CDC Updates COVID Guidelines to 'Streamline' Quarantine and Testing Recommendations

The new guidance places an emphasis on personal responsibility and protection, in an effort to begin learning to live with the virus.

SAN DIEGO, CALIFORNIA - MARCH 29: A fan is swabbed at the COVID-19 testing site prior to opening night of the Tomlin UNITED Tour on March 29, 2022 in San Diego, California. (Photo by Daniel Knighton/Getty Images)
Photo: Daniel Knighton/Getty Images

Unvaccinated people no longer have to quarantine at home after being exposed to someone with COVID-19, the Centers for Disease Control and Prevention (CDC) said in a press release posted on Thursday.

The CDC updated its COVID recommendations, hoping to "streamline" guidance and make it more reflective of the current state of the pandemic, in which there are plenty of treatment and prevention options available, and a variant is circulating that typically does not cause as severe of illness.

In addition to the more relaxed guidance for quarantining after a COVID exposure, the CDC also said that asymptomatic surveillance testing would no longer be recommended in most community settings.

"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," said CDC epidemiologist Greta Massetti, PhD, MPH, in the press release.

According to Keri Althoff, PhD, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, it seems as though the CDC is attempting to "meet people where they are."

"They are more accurately kind of reflecting what people are doing," Althoff told Health.

Here's what you need to know about the new COVID guidelines, why the CDC has made this change, and what it means for the future of the COVID pandemic in the U.S.

Quarantine and Testing Changes

In December 2021, the CDC updated its guidelines and recommended that vaccinated or recently infected people exposed to COVID would not have to quarantine. Unvaccinated people, however, were asked to quarantine for five full days followed by five days of mask-wearing if they came into contact with the virus.

The new recommendations get rid of that distinction between unvaccinated and vaccinated people—now, it's no longer recommended that anyone quarantine after a COVID exposure, though people are still encouraged to mask for 10 days and test at day five.

Consolidating guidelines for the vaccinated and unvaccinated is likely partially due to the high levels of immunity that currently exist in the U.S., according to Rebecca Wurtz, MD, MPH, an associate professor at the University of Minnesota School of Public Health.

"The vast majority of people have some level of immunity, whether it's through vaccination or infection, or both," Dr. Wurtz told Health. "And so even when one is exposed, the risk of getting sick from it, getting sick and passing it on to someone else is substantially lower than it was a year and a half ago."

Making things simpler, regardless of a person's vaccination status, is also another factor.

At this point in the pandemic, people can be vaccinated, recently infected, unvaccinated, or undervaccinated—meaning they're not up to date on recommended vaccines or boosters. And having all of these categories with different quarantining recommendations is a bit confusing.

"By removing that qualification, it really does streamline things," Althoff said. "And you want guidance that can be easily followed—the more complex the guidance, the harder it is going to be for people to really follow. It's really that simple."

As for the CDC's advisory that surveillance testing is no longer necessary in most situations, Dr. Wurtz explained it's another consequence of high levels of immunity in the general population.

"If we put the whole thing in the community context, we should all be well protected against serious COVID if we're vaccinated or we're immune through exposure," she said.

This likely has the biggest impact on families whose children are in school, Althoff added.

"We want to try and keep as many kids in school as safely as we can," she said. "Of course, we would want to try and identify as many cases as early as possible, but given the current status of the pandemic and what we know about the level of severity in different populations in terms of illness, they've really relaxed this guideline about asymptomatic surveillance."

The caveat of most community settings is an important one too. In specific situations where there might be a higher risk of infection—like when kids come back to school from holiday breaks, or in healthcare or residential centers—asymptomatic testing may still be needed to stop outbreaks, added Althoff.

These new exposure and screening testing guidelines, in effect, will put the burden of COVID safety more on the individual, rather than the community.

"The main concern," Dr. Wurtz said, "to someone who's not been vaccinated, is their own level of risk, their own level of getting sick from it."

Other Guidelines Remaining in Place For Now

In addition to the loosening of some guidelines, the CDC reinforced and clarified a number of other recommendations that we've been living with for some time.

In accordance with their 2021 guidance, the CDC still recommends that anyone who tests positive for COVID isolate for five days, and then, if they are fever free for 24 hours, end their isolation and wear a mask for another five days. They also recommend that you avoid anyone who may become seriously ill with COVID in the 11 days after you first test positive.

The CDC also clarified that, for anyone who experiences a rebound in COVID symptoms after their isolation period ends, they should isolate for another five days.

These isolation and masking guidelines are unlikely to change anytime soon.

"Even if it's not COVID, if it's a cold or it's the flu, and we feel crummy we should plan to stay home, should plan to back off from social activities, and if we have to go out, be thoughtful about wearing a mask in the future," Dr. Wurtz said. "Whether it's COVID, or the flu or what else, that's sort of the arc in which our immune systems respond to a respiratory virus like this."

Even still, it's important to remember that these guidelines are responding to the pandemic in this particular moment, Althoff said. If the pandemic were to worsen it's possible that stricter isolation protocols would be recommended. Or, she added, at a later date we may end up in a place where there are no guidelines at all for what to do when you get sick with COVID.

A Focus on Personal Responsibility Going Forward

Though the news of less strict exposure and testing guidelines is probably welcome for most, the CDC's update comes at a time when daily COVID cases have been topping 100,000 for months. And, still only 48% of eligible Americans have received their first booster shot.

"400 people a day die from COVID. Now if we put that in context, in the average year about 100 people die every day on average from influenza," Dr. Wurtz said. "It's important to remain thoughtful and vigilant if you're at a higher risk for serious infection or for death from [COVID]. So again, it kind of shifts the responsibility for being careful to the individual, for better and for worse."

Still, Althoff and Dr. Wurtz say the move by the CDC to loosen these restrictions isn't coming prematurely. The availability of prevention strategies, such as vaccines, masks, and tests, as well as treatments like the antiviral drug Paxlovid mean that, in general, the U.S. has what it needs to prevent serious illness.

"[The guidelines are] starting to really focus on our highest risk populations," Althoff said. "We're not saying that we're all just going to be over COVID here, because we know that there are people who are at greater risk for severe illness and death. But it's refocusing on those populations to ensure protection for them."

Ultimately, Althoff and Dr. Wurtz agree that these new guidelines likely align more closely with how the average American is approaching the pandemic right now.

"COVID is here to stay. We have to learn how to live with it and be thoughtful on a daily and individual basis about how we protect ourselves and then how we protect our community," Dr. Wurtz said. "It's just part of behavior that we have to incorporate and use routinely."

With these new guidelines, is it more important than ever to pay attention to your own local community risk and determine what might be the best strategies available for you to stay safe. Althoff and Dr. Wurtz agree that vaccination is the key to moving forward.

"Your risk level around you is changing," Althoff said. "So it's a good time to have another think about your vaccination status, and seek your answers to the questions you might have so you can make the best choices for yourself and your family."

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