How long should you isolate or quarantine? CDC changed their recommendations but are they the safest?
It’s almost 2022 and SARS-CoV2, the virus that causes COVID-19, is still rampant around the country. With new mutations, the Omicron variant of the virus is barrelling it’s way through the population. It is infecting children and adults, the vaccinated and unvaccinated, the boosted and previously infected; basically everyone is at risk. At this time, it doesn’t seem anyone (by anyone I mean leaders and politicians) has the stomach for another lock down, so our only hope to keep schools, hospitals and the economy going, is to balance public health with a viable work force. Therefore, the Centers for Disease Control and Prevention has updated it’s guidance on isolation and quarantine.
Before going on further, it’s important to differentiate between isolation and quarantine.
- Isolation – is what you do when you are already sick with symptoms or have tested positive. This means staying home, away from others. If you can not stay in a separate room, wear a mask around the people in your home. Good ventilation with open windows or use of an air purifier also helps.
- Quarantine – is what you do when you are exposed to somebody with known COVID-19 infection. This means staying at home and monitoring yourself for symptoms. This is the incubation period of the virus.
What do the new guidelines say?
“Given what we currently know about COVID-19 and the Omicron variant, CDC is shortening the recommended time for isolation from 10 days for people with COVID-19 to 5 days, if asymptomatic, followed by 5 days of wearing a mask when around others. The change is motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after. Therefore, people who test positive should isolate for 5 days and, if asymptomatic at that time, they may leave isolation if they can continue to mask for 5 days to minimize the risk of infecting others.”
CDC
Besides shortening the isolation period, the CDC also shortened the quarantine period. The difference is that the change to isolation guidelines is for everyone regardless of vaccination status. The quarantine guidelines separate individuals based on vaccination or booster status. You can see the recommendations below.
What are the problems with these changes?
My first concern is the blanket statement to be out of isolation/quarantine without testing. PCR tests can remain positive even after someone is no longer contagious, but rapid antigen tests typically do not. While anecdotal experience does not add up to data, many people have stories of continuing to test positive on an antigen test beyond 5 days since diagnosis. Furthermore, many people have stories of testing positive or getting sick up to 14 days after exposure, which was the original quarantine recommendation. Therefore, the best way to shorten both isolation and quarantine is definitive antigen testing before re-entry, not just “if possible”. WE NEED MORE TESTS.
My second concern is the reliance on mask wearing. Not only do we know that many are opposed to wearing masks, those that do wear them don’t always wear them properly. Furthermore, not all masks are created equally. The best mask to reduce the risk of spread, or infection, is a well fitted N95 or KN95 mask. These masks block 95% of particles that would otherwise be inhaled or exhaled by the wearer. They are worn over the nose and mouth and should create a seal all the way around.
My third concern is that everyone defines asymptomatic differently. We know that with colds, for example, coughs can linger long after someone has recovered. What if you still have an occasional cough? What if your nose is still a little runny? What if you still wake up with a scratchy throat but feel better after drinking water? These may sound mild, but they may also signal continued contagiousness. Again, testing is the only way to judge when isolation/quarantine should end.
My final concern is that there are still children out there too young to be vaccinated who deserve safe schools/daycare. Parents deserve peace of mind that those helping care for and educate their children are not at risk of infecting them. The more we allow people who could still potentially be contagious around vulnerable children, the more pediatric cases we will see. There has already been an increase, including hospitalizations and children in the ICU.
So in conclusion, I think the best way to keep everyone safe without having to shut down is to get vaccinated, boosted, wear well fitted masks properly in public and test regularly. Don’t leave isolation or quarantine without testing negative, even if you don’t have symptoms.
Stay safe out there.