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CDC Recommends Shorter COVID Isolation and Quarantine Periods

The new CDC guidance comes after a recent surge in COVID-19 cases due to the omicron variant and following a push from airline companies struggling with short staffing during the holiday season.
Mike Stobbe
The Associated Press
A healthcare worker in blue scrubs swabs a man whose back is turned to the camera.
Health care worker Olga Duran tests a patient for COVID-19 at a Unidos en Salud (United in Health) testing site on 24th and Mission streets in San Francisco on Nov. 30, 2020. The effort is a collaboration between UCSF and the SF Latino Task Force to help vulnerable populations during the pandemic. (Beth LaBerge/KQED)

Don't have time to read the whole guide? Here's a quick breakdown. Click the links below to skip to a specific section:

U.S. health officials on Monday cut isolation restrictions for Americans who catch the coronavirus from 10 days down to five days, and similarly shortened the time that close contacts need to quarantine.

Centers for Disease Control and Prevention officials said the guidance is in keeping with growing evidence that people with the coronavirus are most infectious in the two days before and three days after symptoms develop.

The decision also was driven by a recent surge in COVID-19 cases, propelled by the omicron variant.

Early research suggests omicron may cause milder illness than earlier variants of the coronavirus. But the sheer number of people becoming infected — and therefore having to isolate or quarantine — threatens to crush the ability of hospitals, airlines and other businesses to stay open, experts say.

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CDC Director Rochelle Walensky said the country is about to see a lot of omicron cases.

“Not all of those cases are going to be severe. In fact many are going to be asymptomatic,” she told The Associated Press on Monday. “We want to make sure there is a mechanism by which we can safely continue to keep society functioning while following the science.”

But beleaguered businesses also are amping up the pressure: Airlines have called on the Biden administration to shorten the guidelines for the isolation period for vaccinated workers who get COVID-19, to ease staffing shortages. The union for flight attendants has pushed back against that, saying the isolation period should remain 10 days.

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Last week, the CDC loosened rules that previously called on health care workers to stay out of work for 10 days if they test positive. The new recommendations say workers could go back to work after seven days if they test negative and don’t have symptoms. And the agency said isolation time could be cut to five days, or even fewer, if there are severe staffing shortages.

Now, the CDC is changing the isolation and quarantine guidance for the general public to be even less stringent.

The guidance is not a mandate; it’s a recommendation to employers and state and local officials. Last week, New York state said it would expand on the CDC’s guidance for health care workers to include employees who have other critical jobs that are facing a severe staffing shortage.

It’s possible other states will seek to shorten their isolation and quarantine policies, and the CDC is trying to get out ahead of the shift. “It would be helpful to have uniform CDC guidance” that others could draw from, rather than a mishmash of policies, Walensky said.

The CDC’s guidance on isolation and quarantine has seemed confusing to the public, and the new recommendations are “happening at a time when more people are testing positive for the first time and looking for guidance,” said Lindsay Wiley, an American University public health law expert.

Nevertheless, the guidance continues to be complex.

Breaking down the new isolation rules

The isolation rules are for people who are infected. They are the same for people who are unvaccinated, partly vaccinated, fully vaccinated or boosted. They say:

  • The clock starts the day you test positive.
  • An infected person should go into isolation for five days, instead of the previously recommended 10.
  • At the end of five days, if you have no symptoms, you can return to normal activities but must wear a mask everywhere — even at home around others — for at least five more days.
  • If you still have symptoms after isolating for five days, stay home until you feel better and then start your five days of wearing a mask at all times.

Breaking down the new quarantine rules

The quarantine rules are for people who were in close contact with an infected person but not infected themselves. They say:

  • For quarantine, the clock starts the day someone is alerted they may have been exposed to the virus.
  • People who are vaccinated but not boosted, people who are partly vaccinated and those who are not vaccinated at all can stop quarantine after five days if they wear masks in all settings for five days afterward.
  • People who got booster shots can skip quarantine if they wear masks in all settings for at least 10 days.

That’s a change. Previously, the CDC said people who are not fully vaccinated and who came in close contact with an infected person should stay home for at least 10 days. Also previously, people who were fully vaccinated — which the CDC has defined as having two doses of the Pfizer or Moderna vaccines, or one dose of the Johnson & Johnson vaccine — could be exempt from quarantine. Now only people who've had booster shots are exempt.

Is there still a risk of infection after five days?

Suspending both isolation and quarantine after five days is not without risk.

A lot of people get tested when they first feel symptoms, but many Americans get tested for others reasons, like to see whether they can visit family or for work. That means a positive test result may not reveal exactly when a person was infected or give a clear picture of when they are most contagious, experts say.

When people get infected, the risk of spread drops substantially after five days, but it does not disappear for everyone, said Dr. Aaron Glatt, a New York physician and spokesperson for the Infectious Diseases Society of America.

“If you decrease it to five days, you’re still going to have a small but significant number of people who are contagious,” he said.

That’s why wearing masks is a critical part of the CDC guidance, Walensky said.

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