The CDC may roll back its 5-day COVID isolation guidelines. Here’s why.

The Centers for Disease Control and Prevention (CDC) may soon change its isolation guidelines for people with COVID-19 infections. Under the proposed change, which was first reported by the Washington Post and hasn’t yet been confirmed by the CDC, people would no longer be expected to isolate themselves for five days. Instead, they would be allowed to return to their normal schedules once they’ve been free of fever for at least 24 hours without taking medication. This is similar to recommendations for other respiratory viruses such as influenza and RSV. Here’s more about the possible change, which may happen in April — and what it could mean.

😷 Why is the CDC planning to change COVID isolation guidelines?

There are three key reasons behind the proposed change from five days of isolation to 24 hours after being fever-free without medications. First, the current dominant variant nationwide, JN.1, which is responsible for more than 90% of cases, doesn’t appear to be causing more severe illnesses than previous strains.

Second, at the population level, there appears to be an increase in hybrid immunity to COVID-19 because of higher vaccination rates and more exposure to the virus. A CDC study found that immunity has gone up in the general population due to vaccinations and past infection, but it’s important to note the level of immunity was lowest in older adults compared to other age groups.

“Four years since its emergence, COVID continues to spread through our communities and periodically mutate, leading to spikes in cases,” Dr. Greg Schrank, an epidemiologist at the University of Maryland Medical Center in Baltimore, tells Yahoo Life. “What has changed since the start of the pandemic is that the risk posed by COVID-19 infection is now much lower for most people.” He adds: “Despite an estimated large increase in COVID-19 disease across the U.S. starting last fall, the peak number of hospitalizations was lower than the previous two winter seasons.”

Third, there are concerns that many people weren’t following the isolation recommendations to begin with. “Currently, most people are not testing and isolating in the same manner as when the current isolation guidance was issued in 2021,” says Schrank. More recently, some states — namely, Oregon and California — had already broken away from the guidelines without appearing to have higher infections, deaths or hospitalization rates.

📋 When was the last time the CDC revised its isolation guidelines?

The last time the CDC changed its COVID-19 isolation recommendations was in 2021, when it reduced the isolation time for infected people from 10 days to 5 days. At the time, the CDC stated the change was motivated by scientific research, which showed that most of the virus’s transmission happened early in the course of illness, usually in the first two days before having symptoms and during the two to three days after symptoms show up. But there were also concerns that longer isolation times would cripple the economy by keeping people out of work.

🛎️ Why it matters

The proposed changes to the CDC’s isolation recommendations matter because they would influence public behavior and could increase infection risks, especially for more vulnerable groups. Although only two states have dropped the current isolation guidelines and it appears they aren’t being followed by everyone, there are still concerns about abandoning the current recommendations altogether.

Many health experts are unhappy with the proposed change because it could mislead the public into thinking they don’t need to worry about COVID-19 anymore. Under the revised guidelines, more vulnerable people such as older adults and those who are immunocompromised may face increased risk as many more people go about their daily routines while still infectious.

🖥️ The big picture

With the COVID-19 pandemic in its fourth year, the proposed changes to the isolation guidelines are an attempt to manage a public health issue that is no longer considered an emergency. That said, experts are quick to point out that COVID continues to be a health concern, particularly for vulnerable populations.

“The COVID-19 virus can infect anyone, even after a previous illness or vaccination,” Dr. Tammy Lundstrom, chief medical officer at Trinity Health, tells Yahoo Life. “Because various strains are circulating at different times, it is possible to have multiple episodes of COVID illness.”

An infection, even a mild one, carries the risk of long COVID (also called “post-COVID conditions”), which affects about 7% of American adults. Over 8 million Americans are living with this condition with symptoms such as fatigue, breathing problems and brain fog.

COVID-19 is also responsible for over 1.1 million deaths and 6.8 million hospitalizations over the past four years — and the numbers are rising, with over 20,000 hospitalizations and 1,500 deaths each week. Clearly, the pandemic isn’t over, and experts say it is unwise to pretend that it is, noting it’s still important to take steps to control COVID-19, just like people should for every other serious infectious disease.

If the isolation guidelines do change, Schrank has the same advice for the public that he has shared since 2020, when the pandemic started: “Get vaccinated. If you are sick, stay home as best as possible until you feel well and any fever resolves. If you must be around others, wear a well-fitting mask to protect those around you while you still may be contagious. Staying up-to-date with vaccination is most important for vulnerable people just as it is for other infectious diseases,” he says.

Nsisong Asanga is a writer, public health physician and field epidemiologist.