The Centers for Disease Control and Prevention relaxed Covid-19 guidelines on Thursday, freeing schools and businesses from the burden of requiring unvaccinated people exposed to the virus to quarantine at home.
The changes drastically move away from measures like social distancing requirements and quarantine, which had polarized much of the country, and effectively acknowledge how many Americans have been navigating the pandemic for some time. The agency’s action comes as children across the country return to school and many offices have reopened.
“We know Covid-19 is here to stay,” CDC epidemiologist Greta Massetti said at a press conference Thursday. “The high levels of population immunity from vaccination and previous infection, and the many tools we have to protect people from serious illness and death, have put us in a different position.”
The new CDC guidelines come after more than two years of a pandemic in which more than one million Americans have died. With the spread of the highly contagious BA.5 subvariant of Omicron, the United States is seeing more than 100,000 cases and nearly 500 deaths per day on average.
But many Americans have long since given up on practices such as social distancing, quarantine and mask-wearing.
“I think they’re trying to realize that everyone in the audience is pretty much done with this pandemic,” said Michael T. Osterholm, an infectious disease expert at the University of Minnesota, referring to the CDC. .
The agency has been working on the new guidelines for months, which build on previous recommendations issued in February, when the agency shortened isolation times for many Americans. The CDC said it is making changes now because vaccination and previous infections have given many Americans some degree of protection against the virus, and treatments, vaccines and boosters are available to reduce the risk of serious illness.
The changes shift much of the responsibility for risk reduction from institutions to individuals. The CDC no longer recommends that people stay six feet away from others. Instead, he notes that avoiding crowded areas and maintaining a distance from others are strategies people may want to consider in order to reduce their risk.
And the recommended prevention strategies no longer distinguish between people who are up to date on their vaccinations and those who are not, streamlining a convoluted set of rules that could be difficult for schools and businesses to navigate.
People exposed to the virus no longer need to quarantine at home regardless of their vaccination status, although they must wear a mask for 10 days and get tested for the virus on day 5, according to the new guidelines. Contact tracing and routine surveillance testing of people without symptoms is no longer recommended in most settings.
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Instead of focusing on slowing transmission of the virus, the recommendations prioritize preventing serious illness. They emphasize the importance of vaccination and other preventive measures, including antiviral treatments and ventilation.
Masking guidelines – which recommend people wear them indoors in places with high community levels of Covid-19 – have not changed.
And people who test positive for the virus should still self-isolate at home for at least five days. Those who have had moderate or severe illness, or who are immunocompromised, should self-isolate until day 10.
The agency also addressed rebound infections that some people have reported after taking the antiviral treatment Paxlovid; if symptoms return, people should restart the clock in isolation, the CDC said.
Many health experts hailed the new guidelines as representing a pragmatic approach to living with the virus longer term.
“I think it’s a welcome change,” said Amesh Adalja, senior fellow at the Johns Hopkins Center for Health Security. “It actually shows how far we’ve come.”
The new guidelines will also be easier for the public to follow, he added.
But the pandemic is not over, experts noted, and tougher measures may be needed in the event of new variants or future outbreaks.
While almost all Americans are now eligible to be vaccinated, many are not up to date on their vaccines. Only 30% of 5-11 year olds and 60% of 12-17 year olds have received their primary vaccine series nationwide. Among adults 65 and older, who are most at risk of serious illness, 65% received a booster. Essential therapies, such as antiviral treatments, remain difficult to access for many.
“Obviously, we need to do more work to ensure that more people take advantage of the protection these tools have to offer and that more people can access these tools,” said Jennifer Nuzzo, director of the Pandemic Center of Brown University School. of Public Health. “I think there’s been a global recall in the ground game that’s needed to get people vaccinated.”
The guidance moves away from general population-level precautions to more targeted guidance for vulnerable populations and specific high-risk settings and circumstances.
For example, the guidelines note that schools may consider monitoring testing in certain scenarios, such as when students return from school holidays or for those participating in contact sports.
Unvaccinated students who are exposed to the virus will no longer need to test themselves frequently to stay in class, an approach known as “testing to stay”. The CDC is no longer recommending a practice known as cohorting, in which schools divide students into small groups and limit contact with each other to reduce the risk of viral transmission.
Health experts said the change in focus was particularly welcome as students returned to school, a setting in which quarantines had been particularly disruptive.
“It will really help minimize the impact of Covid-19 on education,” said Christina Ramirez, a biostatistician at the University of California, Los Angeles.
Mercedes Carnethon, an epidemiologist at Northwestern University Feinberg School of Medicine, said she doesn’t view the changes, even the elimination of quarantines in favor of 10 days of masking, as a relaxation of agency guidelines.
“We certainly know that wearing a high-quality mask will provide one of the strongest protections against it spreading to someone else, and quarantine is logistically heavy,” she said. declared. “It could be seen as a relaxation of the guidelines, but I think it’s a much more appropriate and targeted solution.”
Joseph Allen, a Harvard University researcher who studies indoor environmental quality, welcomed the new guidelines for putting more emphasis on improving ventilation.
“Good ventilation is something that helps reduce the risk of transmission that is not political and does not require behavior change,” he said.
Sheryl Gay Stolberg contributed reports