Here's why critics are disturbed by the CDC's new guidance on isolating after getting COVID
Photo by Mulyadi on Unsplash
man in green shirt and blue knit cap sitting on floor
Julia Conley and
Common Dreams
December 28, 2021
Workers' rights advocates accused the Centers for Disease Control and Prevention of putting business interests ahead of public health Tuesday after the agency released new guidelines for asymptomatic Americans with Covid-19, while experts expressed concern that the guidance will result in confusion and more transmission of the disease.
The CDC announced late Monday that instead of isolating at home for 10 days, people who contract the coronavirus will be advised to isolate for five days immediately after testing positive. If the person is asymptomatic after five days f, they may return to work, school, and other activities but should wear a mask everywhere, including at home if they live with others, for five more days.
People who still exhibit symptoms after five days of isolating should continue to stay home until they are asymptomatic, the CDC said.
The agency said the guidance was revised because scientists now understand people with Covid-19 to be most contagious in the two days prior to showing symptoms and for three days afterward.
CDC director Dr. Rochelle Walensky also said concerns about economic activity provoked the new guidelines, as the fast-spreading Omicron variant overwhelms airlines, hospitals, and other businesses.
Sick crew members forced the cancellation of thousands of flights on Christmas Eve and Christmas Day, and the spread of the variant is "significantly diminishing" the healthcare workforce at hospitals across the country, according to the American Public Health Association.
"We want to make sure there is a mechanism by which we can safely continue to keep society functioning while following the science," Walensky told the Associated Press.
As Common Dreams reported Sunday, the CDC's amended guidance for healthcare workers—who as of last week are advised to stay home for seven days instead of 10 if they are asymptomatic and test negative—alarmed the nation's largest nurses' union, which said the guidelines were changed in the interest of hospitals' "business operations, revenues, and profits."
The CDC's new guidelines for the larger public come after officials at Delta Air Lines and JetBlue Airways wrote to the agency asking them to consider shortening the advised isolation period for people with Covid-19.
Sara Nelson, international president of the Association of Flight Attendants, acknowledged that the CDC provided a medical explanation for the new guidance, but emphasized that "the fact that it aligns with the number of days pushed by corporate America is less than reassuring" and warned that businesses may use the guidelines to pressure employees out of isolation before they are ready to return to work.
"If any business pressures a worker to return to work before they feel better we will make clear it is an unsafe work environment, which will cause a much greater disruption than any 'staffing shortages,'" Nelson said in a statement. "We cannot allow pandemic fatigue to lead to decisions that extend the life of the pandemic or put policies on the backs of workers."
Dr. Megan Ranney, an emergency physician at Brown University, also expressed concern that the new guidelines "will too easily move to 'go back to work when you have symptoms'" and that many people who come out of isolation after just five days will not wear face masks after the isolation period.
Dr. Aaaron Glatt, a spokesperson for the Infectious Diseases Society of America, pointed out that the shortened isolation timeframe will make it more likely that people return to normal activities when they are still infectious.
"If you decrease it to five days, you're still going to have a small but significant number of people who are contagious," Glatt told the AP.
Some observers also urged the CDC to clarify the guidance, as the agency's website suggested people can come out of isolation if they are asymptomatic or if their "symptoms are resolving after five days."
While calling the new guidance "reasonable" and noting that the shorter isolation period could push people to get tested who otherwise would not have, Harvard Medical School professor Dr. Ashish Jha said the CDC should include more precautions to help prevent transmission as people come out of isolation.
Epidemiologist Dr. Michael Mina noted that he has previously recommended a shorter isolation period to the CDC, but pointed out that recommendation "was always with a negative test."
Pushing people to return to normal activities without a negative test is "reckless," Mina tweeted.
In the U.K., epidemiologist Dr. Eric Feigl-Ding pointed out, two negative tests are required before people can exit isolation.
"But somehow a five-day exit with zero negative test is okay in [the U.S.]?" he said. "American exceptionalism does not apply to a pandemic virus."
With the highly transmissible Omicron variant, Mina said, "Someone KNOWN to be positive for five days is, in my view, still one of the highest risk individuals in society for onward spread."
