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.
1/ The issue isn’t whether CDC is changing their guidance to what the average person might already be doing. The issue is there are still thousands of deaths, thousands infected/out of work; we aren’t any better at slowing transmission; & burden is on those who stand most to lose
The @CDCgov has normalize the uncontrolled spread of #covid19. More people will develop Long Covid and end up with chronic diseases. That is the opposite of normal. #UrgencyofIllness
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.”
If the @CDCgov was going to do one positive change in their guidance to help better protect people by messaging alone, then they should have changed what it means to be "up to date" or "fully vaccinated." Everyone 5 years and older needs three doses. #covid19 #covidvaccine
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.
#CDC is the worlds headquarters for controlling & preventing disease. What is it controlling ? And what is it preventing? Anyone seen their latest guidelines on “#schools & #COVID”? So if we aren’t dying from COVID, it’s ok to get COVID over & over again!
The previous guidance said only unvaccinated people had to quarantine after exposure, but the CDC has now leveled the playing field.
Many experts actually agree this change is warranted. Faust wrote that “exposures are too frequent for routine quarantine to be workable” and that the update “acknowledges where the science is and what the public can be reasonably asked to do.”
Applying the CDC's COVID logic elsewhere: colleges should stop giving away condoms because 1) many students prefer to have unprotected sex, and 2) a small but vocal minority say they will continue to have unprotected sex regardless of whether free condoms are available or not
Isolation
If you have COVID, you still need to isolate yourself from other people for at least five days and wear a “well-fitting” or high-quality mask or respirator if around others (like an N95 mask).
Infected people, regardless of vaccination status, can leave isolation after five days (when you’re likely to be most contagious) only if they haven’t had a fever for over a day without the use of medications and other symptoms have improved. The same guidance applies even if someone never experienced symptoms.
A mask should be worn around others at home and in public until day 10.
I still can't get over the fact that instead of recommending mask requirements when COVID spread is high, the CDC has backslid so much they are recommending that schools should *consider not punishing people* who wear masks to protect their communities. https://t.co/zDI7QxXJ67
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.)
Dear @CDCgov Wondering if ppl still INFECTIOUS at day 5 from Symptom start? Just look to @NIH & @US_FDA Their study shows @ Day 5 since Symptom (maps to ~4 since PCR Positive) ~94% of ppl Rapid Ag test Positive!! Likely at PEAK Virus load & exiting iso per your guidance
The CDC suggests these people continue to wear a well-fitting or high-quality mask at home and in public until they receive two consecutive negative rapid tests taken two or more days apart. This means some people should keep wearing a mask for more than 10 days after their symptoms start.
New CDC guidance effectively ends test to exit. Now: testing to remove mask. Asymptomatic people can now go back to public, even if + on rapid test ≥day 6. This goes against science. Asymptomatic people CAN spread virus. Masking is imperfect (esp. if not N95).
The agency also emphasizes that infected people should avoid individuals at high risk of severe disease until at least day 11, which some experts argue is impossible to do successfully because there’s no way to tell if someone around you is immunocompromised.
People with weakened immune systems should isolate for the full 10 days, the CDC says, and consult with their doctor before going out in public again.
I dunno man as someone with a heart condition the CDC’s new covid guidelines really make it feel like they looked me dead in the eye and said “good luck, sucker”
Revised CDC guidance on COVID does not make sense. We are still losing 500 people a day to COVID. It’s a big risk. It’s like we are giving up. As a cancer doctor I am also worried for my vulnerable patients. #CovidIsNotOver
Social distancing
The CDC now says “it may not be practical” to stay away from someone who has COVID, so it may make more sense to practice other preventive measures such as washing your hands, wearing a mask, improving ventilation, and “keeping your distance when possible.”
To be perfectly honest, I can't recall the last time I even knew with certainty what the CDC guidelines for Covid were anymore. They stopped being of much clinical use at least a revision or two ago. https://t.co/qrrmo2iRYF
The closer you are to a large number of people, the higher your chances of becoming exposed to COVID, the agency says, so “you may want to avoid crowded areas,” too.
The new CDC guidelines are to get covid and give it to other people, essentially.
at this point, I'm just waiting for the cdc to update guidelines to: everyone who tests positive for covid should mouth kiss everyone they know ASAP.
CDC relaxed covid guidelines but covid ain’t relaxing.