Wednesday, January 5, 2022

Coronavirus Update 1-5-22: What the hell is the CDC doing?

Confused by the CDC's changed guidance on when employees can break isolation? I'm here to help.

Just after Christmas, the CDC shortened its isolation guidance from the previous 10 days to 5 days for asymptomatic individuals, provided that they wear a mask for the next 5 days when around others. That change applied regardless of the vaccination status of the individual.

The same shortened 5-day rule applied to someone whose COVID-19 symptoms resolved after 5 days.

The isolation rules for symptomatic individuals remained the same – 10 days.

The CDC said that the change was supported by the science as to when individuals are most contagious. There are also reports, however, that a few prominent employers (I'm looking at you, Delta Airlines) lobbied the CDC for this change to help manage employee absences and operations during the current Omicron-fueled surge.

Whatever the reason, the optics of shortening isolation rules while hospitals are critically full and we are headed to a million-plus Covid cases per day are poor. People questioned the science the logic of this change and its timing.

The CDC listened and now has altered its isolation guidance … sort of, but not really.
If an individual has access to a test and wants to test, the best approach is to use an antigen test towards the end of the 5-day isolation period. Collect the test sample only if you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved (loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation). If your test result is positive, you should continue to isolate until day 10. If your test result is negative, you can end isolation, but continue to wear a well-fitting mask around others at home and in public until day 10.
There was hope by some (including me) that the CDC would require a negative test to break isolation after 5 days. Instead, the CDC didn't even give us testing as a recommendation or recommended best practice. I'm not even sure what its revised guidance hopes to achieve. "If an individual has access to a test and wants to test?" What does that even mean? Why is the CDC doubling down on its 5-day isolation recommendation and trusting people to "do the right thing" re: testing when trusting people is what got us into our national Covid mess in the first place.

Still, the CDC's recommendations are just that, and employers are free to establish their own rules by sticking with the CDC’s prior 10-day isolation guidance. And that's my recommendation.