Got COVID (Again)? Here's What the CDC Says About 2024 Isolation Guidelines

Updated 9:10 a.m. Friday, July 19

We’re now in the fifth year of the COVID-19 pandemic and still the virus continues to spread, with California currently in the “Very High” category for levels of the virus in wastewater. And after several years of evolving guidelines and best practices from public health officials, if you’re unclear on the current recommendations on what anyone with COVID-19 should actually do when it comes to what we all used to call “quarantine,” you’re definitely not alone.

This spring, the Centers for Disease Control and Prevention (CDC) officially revised their national guidance for how long people with COVID-19 should isolate from others — saying that COVID-positive people can now return to work or regular activities once their symptoms are “improving overall,” and they’ve been fever-free for at least 24 hours without use of a fever-reducing medication. The CDC’s new isolation guidelines have been in effect since March 1.

Previously, the CDC advised that people who test positive for COVID-19 should stay home and isolate from other people for at least five days, regardless of the severity of their symptoms — or whether they had symptoms at all. Now, the CDC says that the number of days you isolate for instead depends on how long you have symptoms, which could be longer (or shorter) than five days.

Keep reading for a breakdown of the CDC’s 2024 COVID-19 isolation guidelines, how they’re different to the recommendations you may have become used to over the past few years and how to think about the risk your positive COVID-19 test still poses to others.

And remember, if you get COVID-19 there’s nothing stopping you — if you’re able — from continuing to use at-home antigen testing and leaving isolation only when you get that negative result. Unfortunately, this option has become a lot more difficult for many people in 2024, due to limited sick days and how it’s become far harder to find free COVID-19 tests to do that repeat testing. Remember, you can still get your health insurer to reimburse you for the costs of up to eight antigen tests per month.

Jump straight to:

• I tested positive. How do the CDC’s latest COVID isolation guidelines work?
• Are California’s isolation guidelines any different from the CDC’s?
• Why did public health officials change COVID isolation guidelines?
• Why do officials think it’s safe for asymptomatic COVID-positive folks to be in public?
• What are the concerns over this latest guidance?

I just tested positive. How do the CDC’s latest COVID isolation guidelines work?

According to the CDC, you should isolate from other people for as long as you’re experiencing COVID-19 symptoms that aren’t improving.

When can I start to consider leaving isolation, according to the CDC?

Once your symptoms start improving, and any fever you’ve had has been gone for 24 hours without the aid of fever-reducing medication, the CDC says that you can exit isolation.

But you’ll need both of these things — symptoms improving and the absence of fever for more than a day — to happen before you can leave isolation.

So if your fever has been gone more than 24 hours but your other symptoms haven’t improved, you still need to keep isolating until they do improve, says the CDC. And if your other symptoms get better but you get a new fever, you need to keep isolating (or go back into isolation) until that fever has been gone for 24 hours.

(Remember, there’s growing evidence that some people take longer to get a positive test on an at-home antigen test. If you have symptoms but have tested negative, don’t assume it means you’re COVID-free. The CDC recommends that you take another antigen test 48 hours later and then test again after another 48 hours. (You can also seek out a PCR test, which is more sensitive.)

What should I do when I leave isolation, according to the CDC?

Once your COVID-19 symptoms are mild and improving for at least 24 hours, and any fever has been gone without the aid of medication for that period of time, the CDC says that you should still take “added precaution over the next 5 days.” These precautions include:

• Wearing a mask around others.
• Taking additional steps for cleaner air.
• Taking additional steps for hygiene.
• Maintaining physical distance around others.
• Testing when you will be around other people indoors.

The CDC recommends that you “keep in mind that you may still be able to spread the virus that made you sick, even if you are feeling better.” How much less contagious you actually are during this time “depend[s] on factors like how long you were sick or how sick you were,” says the CDC.

See the CDC’s visualizations of different isolation timelines for people who test positive for COVID.

What if I test positive but don’t have any symptoms?

“You may be contagious,” says the CDC, so assume that you are, for the safety of those around you.

The CDC recommends that for five days after you test positive without symptoms, you should take those same added precautions they advise for symptomatic people once they leave isolation: masking, creating cleaner air, enhanced hygiene and physical distancing. This is, the agency says, “especially important to protect people with factors that increase their risk of severe illness from respiratory viruses.”

Are California’s isolation guidelines any different from the CDC’s?

No. California’s own online resources around COVID-19 and other respiratory viruses now recommend that Californians with COVID-19 refer directly to the CDC’s guidelines around isolation.

But if you feel like the state’s quarantine guidance used to be different to the CDC’s, you’re not imagining it — they were. Back in January, when the CDC was still recommending that people who test positive should stay away from other people for at least five days regardless of whether or not they had symptoms, the California Department of Public Health announced it was softening those guidelines for Californians — and was instead advising a move away from the five-day rule in favor of “instead focus[ing] on clinical symptoms to determine when to end isolation.” Then in March, the CDC’s own update isolation guidance almost exactly resembled the policy California had adopted a few months earlier.