"We do SO much just to find people who are positive in [the] first place," he added. "When we do identify them, we should do everything possible to keep them from spreading."
Flight attendants fire back after CDC cuts quarantine time
Quintin Soloviev / Wikimedia Commons
Meaghan Ellis December 29, 2021
Flight attendants are not pleased with the Centers for Disease Control and Prevention's (CDC) decision to loosen COVID guidelines as the Omicron variant spreads rapidly across the United States, per Politico.
After the CDC announced its recommendation to cut the COVID quarantine time from 10 to 5 days, the Association of Flight Attendants-CWA International President Sara Nelson released a statement expressing airline workers' concerns. According to Nelson, the directive appears to be one that is influenced by the desires of corporate America as opposed to medical professionals.
"We said we wanted to hear from medical professionals on the best guidance for quarantine, not from corporate America advocating for a shortened period due to staffing shortages,” said Sara Nelson.
Although the CDC has insisted that there is a medical explanation behind its recommendation, Nelson notes that it actually aligns with the demands of corporations.
“The CDC gave a medical explanation about why the agency has decided to reduce the quarantine requirements from 10 to five days, but the fact that it aligns with the number of days pushed by corporate America is less than reassuring,” Nelson said.
Also speaking on behalf of flight attendants, Airlines for America President and CEO Nicholas Calio also penned a letter addressed to CDC Director Rochelle Walensky. Calio urged the CDC to make 'scientifically sound" decisions based on clear data.
“As an industry, we stand ready to partner with the CDC to make scientifically sound policy decisions and work with you to collect empirical data necessary to appropriately monitor any guideline modifications,” Airlines for America President and CEO Nicholas Calio said in the letter.
The latest changes came shortly after Delta Air Lines made the initial request for the quarantine time period to be reduced to five days. The airline also argued that the previous 10-day guidance “was developed in 2020 when the pandemic was in a different phase without effective vaccines and treatments.”
Quintin Soloviev / Wikimedia Commons
Meaghan Ellis December 29, 2021
Flight attendants are not pleased with the Centers for Disease Control and Prevention's (CDC) decision to loosen COVID guidelines as the Omicron variant spreads rapidly across the United States, per Politico.
After the CDC announced its recommendation to cut the COVID quarantine time from 10 to 5 days, the Association of Flight Attendants-CWA International President Sara Nelson released a statement expressing airline workers' concerns. According to Nelson, the directive appears to be one that is influenced by the desires of corporate America as opposed to medical professionals.
"We said we wanted to hear from medical professionals on the best guidance for quarantine, not from corporate America advocating for a shortened period due to staffing shortages,” said Sara Nelson.
Although the CDC has insisted that there is a medical explanation behind its recommendation, Nelson notes that it actually aligns with the demands of corporations.
“The CDC gave a medical explanation about why the agency has decided to reduce the quarantine requirements from 10 to five days, but the fact that it aligns with the number of days pushed by corporate America is less than reassuring,” Nelson said.
Also speaking on behalf of flight attendants, Airlines for America President and CEO Nicholas Calio also penned a letter addressed to CDC Director Rochelle Walensky. Calio urged the CDC to make 'scientifically sound" decisions based on clear data.
“As an industry, we stand ready to partner with the CDC to make scientifically sound policy decisions and work with you to collect empirical data necessary to appropriately monitor any guideline modifications,” Airlines for America President and CEO Nicholas Calio said in the letter.
The latest changes came shortly after Delta Air Lines made the initial request for the quarantine time period to be reduced to five days. The airline also argued that the previous 10-day guidance “was developed in 2020 when the pandemic was in a different phase without effective vaccines and treatments.”
CDC guidelines endorsing to end isolation 5 days after infection prompt reactions amid concerns over high transmissibility of omicron variant
Dilan Pamuk |29.12.2021
ANKARA
The US Centers for Disease Control and Prevention's (CDC) recent guidelines to cut the isolation and quarantine period in half have raised questions among experts and caused concern among the general public in the US.
As omicron, the variant notorious for its rapid contagiousness, pervades and triggers new spikes in the number of cases worldwide, the CDC guidelines have been met with strong criticism and disagreement for recommending shorter isolation and allowing it to end without the requirement of a negative PCR test.
