CDC on Thursday released new Covid-19 guidelines, loosening quarantine and exposure recommendations. The agency also said that because of population-level immunity and available treatments, the risk of developing severe Covid-19 is low in the United States.

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Details on the new CDC guidance

According to the new guidance, people exposed to the coronavirus—regardless of vaccination status—no longer need to quarantine. Instead, individuals are recommended to wear a mask for 10 days and take a Covid-19 test on day five.

Those who test positive for Covid-19 are recommended to isolate for five days. CDC noted that those who test positive are most infectious during the first five days following their positive test, and even if they are asymptomatic, CDC still recommends a five-day isolation. After that period, those who feel better and have no fever may end their isolation.

Those who test positive for Covid-19 should also wear a mask for a full 10 days, regardless of their symptoms, CDC said. And those who experience a resurgence of symptoms after day 10 should restart their isolation period.

In addition, CDC no longer recommends that people stay six feet away from each other. Instead, it recommends avoiding crowded areas and maintaining a distance from others as ways to reduce individuals' risks. The agency also "recommends case investigation and contact tracing only in healthcare settings and certain high-risk congregate settings."

The guidelines end the "test to stay" recommendations for schools, in which unvaccinated students exposed to the coronavirus were required to test negative in order to return to in-person schooling. CDC also recommends schools consider surveillance in specific situations, including when students return from school break or for students participating in contact sports.

"We know that Covid-19 is here to stay," said Greta Massetti, an epidemiologist at CDC. "High levels of population immunity due to vaccination and previous infection, and the many tools that we have available to protect people from severe illness and death, have put us in a different place."

FDA recommends taking multiple at-home Covid-19 tests

FDA on Thursday released new guidance, acknowledging that at-home Covid-19 tests are less accurate than PCR tests and recommending that people take multiple at-home tests.

"Currently, all at-home COVID-19 antigen tests are FDA-authorized for repeat, or serial use," FDA said. "This means people should use multiple tests over a certain time period, such as 2-3 days, especially when the people using the tests don't have COVID-19 symptoms."

FDA recommended that, after exposure to the coronavirus, people should take an at-home test. If that test comes back negative and the person still has symptoms, they should take another test 48 hours later. If the second test is negative, they should consider a PCR test.

Meanwhile, if a person has no symptoms but believes they've been exposed to the coronavirus, FDA recommends they take a second at-home test 48 hours after their first one. If the second one is also negative, they should take a third test another 48 hours later.

Reaction

Many health experts praised CDC's new guidance. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, said the new guidance is "a welcome change. It actually shows how far we've come," adding that the new guidelines will also be easier for the public to follow.

Daniel McQuillen, president of the Infectious Diseases Society of America, also praised the new guidelines, saying they are "a positive sign that advances in vaccines and treatments have significantly lowered the risk of severe illness, hospitalization, and death."

However, he added, "with much of the country experiencing higher than 20% transmission rates, we cannot let our guard down."

Marcus Plescia, CMO for the Association of State and Territorial Health Officials, said the new guidelines aren't a significant overhaul of existing guidance but instead focus on individuals making their own decisions about their own risk of exposure to the coronavirus.

"That is consistent with where we are in the pandemic right now," he said. "I don't really think there are many state or local jurisdictions that are feeling they're going to need to start making mandates."

Mercedes Carnethon, an epidemiologist at the Northwestern University Feinberg School of Medicine, said she doesn't believe the new guidance should be viewed as a loosening of recommendations.

"We certainly know that wearing a high-quality mask is going to provide some of the strongest protection against spreading it to somebody else, and quarantine is logistically burdensome," she said. "That could be seen as a relaxing of guidelines, but I think it's a much more appropriate and targeted solution."

In addition, the American Federation of Teachers and other education experts welcomed the updated school guidance.

"Entire classrooms of kids had to miss school if they were deemed a close contact," said Joseph Allen, director of Harvard University's healthy building program. "The closed schools and learning disruption have been devastating."

However, Anne Sosin, a public health researcher at Dartmouth College, argued that CDC went too far in its new guidance, and said allowing students to return to school five days after an infection without a negative Covid-19 test could lead to outbreaks in schools, which could cause those schools to temporarily shut down.

"All of us want a stable school year, but wishful thinking is not the strategy for getting there," she said. "If we want a return to normal in our schools, we have to invest in the conditions for that, not just drop everything haphazardly like we're seeing across the country." (Cohen, Roll Call, 8/11; Anthes, New York Times, 8/12; Stone/Huang, "Shots," NPR, 8/11; Choi, The Hill, 8/11; Stobbe/Binkley, Associated Press, 8/11; Frieden, MedPage Today, 8/11)