The biggest difference between California’s January guidelines and the CDC’s revised advice was what people who test positive for COVID but do not have symptoms — known as asymptomatic infections — should do when it comes to isolation and avoiding infecting others. The state said that asymptomatic people with COVID should wear a mask indoors around others for 10 days and avoid higher-risk people for the same duration. The CDC’s update noted that asymptomatic people “may be contagious” and should only take “added precautions[s],” including possible masking, for five days — advice that California’s public health officials have now also adopted.

California’s January guidelines also recommended that COVID-positive people with symptoms should mask around other people indoors for a full 10 days after their positive test or symptom onset. Now that California public health officials are directing state residents to the CDC’s own advice, this 10-day requirement is no longer mentioned.

The March 1 update represented the first time during the pandemic that the CDC had moved away from set periods of isolation for people with COVID. At the outset of the pandemic in 2020, the CDC stipulated a 10-day period of isolation for COVID-positive patients — a period shortened to five days in December 2021. This update was still accompanied by guidance to wear a well-fitted mask for another five days.

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Why did public health officials make this change to COVID isolation guidelines?

The CDC says that this latest guidance “brings a unified approach to addressing risks from a range of common respiratory viral illnesses,” bundling guidance on COVID into that for other viruses like flu and RSV as one set of Respiratory Virus Guidance.

Doing this, said the agency, “makes recommendations easier to follow and thus more likely to be adopted and does not rely on individuals to test for illness, a practice that data indicates is uneven.”

CDPH says that in 2024, the agency’s “policies and priorities for intervention are now focused on protecting those most at risk for serious illness while reducing social disruption that is disproportionate to recommendations for the prevention of other endemic respiratory viral infections.”

Why does the state now think it’s safe for asymptomatic COVID-positive folks to be in public?

After over four years of public health policy at the federal and state levels that’s emphasized “If you’re COVID-positive, stay the heck away from other people,” the 2024 update might seem jarring to you.

There’s also the fact that since 2020, we’ve been told that not only can asymptomatic people be contagious with COVID-19, they might be responsible for fueling a lot of the spread of COVID-19 — because those folks are so often unaware they even have the virus.

“We know that you can be contagious without symptoms,” said Dr. Abraar Karan, an infectious disease physician and researcher at Stanford University. “We also know that symptomatology can increase the risk of transmission. So if you’re coughing and sneezing, you’re probably emitting more viral particles.”

This latest guidance focuses on symptomatic people as posing the most risk to others, noted Karan — hence the continuing recommendation that those people stay home until those symptoms get milder.

What are the concerns over this latest guidance?

Karan says he’d have liked to have seen California public health officials give the public more information about “the rationale behind why they were doing it,” so that the public could understand that this guidance wasn’t a green light to go out into the world with COVID-19.

“If they’d said, ‘People that are not symptomatic can be contagious, but it’s less likely, and people without symptoms are likely going to be shedding less virus, so if you wear a high filtration mask, your risk of infecting others is quite low, and that’s why we’re doing it’? I think that would have made a lot of sense,” Karan says.

Calmatters has reported that disability and equity advocates particularly criticized the latest guidelines when they were first announced by California health officials, saying the guidance could increase the risk of infection for Californians most vulnerable to severe illness or death from the virus.

“This policy is not based in science, equity or public health,” Lisa McCorkell, cofounder of the Patient-Led Research Collaborative that studies the impacts of long COVID, told CalMatters. “It devalues the lives of immunocompromised and disabled people and completely ignores the risk of long COVID.”

Michelle Gutierrez Vo, a registered nurse with Kaiser Permanente and a president of the California Nurses Association, echoed these concerns back when CDPH announced their guidelines relaxing isolation requirements, calling them “a step backwards from protecting public health” and “very dangerous.”

“High risk people do not walk around with a flag saying ‘I am high risk,’ so then the people that are COVID-positive can identify them and stay away from them,” said Gutierrez Vo. “It doesn’t work that way.”

“So therefore, if you cannot be selective of who you need to be getting away from, then there just has to be a general understanding or a mandate — which is what we had — to make sure to protect the general public. It is the Department of Public Health’s responsibility to uphold public health, and they are not doing that with this new guidance,” said Gutierrez Vo.

On the risks of long COVID, Gutierrez Vo said that California’s relaxing of isolation protocol “puts everyone in danger.” COVID, she said, “is not like any other respiratory illness. When you have flu and you get over it, it doesn’t have long term effects. When you have RSV, or any other respiratory illness like a viral syndrome, it doesn’t damage your kidney or it doesn’t damage your heart.”

This story contains reporting by KQED’s Lesley McClurg. An earlier version of this story originally published on March 4.

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