The unexpected changes in isolation and quarantine periods, amid recent spikes in cases due to the omicron variant, raised doubts about whether the CDC was caving in to the pressures of major sectors and profit-driven laypeople affected by the pandemic's negative impact on the workforce.
Concerns have also been raised about the health care sector, as health professionals may be required to return to work before fully recovering from COVID-19, leading to the spread of the virus and, as a result, a reduction in the number of health care workers available in hospitals.
Meanwhile, experts point out that there is not enough research involving the omicron form to back up CDC2's decision.
The CDC reduced the recommended COVID-19 isolation period from 10 days to five days on Monday, followed by another five days of wearing a mask around others for asymptomatic patients.
If the patient is asymptomatic, they may be released from isolation on the condition that they wear a mask around others for another five days to minimize the risk of infecting others, according to the CDC.
The CDC attributed the change in guidelines to the fact that the virus is transmitted in the early stages of the illness, usually within the first two days of infection.
The center also altered its quarantine recommendations for people who have been exposed to the coronavirus, depending on whether or not they have been vaccinated.
People who have not been vaccinated or have not had their last mRNA dose in more than six months should undergo a five-day quarantine followed by strict mask wear for another five days.
If a five-day quarantine is not feasible, the CDC recommends wearing a well-fitting mask at all times while around others for 10 days after exposure.
Individuals who have had their booster shot do not need to be quarantined after being exposed, but they should wear a mask for 10 days afterwards, it added.
CDC draws criticism for shorter COVID quarantine, isolation as omicron bears down
Data backs shorter periods, but experts say testing is key.
BETH MOLE - 12/28/2021
Enlarge / Travelers wait in line to check-in at LaGuardia Airport in New York, on December 24, 2021. -On Christmas Eve, airlines, struggling with the Omicron variant of Covid-19, have canceled over 2,000 flights globally, 454 of which are domestic, into or out of the US.
As the ultratransmissible omicron coronavirus variant bears down on the US, the Centers for Disease Control and Prevention on Monday made a controversial decision to ease COVID-19 isolation and quarantine rules.
The country's omicron surge has sent graphs of case counts vertical, and is already causing severe strain on health systems, shuttering businesses, and wreaking havoc on holiday travel and festivities. The US is currently averaging over 243,000 new COVID-19 cases per day, near the country's all-time high of an average just over 250,000 per day set in early January 2021. Still, federal officials and public health experts say this is only the beginning of omicron's towering wave, which may not peak until next month.
The CDC's decision Monday is intended to ease the economic burden of the skyrocketing cases and follows an accumulation of data suggesting that infectiousness tends to wane two to three days after the onset of symptoms. However, some public health experts called the new rules "reckless" for not incorporating testing requirements.
As of Monday, the CDC says that people who test positive for COVID-19 but do not develop symptoms can cut their isolation period down from 10 days to only five—though they must wear a mask for an additional five days when around others. The new guidance does not stipulate that people should test negative prior to ending isolation at the earlier time period.
"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," the CDC said in its announcement.Advertisement
Similarly, the CDC slashed quarantine periods for people who are unvaccinated or are vaccinated but past due for a booster dose. If someone in one of these two groups is exposed to someone with COVID-19—that is, they were within six feet of an infected person for a cumulative 15 or more minutes over a 24-hour period—they can quarantine for only five days, rather than the previous recommendation of 14 days. The exposed person must still mask for an additional five days after the quarantine period. Again, the new rule does not stipulate that an exposed person receive a negative test result to end quarantine.
A balance
The CDC did not change its guidance for people who are vaccinated and boosted or vaccinated and not yet eligible for a booster. For these groups, people do not need to quarantine after an exposure unless they develop symptoms. However, the CDC still recommends that they get tested and mask indoors.
In a statement Monday, CDC Director Dr. Rochelle Walensky called the new recommendations a "balance" between the fighting the formidable variant and keeping the country functioning. “The omicron variant is spreading quickly and has the potential to impact all facets of our society," Walensky said. "CDC’s updated recommendations for isolation and quarantine balance what we know about the spread of the virus and the protection provided by vaccination and booster doses. These updates ensure people can safely continue their daily lives. Prevention is our best option: get vaccinated, get boosted, wear a mask in public indoor settings in areas of substantial and high community transmission, and take a test before you gather.”
