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COVID-19 is becoming more like the flu and, as such, no longer requires its own virus-specific health rules, the Centers for Disease Control and Prevention said Friday along with the release of a unified document “respiratory virus guide“.
in a long background document, the agency laid out its rationale for consolidating COVID-19 guidance into general guidance for respiratory viruses, including influenza, RSV, adenoviruses, rhinoviruses, enteroviruses and others, although specifically not measles. The agency also noted that the guidance does not apply to healthcare settings or outbreak scenarios.
“COVID-19 remains a significant public health threat, but it is no longer the emergency it once was, and its health impacts increasingly resemble those of other respiratory viral diseases, including influenza and VRS,” the agency wrote.
The most notable change in the new guidance is the previously reported decision to no longer recommend a minimum five-day isolation period for people infected with the pandemic coronavirus, SARS-CoV-2. Instead, the new isolation guidance is based on symptoms, which is consistent with long-standing isolation guidance for other respiratory viruses, including influenza.
“The updated Respiratory Virus Guidance recommends that people with respiratory virus symptoms that are not better explained by another cause stay home and away from others until at least 24 hours after both fever and overall symptoms improve.” , the document states. “This recommendation addresses the period of greatest infectiousness and highest viral load for most people, which typically occurs in the early days of illness and when symptoms, including fever, are worst.”
“Residual risk”
The CDC acknowledged that the isolation guidance provided will create a “residual risk of SARS-CoV-2 transmission” and that most people will no longer be contagious only after 8 to 10 days. As such, the agency urged people to follow additional interventions (including masking, testing, distancing, hygiene, and improving air quality) for five additional days after their isolation period.
“Today’s announcement reflects the progress we have made in protecting against serious illness caused by COVID-19,” CDC Director Dr. Mandy Cohen said in a statement. “However, we still need to use the common sense solutions that we know work to protect ourselves and others from serious illness caused by respiratory viruses; this includes vaccination, treatment, and staying home when we get sick.”
Overall, the agency argued that a shorter isolation period would be of no consequence. Other countries and states that also abandoned fixed isolation times saw no increases in emergency department visits or COVID-19 hospitalizations, the CDC noted. And most people who have COVID-19 don’t know they have it anyway, making COVID-19-specific guidelines moot, the agency argued. In a recent CDC survey, fewer than half of people said they would get tested for SARS-CoV-2 if they had cough or cold symptoms, and fewer than 10 percent said they would go to a pharmacy or provider. healthcare provider to get tested. Meanwhile, “the overall sensitivity of COVID-19 antigen tests is relatively low and even lower in individuals with mild symptoms,” the agency said.
The CDC also raised practical concerns about isolation, including the lack of paid sick leave for many, social isolation, and “social costs.”
The points likely won’t go down well with critics.
“The CDC is once again prioritizing short-term business interests over our health by bowing to employer pressure over COVID guidelines. This is a pattern we have seen throughout the pandemic,” he said in Press release last month after news of the CDC’s planned isolation update first broke. Jirmanus is a member of the People’s CDC, a group advocating for more aggressive COVID-19 policies, which issued the press release.
Another member of the group, Sam Friedman, a professor of population health at New York University Grossman School of Medicine, also criticized the CDC’s stance last month. The guidance “will make workplaces and public spaces even more unsafe for everyone, particularly people at high risk for COVID complications,” he said.
COVID and flu
But the CDC maintains that the threat of COVID-19 is fading. Hospitalizations, deaths, prevalence of long COVID, and complications of COVID-19 in children (MIS-C) have decreased. COVID-19 vaccines are safe and effective at preventing serious illness, death, and, to some extent, long COVID; We just need more people to receive them. More than 95 percent of adults hospitalized with COVID-19 in the 2023-2024 respiratory season had no history of receiving the seasonal booster dose, the agency noted. Only 22 percent of adults received the latest vaccine, including just 42 percent of people 65 and older. In contrast, 48 percent of adults received their last flu vaccine, including 73 percent of people 65 and older.
But even with dismal COVID-19 vaccination rates, a combination of past infections and vaccinations has led to substantial protection in the general population. The CDC even went so far as to argue that COVID-19 deaths have fallen to a level similar to that seen with the flu.
“Reported deaths related to COVID-19 are several times higher than those reported related to influenza and RSV. However, influenza and probable RSV are often underreported as causes of death,” the CDC said. In the 2022-2023 respiratory virus season, nearly 90,000 COVID-19 deaths were reported. From the flu, 9,559 deaths were reported, but the CDC estimates the true number to be between 18,000 and 97,000. In the current season, 32,949 COVID-19 deaths and 5,854 influenza deaths have been reported to date, but the agency estimates actual influenza deaths to be between 17,000 and 50,000.
“It is likely that the total deaths from COVID-19, taking into account underreporting, are greater than the total deaths from influenza, but of the same order of magnitude,” the agency concluded.
In all, the CDC was ready to include SARS-CoV-2 in the group of common seasonal respiratory viruses, and most cases are mild and undiagnosed. “Viruses cause most acute respiratory illnesses, but it is rarely possible to determine the type of virus without testing, and testing often does not change clinical treatment,” the agency wrote.