CDC updates Covid 5-day isolation guidelines as deaths and hospitalizations fall

People who test positive for Covid no longer need to isolate for five days, the Centers for Disease Control and Prevention said Friday.

The CDC’s new guidance now matches public health advice for flu and other respiratory illnesses: Stay home when you’re sick, but return to school or work once you’re feeling better and you’ve been without a fever for 24 hours.

The shift reflects sustained decreases in the most severe outcomes of Covid since the beginning of the pandemic, as well as a recognition that many people aren’t testing themselves for Covid anyway.

“Folks often don’t know what virus they have when they first get sick, so this will help them know what to do, regardless,” CDC director Dr. Mandy Cohen said during a media briefing Friday.

Over the past couple of years, weekly hospital admissions for Covid have fallen by more than 75%, and deaths have decreased by more than 90%, Cohen said.

“To put that differently, in 2021, Covid was the third leading cause of death in the United States. Last year, it was the 10th,” Dr. Brendan Jackson, head of respiratory virus response within the CDC’s National Center for Immunization and Respiratory Diseases, said during the briefing.

Many doctors have been urging the CDC to lift isolation guidance for months, saying it did little to stop the spread of Covid.

The experiences of California and Oregon, which previously lifted their Covid isolation guidelines, proved that to be true.

“Recent data indicate that California and Oregon, where isolation guidance looks more like CDC’s updated recommendations, are not experiencing higher Covid-19 emergency department visits or hospitalizations,” Jackson said.

Changing the Covid isolation to mirror what’s recommended for flu and other respiratory illnesses makes sense to Dr. David Margolius, the public health director for the city of Cleveland.

“We’ve gotten to the point where we are suffering from flu at a higher rate than Covid,” he said. “What this guidance will do is help to reinforce that— regardless of what contagious respiratory viral infection you have — stay home when you’re sick, come back when you’re better.”

Dr. Kristin Englund, an infectious diseases expert at the Cleveland Clinic, said the new guidance would be beneficial in curbing the spread of all respiratory viruses.

“I think this is going to help us in the coming years to make sure that our numbers of influenza and RSV cases can also be cut down, not just Covid,” she said.

Still, the decision was likely to draw criticism from some clinicians who point to the fact that the U.S. logged 17,310 new Covid hospitalizations in the past week alone.

“It’s something that is likely to draw a wide array of opinions and perhaps even conflicting opinions,” said Dr. Faisal Khan, Seattle’s director of public health. “But [the CDC’s] rationale is sound in that the pandemic is now in a very different phase from where it was in 2021 or 2022 or 2023.”

Though the isolation guidelines have been wiped away, the CDC still encourages people to play it safe for five days after they are feeling better. That includes masking around vulnerable people and opening windows to improve the flow of fresh air indoors.

The majority of viral spread happens when people are the sickest. “As the days go on, less virus spreads,” Cohen said.

People at higher risk for severe Covid complications, such as the elderly, people with weak immune systems and pregnant women, may need to take additional precautions.

Dr. Katie Passaretti, chief epidemiologist at Atrium Health in Charlotte, said it was a “move in the positive direction.”

“We are continuing to edge into what the world looks like after Covid, with Covid being one of many respiratory viruses that are certain that circulate,” she said.

The new guidance is for the general public only, and does not include isolation guidelines in hospital settings, which is generally 10 days.

On Wednesday, the agency said that adults 65 and older should get a booster shot of the Covid vaccine this spring. It’s anticipated that the nation will experience an uptick in the illness later this summer.

Winter and summer waves of Covid have emerged over the past four years, with cases peaking in January and August, respectively, according to the CDC.

Another, reformulated, shot is expected to be available and recommended this fall.

CDC’s main tips for reducing Covid spread:

• Get the Covid vaccine whenever it is available. Cohen said that 95% of people who were hospitalized with Covid this past winter had not received the latest vaccine.
• Cover coughs and sneezes, and wash hands frequently.
• Increase ventilation by opening windows, using air purifiers and gathering outside when possible.