The decision drew praise from businesses and industry leaders, particularly those in charge of airlines. There have been thousands of flights cancelled over the holidays due, in part, to staff shortages. Just last week, the airline trade group, Airlines for America lobbied the CDC to cut recommended isolation periods.
In a statement late Monday, Delta Air Lines welcomed the CDC's updated guidance, saying it "allows more flexibility for Delta to schedule crews and employees to support a busy holiday travel season and a sustained return to travel by customers."
Delta's Chief Health Officer Dr. Henry Ting added that it "is a safe, science-based and more practical approach based on what we now know about the omicron variant."
"Reckless"
But, while other public health experts generally agreed with Ting's point, they were frustrated that the CDC's new guidance did not also require negative test results. Dr. Michael Mina, a Harvard epidemiologist and long-time advocate of rapid testing, called the new guidance "reckless."
He noted that while some people may be infectious for only three days, some may be infectious for longer periods, even up to 12 days. "I absolutely don’t want to sit next to someone who turned [positive] five days ago and hasn't tested [negative]," Mina wrote on Twitter. Requiring a negative test result to leave isolation early is "just smart," he concluded.
Similarly, Dr. Céline Gounder, an infectious disease expert at New York University, said on Twitter that the shortened isolation and quarantine periods are only reasonable if they're paired with rapid testing. "People are infectious for a wide range of time. Some for a couple days. Others, for over a week," she wrote.
Gounder and others pointed out that the CDC may not have included testing requirements in their update because the country is currently seeing shortages of rapid tests and long lines at testing centers. "CDC's isolation policy is being driven by a scarcity of rapid antigen tests," she concluded. But, Mina pushed back on this excuse, calling it an "artificial" problem stemming from a failure to fortify testing capacity earlier in the pandemic.
BETH MOLEBeth is Ars Technica’s health reporter. She’s interested in biomedical research, infectious disease, health policy and law, and has a Ph.D. in microbiology.
Data backs shorter periods, but experts say testing is key.
BETH MOLE - 12/28/2021
Enlarge / Travelers wait in line to check-in at LaGuardia Airport in New York, on December 24, 2021. -On Christmas Eve, airlines, struggling with the Omicron variant of Covid-19, have canceled over 2,000 flights globally, 454 of which are domestic, into or out of the US.
As the ultratransmissible omicron coronavirus variant bears down on the US, the Centers for Disease Control and Prevention on Monday made a controversial decision to ease COVID-19 isolation and quarantine rules.
The country's omicron surge has sent graphs of case counts vertical, and is already causing severe strain on health systems, shuttering businesses, and wreaking havoc on holiday travel and festivities. The US is currently averaging over 243,000 new COVID-19 cases per day, near the country's all-time high of an average just over 250,000 per day set in early January 2021. Still, federal officials and public health experts say this is only the beginning of omicron's towering wave, which may not peak until next month.
The CDC's decision Monday is intended to ease the economic burden of the skyrocketing cases and follows an accumulation of data suggesting that infectiousness tends to wane two to three days after the onset of symptoms. However, some public health experts called the new rules "reckless" for not incorporating testing requirements.
As of Monday, the CDC says that people who test positive for COVID-19 but do not develop symptoms can cut their isolation period down from 10 days to only five—though they must wear a mask for an additional five days when around others. The new guidance does not stipulate that people should test negative prior to ending isolation at the earlier time period.
"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," the CDC said in its announcement.Advertisement
Similarly, the CDC slashed quarantine periods for people who are unvaccinated or are vaccinated but past due for a booster dose. If someone in one of these two groups is exposed to someone with COVID-19—that is, they were within six feet of an infected person for a cumulative 15 or more minutes over a 24-hour period—they can quarantine for only five days, rather than the previous recommendation of 14 days. The exposed person must still mask for an additional five days after the quarantine period. Again, the new rule does not stipulate that an exposed person receive a negative test result to end quarantine.
