CDC statement on updated recommendations leaves more confusion than clarification

by mcardinal

Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News 

 

The CDC issued a clarifying statement through its website on Tuesday on the rationale behind shortening COVID quarantine recommendations a week ago. The organization cited a better understanding of the Omicron variant, saying “a review of 113 studies from 17 countries, show that most SARS-CoV-2 transmission occurs early in the course of infection” as the reason for these updates.

This explanation was issued days after Dr. Anthony Fauci suggested the agency may reconsider their stance on requiring a negative test prior to breaking quarantine. The CDC rebutted these suggestions stating that they will not require a negative COVID-19 test to end isolation or quarantine.

They did however, give a plug for self-testing, similar to those of director Rochelle Walensky a day earlier. “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,” the agency said.

Last week the CDC changed COVID-19 quarantine and isolation guidance for the general public. For all individuals who test positive for COVID-19, regardless of vaccination status, the new recommendation is 5 days of isolation. If no symptoms develop “or are resolving after 5 days, you can leave your house,” but you should continue to wear a mask for an additional 5 days. 

The CDC continues to have sliding recommendations on masking based on one’s vaccination status. For fully vaccinated individuals that have been exposed to COVID-19 who have also received the recommended booster shot, the guidelines advise that individuals wear a mask for 10 days and get tested on day 5. For those who have not received a booster or are unvaccinated it is recommended that individuals quarantine for 5 days and wear a mask around others for an additional 5 days, however if quarantining is not feasible, individuals should wear a mask for 10 days. In both situations testing on day 5 is recommended and if any symptoms develop individuals should stay home and get tested.  

The guidance says that the changes are based on “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.” Similar changes were made to how long healthcare workers who are infected or exposed to COVID-19 must quarantine or isolate. “Healthcare workers with a COVID-19 infection who are asymptomatic can return to work after 7 days with a negative test” and those “who have received all recommended COVID-19 vaccine doses, including a booster, do not need to quarantine at home following high-risk exposures.” 

Many see the updated recommendations as a strategy to avoid potential staffing crisis, especially as hospitals have terminated employees who did not comply with vaccine mandates. These changes allow isolation periods to be shortened for COVID-19 infected staff to return to work to meet staffing demands. 

Dr. Fauci told CNN’s Jim Acosta that these new measures will “get people back to the jobs, particularly the essential jobs, to keep society running smoothly.”  

The Pennsylvania Department of Health has updated similar guidelines for its healthcare facilities with staff that are confirmed or suspected to have a COVID-19 infection, allowing providers to return to work after 7-10 days or following a negative testm48 hours before they return to work, if they are fever free for at least 24 hours, and symptoms are resolving.

Infected workers “who feel well enough to work, but have not fully recovered from illness” may return, but this is a “a decision that can only be made by the healthcare worker.” To avoid a staffing crisis, COVID-19 infected providers may return to work where they do not interact with others, and in some cases may provide care to COVID-10 infected patients or presumed positive patients, and as a last resort may provide direct care to all patients, although this should be used as a “bridge to longer term strategies.”

This is concerning as prevention measures are not 100% effective in preventing transmission and vaccinated individuals can easily catch and spread the virus to others. This begs the question, “Why is it that we fired essential workers for failure to comply with vaccine mandates, but are now allowing infected healthcare providers to take care of our most vulnerable members of society?”

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