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The U.S. Centers for Disease Control and Prevention (CDC) is considering dropping the COVID-19 isolation recommendations for the first time since 2021, which may shorten the isolation period guidance for all Americans.

Under the new guidelines, those who test positive for COVID-19 would use clinical symptoms to decide when to end isolation — rather than staying home for five days, per a report from The Washington Post. Those infected would no longer need to stay home if they have been fever-free for at least 24 hours without the help of medication and their symptoms are mild and improving.

The report was based on agency officials who agreed to speak on the condition of anonymity, but other experts seem to agree with the shift in direction, which aligns with guidance on avoiding the spread of flu and RSV.

Last month, California shortened its five-day isolation recommendation, and Oregon did the same last May. California continues to recommend that people with COVID-19 wear masks indoors when around others for 10 days after they test positive, even if they don’t have symptoms.

“The updated CDC guidance — like that issued by Oregon and California — reflects a harm reduction approach to a virus that is endemic and for which there are more tools than any other respiratory virus,” says infectious disease physician Amesh A. Adalja, MD, a Senior Scholar at Johns Hopkins Center for Health Security. “Increasingly, it has been clear that COVID guidance would need to be integrated with other respiratory viruses and not singled out in perpetuity.”

However, if you’re immunocompromised, you may be particularly concerned about the risk of exposure and the potential for subsequent long COVID. “I need resources and support for staying COVID-free,” patient Tracey R. told the Global Healthy Living Foundation recently. “Everyone should avoid getting repeatedly infected.”

People with underlying health conditions like autoimmune disease and those who have experienced severe COVID-19 are among the groups at higher risk for long COVID, per the National Institutes of Health.

“Long COVID has completely upended my life,” another patient, Shivuan M., told the Global Healthy Living Foundation. “Most resources and support groups are more generalized and don’t address the specific ways autoimmune diseases and inflammatory arthritis complicate the situation.”

Currently, about 20,000 people are still hospitalized with COVID-19 every week in the United States — and over 2,000 are dying weekly, per a CDC report.

Although the new guidelines haven’t officially been released by the CDC yet, they don’t appear to have provisions for those with compromised immune systems. “For the severely immunocompromised, it will remain important for them to stay up to date with vaccines, have a low threshold to obtain antivirals, and wear masks in high-risk indoor situations,” says Dr. Adalja.

However, in terms of the general spread of COVID-19, experts like Dr. Adalja are not concerned about the potential impact. “I don’t think this guidance change will have a major impact on COVID’s impact, as many countries have already adopted it, as have California and Oregon,” adds Dr. Adalja.

The CDC is expected to release the guidance in April for public feedback, which the White House will have yet to sign off on.

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CDC plans to drop five-day covid isolation guidelines. The Washington Post. February 13, 2024.

COVID-19 Isolation Guidance. California Department of Public Health. January 9, 2024.

COVID-19. Oregon Health Authority. Accessed February 16, 2024.

Interview with infectious disease physician Amesh A. Adalja, MD, a Senior Scholar at Johns Hopkins Center for Health Security

Long COVID. National Institutes of Health. September 28, 2023.  

Trends in United States COVID-19 Hospitalizations, Deaths, Emergency Department (ED) Visits, and Test Positivity by Geographic Area. COVID Data Tracker. U.S. Centers for Disease Control and Prevention. Accessed February 16, 2024.

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