States Ease Covid Isolation Rules, Diverging from CDC Advice
In California and Oregon, if you get a positive Covid-19 test, things have changed. You don't have to isolate for a specific time anymore. And if you don't have symptoms, you don't have to isolate at all, according to the rules of these states. If you do have symptoms, you can go back to school or work once you feel better and haven't had a fever for at least 24 hours.
These two states, known for being careful with pandemic rules, are going against the advice from the US Centers for Disease Control and Prevention (CDC). The CDC suggests at least five days of isolation for anyone with Covid-19. Oregon made this change in May when the public health emergency for Covid-19 lifted, and California followed suit recently.
Officials in these states say the changes match the evolving situation with the pandemic. Dr. Tomás Aragón, who heads the California Department of Public Health, explained the shift, saying, "Now, things are different because of vaccines and natural infections giving broad immunity. We also have treatments for infected people. Our focus is on protecting those most at risk and reducing disruptions compared to rules for preventing other common respiratory infections."
The CDC recommends the five-day isolation because that's when people are likely most infectious, and this science hasn't changed. The California health department's recent order notes that the infectious period can last from two days before through 10 days after symptoms or a positive test.
Experts generally agree that extending isolation periods may not significantly increase the spread of the virus or the severity of its effects. This is partly due to the fact that the virus has been circulating at high levels, even with stricter guidelines in place.
Jennifer Nuzzo, an epidemiology professor and director of the Pandemic Center at Brown University School of Public Health, expresses her view, stating, "I don’t think this is reflecting updated science, but this is reflecting changing social norms and increasing workplace crunches."
Recent data from Oregon indicates that changing isolation policies have had minimal impact on virus trends. Despite a winter surge, the state's Covid-19 hospitalization rates and emergency department visits have remained below the national average, according to CDC data.
Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, emphasizes the inevitability of transmission and the virus's presence in the human population. He states, "We are not going to be able to completely stop transmission, and we’re not going to be able to get rid of this virus in the human population. The decision of how to bring something into policy is really a summation of the medical risks as well as the risks to society as a whole."
As the severity of the disease has lessened, some experts argue that stricter isolation policies could have unintended negative consequences on public health. Dr. Sarita Shah, a clinical care provider and infectious disease epidemiologist at Emory University, notes, "When we’re sick, we typically want to know what we have so that we can get treatment and possibly feel better. The ironic thing is, what I think has happened with Covid because of the isolation policies is that people kind of don’t want to find out because it leads to negative things."
People who have mild symptoms might skip getting tested because they can't afford to miss work for a week. They might also avoid wearing a mask to avoid questions, according to a statement. Making isolation policies less strict could make people more willing to get tested, leading to treatment or taking other protective measures.
Dr. Dean Sidelinger, Oregon's state health officer, highlighted the importance of fairness in changing the state's isolation policy. He explained that the decision aimed at avoiding unnecessary burdens on families, keeping kids out of school, and preventing limited sick leave from affecting people's work.
Experts emphasize that public health decisions are not always straightforward; they involve weighing tradeoffs and can be more art than perfect science. Even with everyone looking at the same data and good intentions, different perspectives can lead to different conclusions.
Barouch, a commentator, pointed out that well-meaning people may reach varying conclusions about the best way forward. It's a reminder that public health policies are complex and require careful consideration.
The CDC, in line with this complexity, states that it will keep evaluating the latest data. The decline in hospitalizations and COVID-related deaths, likely due to widespread vaccination and prior infection, is considered. The CDC aims to provide recommendations on how people can best protect themselves and their loved ones from the virus.
Local jurisdictions have been adapting health guidelines to handle the evolving situations during the pandemic, according to the agency. California and Oregon have recently adjusted their Covid-19 isolation policies, aligning them more closely with the approach taken for other respiratory viruses, experts reveal. For instance, decisions on whether a child with a mild sore throat or fever should attend school are not solely based on Covid-19 test results.
Navigating through a respiratory season without widespread testing makes it challenging to formulate disease-specific policies, explains Nuzzo. She emphasizes that individuals who are unwell should take necessary precautions, and testing should serve as a tool rather than a punitive measure.
Although the severity of Covid-19 outcomes has decreased over time, it remains distinct from a common cold or the flu. Recent CDC data indicates that hospitalization rates for Covid-19 have consistently been at least twice as high as those for the flu this respiratory virus season. Disturbingly, thousands of people have succumbed to Covid-19 in the initial weeks of this year.
This persistent disease burden is fueling intense debates about policy changes, notes Shah. The ongoing impact of Covid-19 prompts careful consideration and discussions surrounding the best course of action.
The way we deal with Covid-19 has changed a lot, and experts say we've got better tools now. It's not just about isolation; there are more options. In places like Oregon and California, if you test positive, they suggest wearing a mask for 10 days.
California and Oregon made big changes in how they handle Covid-19, thinking about the whole population. But individual places, like hospitals, might do things differently based on how much risk they can handle.
Deciding what's right for your health is usually something personal. Your doctor helps you figure out what's best for you. This has been true for years, and it's the same with Covid-19. The balance between the risks and benefits might be different now, and it's a good time to talk about it and have a debate.