CDC shortens 5-day COVID isolation, updates guidance on masks, testing

CDC sign outside agency headquarters in Atlanta

The Centers for Disease Control and Prevention announced Friday that it would wind down much of its remaining guidance specifically targeted at COVID-19, including an official end to a pandemic-era plea for Americans to stay home for five days after testing positive.

The agency cited improvements in the rates of hospitalizations and deaths inflicted by the virus this past season for the change in its recommendations.

“COVID-19 remains an important public health threat, but it is no longer the emergency that it once was, and its health impacts increasingly resemble those of other respiratory viral illnesses,” the agency said Friday in a report justifying its decision.

Instead of offering recommendations specific to COVID-19, the agency said it would switch to offering a “unified, practical approach to addressing risk” from the virus alongside influenza and respiratory syncytial virus, or RSV.

“We’re taking this unified approach so things can be simpler and more likely to be followed. And if they’re easier and more likely to be followed, then we’re protecting everyone, right? So the folks who are more vulnerable were top of mind when we did this,” CDC Director Dr. Mandy Cohen told CBS News.

The decision follows a months-long effort started last year to draw up a new “pan-respiratory” approach blending together federal recommendations for COVID-19, flu and RSV. Cohen blamed the emergence of the highly mutated variant BA.2.86 last summer and fall, and the fast-spreading descendant it spawned, JN.1, for delaying the rollout of the new guidance.

“We wanted to see if the trends would hold through another respiratory season. We wanted to see continued decreases in hospitalizations, decreases in deaths, even with that larger change in the virus,” Cohen said.

The changes include new guidance for when to stay home when sick, when people should test for COVID-19 and when to put on masks.

Here’s the latest about the CDC’s new recommendations.

Are COVID-19 tests still recommended?

Similar to influenza, where antiviral treatments are available for those who test positive and are more likely to face severe disease, the CDC’s new guidance says everyone who is at higher risk should seek out testing when they develop symptoms.

“If you are feeling sick, it is still important to know what you have, because you could get access to treatment. We have treatment for flu and COVID, and treatment can also save someone’s life and reduce the risk of long COVID,” said Cohen.

For people without additional risk factors, the agency says testing can be an “additional prevention” strategy to choose. Cohen said the agency would also continue to say testing was an option to be “proactive to protect those around you,” like before visiting others who might be more vulnerable.

“If it’s positive, we see very few false positives, we know that you have COVID. But it is still possible to have a false negative. So it can be reassuring, but it is not a guarantee that you don’t have COVID if you see a negative,” said Cohen.

A recent CDC survey found that less than half of people would do an at-home COVID-19 test if they had cough or cold symptoms.

It also acknowledged that mild cases are now often not detected by home tests until past the peak of infectiousness, given the risk of false negative results soon after an infection.

“Even when testing occurs, COVID-19 is often not identified early in illness. The overall sensitivity of COVID-19 antigen tests is relatively low and even lower in individuals with only mild symptoms,” the CDC said in its report.

The agency’s new guidance also moves away from an earlier recommendation on using test results to decide when to stop isolation after an infection.

“While COVID-19 at-home testing can give a rough approximation of whether a person is still infectious, at-home testing for other respiratory viruses is not widely available. CDC guidance throughout the pandemic recognized that repeated testing through the course of illness is not practical for many people,” the agency says.

When should I wear a mask? 

For people who are sick with COVID-19 or another respiratory virus, the CDC will suggest masking as part of five additional days of ramped-up precautions after they are no longer staying home, alongside distancing and improved ventilation.

The agency had previously suggested wearing a mask for up to 10 days after stopping isolation when indoors near other people.

Much of the data the CDC had tracked on COVID-19 alongside other trends, like influenza and RSV, will also continue to be published. But specific benchmarks, which had guided county-by-county recommendations on when people should wear masks to avoid getting sick, are now being discarded.

“This guidance is not going to tie to any specific colors or anything like that. We’re trying to give folks broad tools that they can use to protect themselves, and then give them information about what’s happening in their community,” said Cohen.

Cohen stressed that guidance for health care facilities, like long-term care nursing homes, would not be changing at this time.

It is unclear how benchmarks will be updated for these settings. This past season, some hospitals and other more vulnerable settings had relied on the weekly map to make decisions on when to require masks and take other precautions.

When can I go back to work after COVID-19?

A pandemic-era plea for Americans to isolate at home for five days after testing positive for COVID-19 is also being ended.

Instead, the CDC will urge people sick with symptoms of respiratory viruses to stay home until their fever has disappeared for at least 24 hours without relying on fever-lowering medications and their symptoms are improving.

The agency cited states that have already adopted these kinds of recommendations, like Oregon and California, as well as other countries abroad. Experts have questioned how often the five-day recommendations were followed, given hurdles like the lack of paid sick leave.

“Importantly, states and countries that have already shortened recommended isolation times have not seen increased hospitalizations or deaths related to COVID-19,” the agency said.

Over the following five days, the CDC suggests people take additional precautions like distancing, improving ventilation and wearing masks especially around vulnerable people.

“Keep in mind that you may still be able to spread the virus that made you sick, even if you are feeling better. You are likely to be less contagious at this time, depending on factors like how long you were sick or how sick you were,” the guidance says.