COVID

How reasonable are the CDC’s recent changes to COVID guidelines?

"I think they're trying to thread a pretty difficult needle."

A sign at the entrance to the Centers for Disease Control and Prevention in Atlanta. Ron Harris/Associated Press

Last week, The Centers for Disease Control and Prevention made major changes to its COVID-19 guidelines. Officials dropped the recommendation that people quarantine themselves if they come into close contact with an infected person, and said that people do not need to stay at least 6 feet away from others to prevent the spread of the virus. 

These changes were spurred by the fact that most Americans now have some level of immunity, whether that comes from a vaccination or previous infection, CDC officials said. 

To some, these changes are seen as a reckless step that will only endanger more Americans. Others believe that too much COVID-related guidance is still in place. 

A push for practicality

Mark Siedner, an infectious disease clinician and researcher at Massachusetts General Hospital, sees the changes as a logical move for the CDC aimed at giving people practical advice that can keep them safe.  

“I think they’re trying to thread a pretty difficult needle,” he said. “They’re trying to increase the practicality of these guidelines, get people towards things that are going to have the most benefit and away from things that probably were important early in the epidemic but have less relevance with the new variants and the new amount of immunity across the population.”

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Siedner characterized the CDC as more of a political organization, one that doesn’t necessarily have the ability to mandate practice at the state level. Still, its role in attempting to simplify and streamline public health information is important. 

COVID is extremely complicated, he said. As more data is collected, researchers can better understand the virus while also being more aware of its complexities. New variants and a changing vaccination landscape in America have added further wrinkles. 

So Siedner views these new guidelines as an attempt to take a massive amount of information and condense it into digestible pieces for the average person that wants to do the best they can within their means. 

Quarantine changes

An example, he said, is the change to quarantine recommendations. Especially with the spread of the highly-contagious BA.5 variant, asking everyone who’s been exposed to someone with the virus to quarantine is just unlikely to be successful.

“Are people really going to follow a guideline where they have to remove themselves from work or school for ten days? What this is focusing on is saying ‘how do we make sure that the highest-risk people during the highest-risk time periods are protected? How do we stop transmission from the most likely situations and focus on things that people really are going to be able to accomplish in their day-to-day lives?'” he said. 

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The CDC previously recommended that people who were not up-to-date on vaccinations and had been in close contact with an infected person quarantine for at least five days. They also specified that people with all their vaccinations did not need to quarantine if they were asymptomatic. 

Now, the CDC says that anyone who has been exposed to the virus can continue about their lives regardless of vaccination status, as long as they are asymptomatic. They should still wear a mask for ten days, monitor themselves for symptoms, and get tested. 

Siedner said this is reasonable. Through research, Siedner and his colleagues found that once a person is infected, how long they shed the virus doesn’t differ based on vaccination status. If a person knows they are infected, they should completely isolate themselves irrespective of vaccination status, he said. 

But he stressed that vaccinations remain essential in the fight to save lives. 

“That shouldn’t be confused with the point that vaccinations are massively protective. It’s the best protection we have against severe disease, hospitalization, and death.”

Masking measures

Notably, the general mask guidelines did not change. CDC officials still recommend that everyone aged two and older wear a well-fitting mask in public indoor spaces when the local COVID community level is high. People who are at high risk for severe disease should also mask up when their communities are at a medium level. 

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Right now, CDC data shows that just under 40% of counties in America have a community level classified as high. Just over 40% of counties have a medium community level. Information about how community levels are calculated can be found on the CDC website

Although many people may have stopped wearing masks, Siedner said that they are still a much-needed tool to prevent transmission. They should absolutely be worn in places like nursing homes and hospitals, he said, but people should also be aware that immunocompromised people can be anywhere and masking helps protect them. 

“We know masks work. They’re not a panacea, they don’t solve the entire problem, but I do think they have an important role to play in helping to reduce risk,” he said.

Although the relaxation of CDC guidelines makes sense in Siedner’s view, the public should not lose sight of the fact that many are still dying from the virus. The best way to save lives, he said, is widespread vaccination. 

“There are still 400 or 500 people in the U.S. dying a day of COVID-19, which would make it the third or fourth biggest killer in the country next year if that continues,” Siedner said. “We know how to stop that from happening. It’s vaccinating and boosting. Our vaccination rates are pretty good, our boosting rates are moderate, and our vaccination rates for children are extremely low. We have a lot of work to do, and the best way we can protect ourselves is to make sure that we stay up-to-date on vaccinations.”

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