A balance
The CDC did not change its guidance for people who are vaccinated and boosted or vaccinated and not yet eligible for a booster. For these groups, people do not need to quarantine after an exposure unless they develop symptoms. However, the CDC still recommends that they get tested and mask indoors.
In a statement Monday, CDC Director Dr. Rochelle Walensky called the new recommendations a "balance" between the fighting the formidable variant and keeping the country functioning. “The omicron variant is spreading quickly and has the potential to impact all facets of our society," Walensky said. "CDC’s updated recommendations for isolation and quarantine balance what we know about the spread of the virus and the protection provided by vaccination and booster doses. These updates ensure people can safely continue their daily lives. Prevention is our best option: get vaccinated, get boosted, wear a mask in public indoor settings in areas of substantial and high community transmission, and take a test before you gather.”
The decision drew praise from businesses and industry leaders, particularly those in charge of airlines. There have been thousands of flights cancelled over the holidays due, in part, to staff shortages. Just last week, the airline trade group, Airlines for America lobbied the CDC to cut recommended isolation periods.
In a statement late Monday, Delta Air Lines welcomed the CDC's updated guidance, saying it "allows more flexibility for Delta to schedule crews and employees to support a busy holiday travel season and a sustained return to travel by customers."
Delta's Chief Health Officer Dr. Henry Ting added that it "is a safe, science-based and more practical approach based on what we now know about the omicron variant."
"Reckless"
But, while other public health experts generally agreed with Ting's point, they were frustrated that the CDC's new guidance did not also require negative test results. Dr. Michael Mina, a Harvard epidemiologist and long-time advocate of rapid testing, called the new guidance "reckless."
He noted that while some people may be infectious for only three days, some may be infectious for longer periods, even up to 12 days. "I absolutely don’t want to sit next to someone who turned [positive] five days ago and hasn't tested [negative]," Mina wrote on Twitter. Requiring a negative test result to leave isolation early is "just smart," he concluded.
Similarly, Dr. Céline Gounder, an infectious disease expert at New York University, said on Twitter that the shortened isolation and quarantine periods are only reasonable if they're paired with rapid testing. "People are infectious for a wide range of time. Some for a couple days. Others, for over a week," she wrote.
Gounder and others pointed out that the CDC may not have included testing requirements in their update because the country is currently seeing shortages of rapid tests and long lines at testing centers. "CDC's isolation policy is being driven by a scarcity of rapid antigen tests," she concluded. But, Mina pushed back on this excuse, calling it an "artificial" problem stemming from a failure to fortify testing capacity earlier in the pandemic.
BETH MOLEBeth is Ars Technica’s health reporter. She’s interested in biomedical research, infectious disease, health policy and law, and has a Ph.D. in microbiology.
COVID-19: Government under pressure to further reduce self-isolation period for positive cases
Despite Omicron being less severe in terms of its symptoms, it is more transmissible, meaning that some industries are struggling to cope due to the quarantine requirements - particularly the NHS.
Wednesday 29 December 2021 UK
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Professor Alison Leary has told Sky News health and social care workers 'are absolutely exhausted' by the pandemic.
In England, those who have tested positive for COVID are able to leave self-isolation after seven days, as long they can produce two negative tests.
Despite Omicron being less severe in terms of its symptoms, it is more transmissible, meaning that some industries are struggling to cope due to the quarantine requirements - particularly the NHS, which at one point last week reported a 50% rise in staff absences.
A record number of people tested positive in the latest reporting period, with 117,093 new infections in England alone, as the new variant sweeps through communities, with up to 800,000 thought to be in isolation.
It's led to calls for the isolation period to be further reduced, to get the economy moving again.
Professor Tim Spector from Kings College London, who runs a nationwide COVID symptoms study, tweeted on Tuesday in favour of the recommendation, saying it would "protect the economy".
That was echoed by Paul Hunter, professor of medicine at the University of East Anglia, who told the BBC that he believes Omicron has become "effectively just another cause of the common cold".
"We're going to have to let people who are positive go about their normal lives as they would do with any other cold.
"I think the whole issue of how long are we going to be able to allow people to self-isolate if they're positive is going to have to be discussed fairly soon, because I think this is a disease that's not going away."
