Regardless of how done you are with COVID, COVID isn’t necessarily done with you.
However, you wouldn’t know that from the new CDC guidelines, which have triggered a social media outcry among doctors and other public health experts who say that the changes could lead to even more infections and cases of potentially disabling long COVID.
On Wednesday, the CDC announced a major overhaul of the agency after an in-depth analysis showed the COVID response was “confusing and overwhelming,” according to the New York Times.
An external review suggested that the CDC’s COVID efforts were being hampered by its focus on publishing scientific studies instead of urgent action and will be reorganized to give promotions based on public health efforts, not study publications. Officials will also remain in key positions for at least six months to reduce confusion and delays, rather than rotate out after a few months.
“For 75 years, CDC and public health have been preparing for COVID-19, and in our big moment, our performance did not reliably meet expectations,” CDC Director Rochelle Walensky said in a statement.
Some of the major guidance updates released last week include:
- People who have been exposed to COVID, regardless of vaccination status, no longer have to quarantine if they aren’t showing symptoms, including in schools.
- Infected people who choose to use rapid tests can end their isolation after day five, even if they still test positive, if symptoms are improving.
- COVID screening tests used to catch asymptomatic infections are no longer recommended “in most community settings.”
- People are no longer recommended to stay 6 feet away from others to avoid infection.
The changes to the CDC’s recommendations, which were released on Aug. 11, come at a time when more than 400 people continue to die from the disease every day. (A polite reminder that we are simultaneously battling a monkeypox outbreak and serious polio threat, in addition to the COVID pandemic.)
The CDC says it's OK to relax COVID-prevention measures given that there are vaccines, boosters, and treatments that reduce the likelihood that people will develop severe disease and die compared to earlier in the pandemic. “This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives,” the agency said in a news release last week.
Experts beg to differ. Some say the CDC’s move reflects what Americans want and are already doing, but that the virus couldn’t care less about what we prefer.
Although these are just recommendations, businesses and schools use the CDC’s guidance to determine how they’ll navigate the ongoing pandemic.
“The CDC’s new guideline looks like a gamble to me. Note that I used the term gamble, as opposed to ‘calculated risk.’ To make a calculated risk, one must do calculations,” Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital and an instructor at Harvard Medical School, wrote in an Aug. 11 blog post for Inside Medicine. “If that work has been done, nobody has shown their work, as far as I can determine. So, [the] guidelines leave me puzzled, curious, and uneasy, rather than impressed.”
Experts are also frustrated that the CDC continues to consider people “fully vaccinated” after receiving two doses of either the Pfizer or Moderna vaccines, or one dose of the Johnson & Johnson shot. Studies show at least three doses are really needed to offer adequate protection against Omicron and other variants that can dodge defenses built up from previous infections and vaccinations that better protect against the Delta variant.
Instead, the CDC says you are “up to date with your COVID vaccines” once you have received all doses in the primary series and all recommended boosters for your age group. (People 5 and older should get one booster after their primary vaccinations and people 50 and older, and those who are 12 and older who are immunocompromised, should get two boosters, according to the CDC.)
Here are some more details, as well as expert commentary, on the updated CDC guidelines.
Quarantine
If you know you’ve been exposed to COVID, you no longer have to quarantine, aka stay away from others. Instead, the CDC suggests you wear a high-quality mask like an N95 for 10 days around other people when indoors and then get tested on day five. (Day one is the first full day after your last exposure.)
You should get tested before day five if you have symptoms, the agency says.
People should also isolate themselves if they suspect they are sick but are waiting for their COVID test results.
Here’s the controversial part. The CDC says infected people who “choose to use testing to determine when to discontinue masking” can leave isolation after day five even if they still test positive on a rapid test.
Experts say this is horrible advice because evidence shows many people are still positive on rapid tests after day five, and that this means they are still contagious, even if they don’t have symptoms. (If you are positive on a rapid test, then you are contagious. If you keep testing positive on a PCR test for weeks, however, you aren't necessarily contagious because those tests are way more sensitive.)
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