CDC eases Covid-19 quarantine and testing guidelines as it marks a new phase in pandemic

People who are not up to date with their Covid-19 vaccines and who are exposed to someone infected with the coronavirus no longer need to quarantine, according to updated recommendations issued Thursday by the Centers for Disease Control and Prevention.

Instead, they should just wear a mask for 10 days in indoor settings and test on day 5,  according to the guidance. They were previously recommended to stay home.

The new guidelines could also ease the testing burden on schools. While people showing symptoms of Covid should be tested, the recommendations say broader screening “might not be cost-effective in general community settings, especially if Covid-19 prevalence is low.” Such widespread testing could still be done in certain settings like long-term care facilities, correctional facilities, and homeless shelters.

The agency is no longer recommending “test-to-stay” policies for schools, when unvaccinated children exposed to someone with Covid could stay in school as long as they tested negative instead of having to quarantine.

Sarah Lee, a school health expert at the CDC, said the agency removed the “test-to-stay” guideline because the agency no longer recommended quarantine broadly. But she said on a press call that schools could still consider using widespread testing during outbreaks or during periods of high Covid-19 prevalence for events like sport tournaments and proms or for after school breaks.

Taken together, the new guidance no longer comes across as a list of things to do or to avoid and instead offers more general guidelines about what settings present more of a threat of transmission (indoor, crowded settings with poor ventilation) and who is at higher risk for a more severe outcome of a Covid infection — essentially, older people and those with other health issues, particularly if they are unvaccinated or not up to date with shots.

For example, the guidelines deemphasize physical distancing as a specific strategy people should adhere to, instead framing it as just one step people can employ to decrease their risk of getting Covid. People can assess their need to take precautions like distancing and masking based on local transmission levels and how well ventilated the area they’re in is, the guidelines say.

One recommendation that remains the same: people with Covid-19 should isolate for at least five days and perhaps longer, depending on how sick they get and whether their symptoms persist. If people leave isolation on day 5, they should wear a mask through day 10, or test negative twice over 48 hours before they stop wearing a mask.

The CDC portrayed its updated guidance as a “streamlining” of policies, a framework that can help people move on from the acute phase of the pandemic while still trying to protect themselves against the ongoing spread of the SARS-CoV-2 virus.

“This guidance acknowledges that the pandemic is not over, but also helps us move to a point where Covid-19 no longer severely disrupts our daily lives,” Greta Massetti, one of the authors of the CDC guidelines, said in a statement.

The agency is still emphasizing all the tools people have to lower their risk of getting Covid and getting severely ill — from vaccinations and boosters to therapies like Evusheld to masking and ventilation. But it added that its new guidelines can help minimize the risk of severe illness as well as strain on the health care system “while reducing barriers to social, educational, and economic activity.”

The guidelines come as the country has entered into perhaps a new phase of the virus, one with persistently high transmission and what would have once been a jarring number of daily deaths, but also one that many experts foresee as our consistent pattern for at least the near future.

Separately, the Food and Drug Administration also issued a safety communication Thursday advising that at-home rapid antigen tests can deliver false-negative results. For those with Covid symptoms, the FDA now advises that people take two home Covid tests over 48 hours. For those who do not have symptoms but suspect a Covid exposure, the FDA now recommends up to three separate tests, each separated by a 48-hour period.

“Be aware that at-home Covid-19 antigen tests are less accurate than molecular tests,” the FDA wrote in its warning. “Covid-19 antigen tests may not detect the SARS-CoV-2 virus early in an infection, meaning testing soon after you were exposed to someone with Covid-19 could lead to a false-negative result, especially if you don’t have symptoms.”

A positive result on any of these tests likely means that a person has Covid, the FDA emphasized. It pointed to data from a study conducted by researchers at the University of Massachusetts Chan Medical School, working with the FDA, that showed that repeat testing reduced the risk of negative results.

The CDC’s latest recommendations are just that. In most cases, actual policies would have to be set at state or local levels, and political leaders broadly rolled back mandatory mitigation efforts months ago.

Already, most communities and individuals have moved on from embracing precautionary measures. The CDC still recommends that people living in areas with high levels of transmission — roughly 40% of communities as of Thursday — wear masks in public indoor settings, but it does not seem that many people are looking to the CDC’s maps to make a decision about whether to mask up or not.

Yet the updated guidelines are also arriving as schools and universities welcome students back, and some districts could look to the agency for best practices on issues including testing and distancing.

As the CDC noted, the vast majority of people in the country — some 95% of people — have some layers of protection against Covid, whether through vaccination, past infection, or both. As of February 2022, 3 in 4 children had already had Covid at least once, according to a federal study. And as of mid-June, vaccines have been available for children as young as 6 months.

As the guidance states, “high levels of vaccine- and infection-induced immunity and the availability of effective treatments and prevention tools have substantially reduced the risk of medically significant Covid-19 illness.”

Matthew Herper contributed reporting.