CDC COVID isolation guidelines: Experts are confused about testing

The Centers for Disease Control and Prevention on Tuesday, January 4, clarified its position on testing in their new COVID-19 isolation guidelines – which led to criticism from experts who say the agency’s update further confuses its guidance.

On December 27, the CDC reviewed its isolation guidelines, saying that people infected with coronavirus should now be isolated for five days instead of 10 days if they are asymptomatic or if their symptoms “disappear”. But the agency said the five-day isolation period should be followed by five days of wearing a face mask around others.

The CDC’s new guidelines do not include a requirement to test negative for COVID-19 to complete isolation – a problem among some experts who have questioned the safety of the guide as the new omicron variant spreads.

Despite the setback, the CDC stood by its decision not to include a test claim. On January 4, the agency clarified that those who have access to a test and who wish to take it before completing their isolation can do so, but it stopped recommending it.

The guidelines now say that for those who want to take a test, the “best approach” is to use an antigen test at the end of the five-day isolation period. If it is positive, continue isolating for five more days, the CDC says. If it is negative, you can finish the insulation, but you should continue to wear a mask around others for five days.

Experts weigh in

Experts have largely been critical of the CDC’s clarification.

“Listen, I am totally into testing-out-of-isolation. No need to keep people at home unnecessarily, ”tweeted Dr. Megan Ranney, the Academic Dean of the Brown University School of Public Health. “But this new guide is so complicated that I have trouble giving a concise tweet about it. Which does not bode well for us to be able to follow it.”

Dr. Céline Gounder, an infectious disease expert and professor at the NYU Grossman School of Medicine, agreed that the change is confusing.

It feels like a bit of a ‘choose your own adventure’: if this, then this; if this, then this, “she said on Wednesday, January 5, on” CBS Mornings. “” I think that kind of complicated algorithm can work in the intensive care unit of a hospital, but it does not work very well as a public health guide. “

Dr. Shikha Jain, a hematology and oncology doctor, made similar comments on Twitter.

“I feel like the person writing ‘Choose Your Own Adventure’ books wrote these …I’m so confused,” she wrote.

Dr. Leana Wen, a professor of health policy and management at George Washington University, told CNN that the CDC’s clarification “made things worse” and discourages testing.

“Now they say that if you somehow get your fingers in a test and you test positive on day five, then you should extend your isolation for five days until day 10,” she said. “So basically they make it a deterrent to be tested. Who wants to be tested so they can stay in isolation for longer?”

She said she believes the CDC should be upfront and “say they can not do this because we just do not have enough testing to test out of isolation.”

Gounder also pointed out that the guide comes under lack of quick tests.

“It’s really about the availability of these rapid antigen tests, and they’re still a scarce commodity across the country,” she told CBS when asked why the CDC stopped recommending a test to end isolation. “If you have access to one of these tests, you should definitely make use of them as part of your decision-making. But unfortunately, too many people still do not have access.”

Dr. Ashish Jha, third dean of the Brown University School of Public Health, considered what an ideal isolation would look like, in his opinion.

Dr. Anthony Fauci, the country’s best expert in infectious diseases, said earlier Sunday, Jan. 2, that the CDC was considering updating its guidelines again after the initial setback to its recommendations.

“Wow I did not see this coming – the updated CDC guide just says that if you want to test, keep going, ”tweeted Dr. Walid Gellad, Professor of Medicine at the University of Pittsburgh. “It was not at all what I expected when Fauci said over the weekend that there is a way to include testing in the isolation manual.”

On the CDC’s guidelines for isolation

The agency updated its guidelines after a push from some experts to shorten the isolation period. The concern was that as omicron – which appears to be able to transmit and avoid COVID-19 vaccines more easily – spread, more people would become infected, making a 10-day isolation unsustainable and disruptive to society.

However, when the agency shortened the isolation period to five days and omitted a test requirement, some experts cast doubt on the safety of the guidelines.

However, the CDC said its guidance is “science-motivated,” showing that the majority of coronavirus transmission usually occurs early in an infection: one to two days before symptoms begin and two to three days after.

CDC Director Dr. Rochelle Walensky said earlier on CNN’s “New Day” that the agency also took into account what period people would “tolerate” as some evidence has shown, few people isolate when they need it.

Fauci explained on MSNBC that the CDC did not include a test requirement because although the antigen tests used are good for determining whether a person is infected or not, they do not have a “good predictable value as to whether you ‘transmit’ viruses.

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Bailey Aldridge is a reporter covering real-time news in North and South Carolina. She holds a degree in journalism from the University of North Carolina at Chapel Hill.

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