Even if there are many people who support loosening the quarantine guidance, others may People are troubled by the latest move by federal health officials to move away from treating the coronavirus as a unique threat to respiratory viruses.
The changes that will occur are The Washington Post first reported. If you have not had a fever for at least 24 hours without the help of medicines, you can return to school or work. They have mild symptoms and their symptoms are improving.
This is similar to the guidance for people with influenza and respiratory syncytial virus (RSV). Advocates, including prominent doctors and public health experts, say it's the right thing to do. reflect The reality that many people are infected with the new coronavirus not isolated, and As a result of vaccination, previous infections, and antiviral treatment, severe symptoms have faded. But critics say the coronavirus is currently causing hospitalizations and deaths and should not be treated like other respiratory viruses. more people than the flu and can It causes long-term complications that scientists are still trying to understand.
“I feel like I'm on an island all by myself,” said Lisa Savage, 60, a retired nonprofit fundraiser. A resident of Charleston, South Carolina, she suffers from several autoimmune diseases and is unable to maintain her body. A state of constant inflammation.
Savage said the changes proposed by the CDC scare her. When she hears people say it's time for this country to move forward, she thinks: Those of us with compromised immune systems don't have that luxury. ”
The CDC plans to release revised quarantine guidelines in April and seek public input.
The science of infectivity and transmission has not changed. People who test positive for covid can remain contagious for more than 5 days. Even people without symptoms or fever can transmit the virus very early in their illness. What we don't know, experts say, is how closely people are following the five-day quarantine recommendation and whether relaxing guidelines will have an impact on community transmission rates.
Oregon lifted its five-day quarantine requirement for COVID-19 in May 2023, telling people to stay home until they recover, as they do with other respiratory illnesses, but has reduced the number of vulnerable people to 10. I avoided the virus for days and wore a mask when around others. The state will continue its five-day quarantine advisory through January 2024, according to data shared last month with the national association representing state health officials. There was no disproportionate increase in community transmission or severity compared to California, which had a
Walid Gerad, a physician and professor of medicine at the University of Pittsburgh, said relaxing quarantine recommendations would increase the risk for people who are immunosuppressed. But those risks need to be weighed against the downsides of prolonged isolation, such as people missing work or school, he said. “It's really a different world now,” he said.
Caitlin Jetelina, an epidemiologist who closely follows COVID-19 policy, said health policy is complex and requires: Consider tradeoffs that change over time US population different priorities, risk factors, actions and beliefs. “Ultimately we need protective guidance. and practical and It is possible,” she wrote in her latest weekly newsletter.
Public health experts say the revised guidance is also reductive, as it sacrifices the immunocompromised and elderly to minimize economic disruption. They say there is a middle ground between living in fear and ignoring the virus.
Paul Offit, a pediatric infectious disease expert at Children's Hospital of Philadelphia, said high-risk populations would benefit if Americans focused on isolating while sick, rather than focusing on which virus they have. He said it would be.
“I think people have this idea that if they don't have COVID, they're safe,” Offit said. “But all of these viruses can get people hospitalized, put them in intensive care, or die. So even if you're not in a high-risk group, you should stay home when you're sick. Please stay.”
Public health officials have justified relaxing measures to limit coronavirus transmission by pointing to sharp declines in hospitalizations and deaths since the pandemic began. But COVID-19 activists have continued to do so, ignoring that the virus can cause lingering, sometimes debilitating symptoms for which there is no clearly defined treatment.
“The CDC has long been complicit in misleading the public to view this crisis as an acute crisis rather than one with chronic, high-impact consequences,” said J.D. David, a longtime COVID-19 activist. says Mr. “This reinforces the dangerous idea that we must always be sick, pass the disease on to others, and just keep working.”
In December 2021, the CDC's quarantine guidelines were significantly revised from 10 days to 5 days, prompting companies such as Walmart, Amazon, CVS, and Walgreens to require employees infected with COVID-19 to stay home. A number of companies have withdrawn their salary payments. Far fewer employers are now offering any kind of paid time off to combat the coronavirus, instead requiring workers to use traditional sick leave benefits. If only they offered it. Some say employees must return to work even if they have no symptoms or fever or are sick.
