The CDC has officially eliminated its 5-day isolation guidelines for COVID, the agency said in a press statement this afternoon. In practice, the CDC is lumping COVID in with flu and other respiratory illnesses - going so far as to archive its website pages about COVID isolation and prevention and instead redirecting to a new, more vague webpage that covers all “respiratory illnesses.” Below, we’ll answer your most pressing questions on the new recommendations:
The new guidance says people should stay home and away from others when sick. They can return to normal activities when symptoms are “improving overall,” and they’ve been fever-free for at least 24 hours without fever-reducing medication. This is more aligned with current recommendations for other respiratory illnesses like flu and RSV.
These symptoms-based guidelines are now the only guidelines about isolation for COVID and other respiratory illnesses, which means that they apply whether you’ve tested positive for COVID (or flu or RSV) or not. Ultimately, that means that employees can return to work after testing positive for COVID if their symptoms are improving and they have been fever-free for 24 hours without meds. The new guidelines do recommend that those people wear masks for at least 5 days.
We were disappointed that masking was buried in a list of other prevention measures that someone should take for at least 5 days after returning to their normal activities, which included: “taking more steps for cleaner air, enhancing hygiene practices, wearing a well-fitting mask, keeping a distance from others, and/or getting tested for respiratory viruses.”
These new guidelines from the CDC are basically designed to reflect the current reality, which is that most people aren’t actually getting tested for COVID. But testing does still matter for getting the proper treatment. CDC says, “ For people with COVID-19 and influenza, treatment is available and can lessen symptoms and lower the risk of severe illness.” If you have respiratory symptoms, especially if you’re over 65 or at higher risk, getting a positive test for flu or COVID can help you get the proper antiviral, which slashes your chances of severe illness and basically ensures that you won’t die from your illness.
Nothing has changed recently about the virus that causes COVID or how it’s transmitted. COVID is still dangerous - and more deadly than the flu. Thousands of Americans are still dying from COVID every week. The risk of long COVID is still much higher than other respiratory viruses, even for those who only have mild symptoms.
What has changed is that hospitalizations and deaths are way down from the peak of the pandemic, in part because of the high population immunity and the availability of vaccines and treatments (though uptake is still low, and there are still over 17,000 hospitalizations per week). CDC is also citing California and Oregon, which removed their guidelines earlier this past year and show no significant additional community spread. CDC is making these changes to try to create guidelines that people will actually follow and to relieve some of the burden for workers without sick leave or child care for sick kids. This is more about human behaviors than about any changes to viral transmission.
Oregon, which enacted similar rules in May, says it hasn’t seen significant increases in transmission. The CDC’s basic idea is that COVID transmission is already happening, and the goal is to create rules that people will actually follow.
OSHA workplace transmission guidance may be subject to change since it refers back to the CDC’s COVID isolation recommendations, which are now basically gone and combined with all other respiratory illnesses on their website. We’ll continue to reach out to employment law experts as this unfolding issue becomes more clear.
Ultimately, the CDC’s guidelines aren’t very useful for employers who need to determine how long to keep a sick employee out. Managers need some basic idea of when an employee will be able to return to staff appropriately. As a result, our team of clinical experts is recommending that those with moderate to severe respiratory illness symptoms stay home for 3 days, including at least 24 hours fever-free without fever-reducing medication, all respiratory and GI symptoms fully resolved, and other symptoms improved. If completely asymptomatic and positive, they may return to work and should wear a mask for at least 5 days.
For our clients who use ZHH Sick Call services, this will go into effect on Monday, March 4th, in the afternoon. While our experts recommend these exclusion lengths based on current clinical information, CDC guidelines, and industry best practices, we can work with your company to reflect your preferred policies in our Sick Call program if they differ from those we recommend.