He did caveat his thoughts though, adding: "Maybe not quite just yet".
Sir John Bell, regius professor of medicine at Oxford University, also piled on the pressure, telling the BBC's Today programme that a negative test is a "better way to measure if we're allowing people to go back into community" instead of isolation periods.
The president of the Confederation of British Industry (CBI), Lord Bilimoria, went further, pointing out to the Today programme that South Africa, which discovered Omicron through genetic sequencing, dropped the requirement to isolate altogether for those who are asymptomatic.
He added: "We have got to do everything we can to stop the disruption to our lives and to our livelihoods and to the economy in as safe a way as possible.
"We need people to isolate for as little time as possible."
The Department of Health said: "Anyone who takes a negative lateral flow test on days six and seven of their self-isolation period can end their isolation early, following analysis by the UK Health Security Agency that this has a similar protective effect to a ten-day isolation without lateral flow testing."
Despite Omicron being less severe in terms of its symptoms, it is more transmissible, meaning that some industries are struggling to cope due to the quarantine requirements - particularly the NHS.
Wednesday 29 December 2021 UK
There are calls to reduce the self-isolation period to help stimulate the economy
A number of scientists have said that the UK should follow in the footsteps of the US and reduce the COVID self-isolation period to five days, in an effort to protect the NHS.
The US Centers for Disease Control and Prevention said on Monday that Americans who catch COVID and don't have any symptoms only need to self-isolate for five days, so long as masks are worn for another five.
It has prompted similar calls in the England, despite the rules being relaxed slightly ahead of Christmas.
A number of scientists have said that the UK should follow in the footsteps of the US and reduce the COVID self-isolation period to five days, in an effort to protect the NHS.
The US Centers for Disease Control and Prevention said on Monday that Americans who catch COVID and don't have any symptoms only need to self-isolate for five days, so long as masks are worn for another five.
It has prompted similar calls in the England, despite the rules being relaxed slightly ahead of Christmas.
This is a modal window. This modal can be closed by pressing the Escape key or activating the close button.
Professor Alison Leary has told Sky News health and social care workers 'are absolutely exhausted' by the pandemic.
In England, those who have tested positive for COVID are able to leave self-isolation after seven days, as long they can produce two negative tests.
Despite Omicron being less severe in terms of its symptoms, it is more transmissible, meaning that some industries are struggling to cope due to the quarantine requirements - particularly the NHS, which at one point last week reported a 50% rise in staff absences.
A record number of people tested positive in the latest reporting period, with 117,093 new infections in England alone, as the new variant sweeps through communities, with up to 800,000 thought to be in isolation.
It's led to calls for the isolation period to be further reduced, to get the economy moving again.
Professor Tim Spector from Kings College London, who runs a nationwide COVID symptoms study, tweeted on Tuesday in favour of the recommendation, saying it would "protect the economy".
That was echoed by Paul Hunter, professor of medicine at the University of East Anglia, who told the BBC that he believes Omicron has become "effectively just another cause of the common cold".
"We're going to have to let people who are positive go about their normal lives as they would do with any other cold.
"I think the whole issue of how long are we going to be able to allow people to self-isolate if they're positive is going to have to be discussed fairly soon, because I think this is a disease that's not going away."
He did caveat his thoughts though, adding: "Maybe not quite just yet".
Sir John Bell, regius professor of medicine at Oxford University, also piled on the pressure, telling the BBC's Today programme that a negative test is a "better way to measure if we're allowing people to go back into community" instead of isolation periods.
The president of the Confederation of British Industry (CBI), Lord Bilimoria, went further, pointing out to the Today programme that South Africa, which discovered Omicron through genetic sequencing, dropped the requirement to isolate altogether for those who are asymptomatic.
He added: "We have got to do everything we can to stop the disruption to our lives and to our livelihoods and to the economy in as safe a way as possible.
"We need people to isolate for as little time as possible."
The Department of Health said: "Anyone who takes a negative lateral flow test on days six and seven of their self-isolation period can end their isolation early, following analysis by the UK Health Security Agency that this has a similar protective effect to a ten-day isolation without lateral flow testing."
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