“I think employers are looking to downsize. [paid leave] They will use CDC guidance as their rationale for doing so,” said Vicki Chabot, a senior fellow who focuses on paid leave policies at the left-leaning think tank New America. “But what we want employers to understand is that when they're highly contagious, they allow their employees to stay home… It's good for business, it's good for morale, it's good for productivity. .”
According to the Bureau of Labor Statistics, nearly one in four workers takes no paid sick leave.
When the coronavirus swept the world in 2020, the United States required companies with between 50 and 499 employees to provide paid leave to employees who contracted the coronavirus. That rule was lifted at the end of the year, and some states and cities began enforcing similar protections, which have now expired.
New York Governor Kathy Hochul (Democratic) has proposed ending the nation's only urban planning system. State law requiring paid leave for COVID-19 quarantine. Business groups in the state say eliminating paid coronavirus leave is long overdue, especially at a time when New York state has extensive laws mandating paid sick leave.
“It's time to eliminate the special COVID-19 benefits that are out there. These are the last benefits left,” said Frank Carbine, director of the Human Resources Center at the New York Business Council. Ta. “Our company does not have a paid leave system for tuberculosis.”
COVID-19 isolation policies have been particularly challenging for health systems that must protect patients from infection while grappling with staff shortages.
Northwell Health, New York's largest health system, is following state guidance for five days of coronavirus leave and requiring employees to wear masks for an additional five days upon returning. In the first week of February, 123 out of more than 80,000 employees were in quarantine., according to the hospital system. But Northwell leaders also believe the CDC's planned 24-hour fever-free approach makes sense as a standard for determining contagiousness for workers.
“We need health care workers when they no longer need to be isolated because they are no longer infectious,” said Peter Silver, senior vice president at Northwell.
CDC officials told the Post that the new quarantine recommendations do not apply to hospitals and other health care settings with more vulnerable populations.
Activists organized to keep New York state's coronavirus leave policy in place, saying its repeal would harm low-wage workers and people at risk of serious illness.
“We know that the coronavirus pandemic is not completely over, and it would be premature to make such major changes when we are still seeing a surge,” he said, leading the Labor Committee and opposing the bill. State Sen. Jessica Ramos (Democratic) said: Governor's attempt to repeal paid leave law. “Workers can be assured as Making them as safe as possible should be one of our top missions. ”
Supporters of relaxing quarantine guidance say the existing recommendations pose a dilemma for some people. — and potentially costly — People isolated due to mild symptoms Instead, we might embrace ignorance as bliss and not test for COVID-19.
Reshma Chughani, a pediatrician in Atlanta, said parents often refuse to test their sick children for the coronavirus because they don't want their kids to miss five days of school, but if the test comes back positive. , parents will have to take time off from work. Additionally, there is no treatment for most children because the antiviral drug paxlobid is only approved for patients with: People over 12 years old.
Many schools that rely on attendance for funding are sending letters home informing parents of the number of absences, even if their children are sick with COVID-19, and are encouraging parents to keep their children out of school for extended periods. increasing pressure on
As a result, pediatricians are “in a bind from a public health perspective,” Chugani said.
“By sending sick children to school, we risk putting vulnerable populations at risk,” she wrote in an email. “Meanwhile, children missing school is a real problem, as we saw at the height of the pandemic with learning loss, isolation and mental health issues.”
Her college student son contracted the coronavirus for the first time last week and had to quarantine in his dorm for five days, per school policy. He didn't have a fever and there was no telemedicine option, so he missed four days of classes and made it in time to attend a Super Bowl party.
Andrew Franks, a Boston-area consultant with a 2-year-old daughter, said he takes the virus seriously as a leading cause of death, but is frustrated that his employer doesn't offer more incentives to quarantine. Told. when you are sick. His wife takes only 7 days of sick leave a year. If his daughter tests positive, he will have to wait at least five days before returning to day care, and if her test result is negative, he will take time off from work to care for her daughter. There is a need.
“One person with COVID-19 can spread to an entire family and easily consume sick time,” said Franks, 37.
He said he understands why many parents have stopped testing their children for coronavirus when they get sick.
“If I test her and it comes back positive, she will have to stay home for up to two weeks.” Franks said. “But if I don't test her and she doesn't suddenly develop a fever, her life can go on. That's a really perverse incentive.”