PSA - go to the source!!

[dreamshark]

 The CDC finally updated their guidance on isolation/quarantine for COVID, a move that was long overdue. But to their credit, the new guidelines are presented on the CDC site in a set of clear and concise bullet points. Isolation guidelines (for people who test positive for COVID-19) are:

• Stay home for 5 days.
• If you have no symptoms or your symptoms are resolving after 5 days, you can leave your house.
• Continue to wear a mask around others for 5 additional days.
• If you have a fever, continue to stay home until your fever resolves.

Pretty straightforward, right? But astoundingly, every major news source that I follow has proven incapable of repeating this information correctly. The headline in the Washington Post reads, "CDC cuts isolation time recommended for people with asymptomatic coronavirus infections," which is absolutely not what the CDC said!  An asymptomatic infection is one where the patient never develops symptoms. The actual CDC guidance clearly covers mild to moderate cases and never uses the widely misunderstood term "asymptomatic." The NPR  report made the same mistake, but was even more explicit about saying, "People who are infected without developing symptoms." MPR just parroted NPR. The Star Tribune got the "symptoms are resolving" part correct but managed to mix up the definitions of isolation and quarantine (which are clearly defined on the CDC site). Infuriating and disappointing. This wasn't that difficult a story, guys! 

Anyway, if you are in a situation where you need to know what the actual guidance is, ignore everything you read or hear in the news media and go right to the source. And that is my Public Service Announcement for today.

Comments

[quadong]

Generally good advice.

[bibliofile]

I suspect the AP story for this error. First paragraph: "asymptomatic". [buzzer sound]

[minnehaha]

The overwhelming assumption is that five days and all is well?

Jen got a sore throat on morning of 26th and became quite sick. She got tested on 27th, and got her positive result on the 28th. She is still sick, but breathing well. So these guidelines say that she can go out on the 31st?

Hmm.

K.

[dreamshark]

Yeah, I guess it is unclear on what you are supposed to do if symptoms last longer than 5 days unless it involves a fever. The explanation at the top of the news release says,

"The change is motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after."

That seems to imply that even people who are symptomatic for a week are not contagious past the 5th day. Is there actually "science" that says that, or is that a figment of averaging? I dunno. But that's what the CDC says.

I note that common wisdom insists that colds are only contagious in the first few days no matter how long symptoms last. I've never been convinced that was true either, but that's what people say. And this coronavirus does seem to be following the trajectory of diminishing into a common cold, although it may not be there quite yet.

[pameladean]

It would be useful if the source could be bothered to define what the hell it means for symptoms to be resolving.

This looks like a pure cave-in to economic pressure to me. I don't think the science is there.

P.

[dreamshark]

I think they should have revisited the isolation and (especially) the quarantine guidelines months ago when it became obvious that the incubation period was not as long as originally thought. And I think there is quite a bit of data supporting the assertion that transmissibility is highest in the early days of infection and that infections are contagious for a shorter time in the vaxed than the unvaxed. But refusing to address the topic for months and then rushing out not one but TWO head-spinning changes in guidance within a week when hospitals and airlines started melting down was not the best way to handle it.

I agree that it looks like "a pure cave-in to economic pressure" even if it is not. The CDC just can't stop shooting its own credibility in the feet.

[pameladean]

While of course it's not a laughing matter, I loved "shooting its own credibility in the feet" and it made me laugh a lot, which was very welcome.

It is certainly hard to sort out the actual rationale from the CDC's general behavior. The CDC was really wrecked by the previous administration; I have seen science writers lamenting that not only the core pandemic response team but also the trained communication team were fired. And that can't be put back together fast.

Epidemiologists and virologists whom I follow are pretty uniformly aghast at this new guidance, but no doubt that is a bubble of sorts. Their concern is that there is plenty of data supporting a shorter quarantine, especially if you add a requirement for one or two negative tests -- but that almost none of the data is about Omicron. It's plausible to speculate that since Omicron is so fast generally, it might clear out faster. But I don't think they actually have that data yet. Several of the epidemiologists are concerned because they acknowledge the CDC may know more than they do, but the CDC didn't present the science, they just said there was some. That, of course, could be from the general disarray rather than an intention to deceive.

I guess we'll see.

P.

[dreamshark]

Good point about the lack of hard info on omicron. But if they had loosened up on the quarantine/isolation periods earlier (which I contend there was good reason to do) the only question would have been whether it needed to be tightened again to deal with Omicron. And there is clearly no evidence of that being necessary (with preliminary data indicating the opposite).

The CDC was certainly under fire from the odious previous administration, but IMHO the problems we are seeing in their response to COVID are part of the long-term culture of the CDC, not due to recent political trauma. They are just very conservative in their guidance and very resistant to assimilating new data into their policy statements.

[davidwilford]

I'll continue to wear a mask (a double one) when I go out anywhere in public. Besides, it's cold out there.