AMA calls CDC's new quarantine guidelines confusing and counterproductive
AMA said the new recommendations are confusing and potentially risk further spread of the virus.
Photo: Xavier Lorenzo/Getty Images
The U.S. Centers for Disease Control and Prevention recently made revisions to federal COVID-19 quarantine and isolation guidance, and those revisions have drawn criticism from the American Medical Association, which said this week that the new guidance is confusing and counterproductive.
In late December, the CDC recommended shortening isolation time for those with COVID-19, to five days for those who are asymptomatic or whose symptoms are resolving, meaning they've been without fever for 24 hours.
Following this recommended five-day isolation period, the CDC has advised that people should wear a mask around others for another five-day stretch in order to minimize the risk of infecting others. The change, the CDC said, is motivated by science demonstrating that the majority of coronavirus transmission occurs early in the course of illness, generally in the day or two prior to onset of symptoms, and the two to three days after.
Separate from the isolation guideline, the federal agency updated its recommended quarantine period for anyone exposed to the virus. For those who are unvaccinated, or whose second vaccine dose was administered more than six months ago, the CDC is suggesting people quarantine for five days followed by five days of strict mask use around others. If a five-day quarantine isn't feasible, the agency said people should wear masks around others at all times when around others for 10 days after exposure. Those who have received a booster don't have to quarantine, the CDC said, but should still wear a mask for 10 days.
The CDC makes a distinction between isolation and quarantine. Isolation, the agency said, relates to behavior after a confirmed infection, while quarantine refers to the time following exposure to the virus or close contact with someone known to have COVID-19.
AMA President Dr. Gerald Harmon said Wednesday that the new recommendations are confusing and potentially risk further spread of the virus.
"According to the CDC's own rationale for shortened isolation periods for the general public, an estimated 31% of people remain infectious five days after a positive COVID-19 test," said Harmon. "With hundreds of thousands of new cases daily, and more than a million positive reported cases on January 3, tens of thousands – potentially hundreds of thousands of people – could return to work and school infectious if they follow the CDC's new guidance on ending isolation after five days without a negative test. Physicians are concerned that these recommendations put our patients at risk and could further overwhelm our healthcare system."
By the AMA's reasoning, a negative test should be required for ending isolation after someone tests positive for COVID-19. Reemerging without knowing one's status, said Harmon, unnecessarily risks further transmission of the virus.
"Test availability remains a challenge in many parts of the country, including in hospitals, and we urge the administration to pull all available levers to ramp up production and distribution of tests," he said. "But a dearth of tests at the moment does not justify omitting a testing requirement to exit a now shortened isolation."
WHAT'S THE IMPACT?
Both updates come as the Omicron variant continues to spread throughout the U.S., though the CDC notes that the recommendations do not supersede state, local, tribal, or territorial laws, rules, and regulations, nor do they apply to healthcare workers, for whom CDC has updated guidance.
Data from South Africa and the United Kingdom demonstrate that effectiveness against infection for two doses of an mRNA vaccine is about 35%. A COVID-19 vaccine booster dose restores vaccine effectiveness against infection to 75%, the CDC said.
"The Omicron variant is spreading quickly and has the potential to impact all facets of our society," said CDC Director Dr. Rochelle Walensky. "CDC's updated recommendations for isolation and quarantine balance what we know about the spread of the virus and the protection provided by vaccination and booster doses. These updates ensure people can safely continue their daily lives. Prevention is our best option: Get vaccinated, get boosted, wear a mask in public indoor settings in areas of substantial and high community transmission, and take a test before you gather."
THE LARGER TREND
Nationally, the U.S. has struggled to shake the pandemic, which is currently experiencing yet another surge. The Johns Hopkins coronavirus tracker shows the country's 28-day case total at about eight million, bringing the overall total to almost 58 million. In the past 28 days, 37,295 Americans have died of COVID-19 or a combination of the coronavirus and other comorbidities.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
