.
“Let’s not pretend you’re suddenly not contagious” after a day, she says. “We have to be very clear and transparent about this – saying we still think there is a risk.”
Wearing masks is still a deeply controversial issue in the United States. But many people avoid masks simply because they fear attracting attention or criticism, says Jay Varma, chief medical officer at Siga Technologies and former deputy health commissioner for New York City.
Over time, sick people wearing masks could become the norm, just like using condoms to prevent HIV infections or helmets to prevent head injuries, he says.
“A strong group of people oppose the use of masks now, but this is not fixed in time,” he adds. “People change. People die. Children become adults.”
CDC officials declined to discuss the proposed changes.
“We will continue to make decisions based on the best evidence and science to keep communities healthy and safe,” says the agency, in a statement.