What to Know About Possible Changes to COVID Isolation Guidelines by CDC in the Coming Months

The Centers for Disease Control and Prevention (CDC) may soon dial back its isolation guidance for people with COVID-19, the Washington Post reported on Tuesday.

The potential pivot—which the Post attributed to several unnamed CDC officials—would reduce the isolation time after a COVID diagnosis from five days to just 24 hours without a fever. The change could come as early as April.

The CDC has not yet confirmed the report. “[There are] no updates to COVID guidelines to announce at this time,” a CDC spokesperson told Health in a statement. “We will continue to make decisions based on the best evidence and science to keep communities [healthy] and safe.”

If the change takes place, the new COVID isolation guidance would be in line with CDC guidance around other respiratory viruses, like the flu. And while the move may be controversial, given that it comes with some added public health risk, many experts see it as a practical move.

“I think it makes sense from the broad perspective,” said Timothy Murphy, MD, senior associate dean for clinical and translational research at the University at Buffalo. “For us to say, ‘Hey, isolate for five days,’ when already nobody is isolating for five days, is not really realistic.”

Here’s what to know about the potential changes and what they could mean for your future COVID strategy.

Should the reported changes in COVID guidance go into effect, the CDC would recommend that people who test positive for the virus rely on their symptoms rather than a specific number of days to determine the end of their isolation.

People would no longer need to stay home with COVID if they have been fever-free for 24 hours, without the use of medication, and if their symptoms are mild and improving. This is the same guidance that the CDC provides for people who have the flu. It’s unclear if masks would still be recommended after a person’s isolation period is up.

This wouldn’t be the first change in isolation guidance: In December 2021, the CDC walked back its recommendation of a 10-day isolation period for those with COVID to just five days of isolation in the absence of symptoms.

That previous change was attributed to various factors, including the country's increased immunity, more treatment and prevention tools, and a better understanding of the virus by public health officials.

The guideline changes would also follow similar moves by Oregon and California—both states have moved away from suggesting isolation for a set number of days and instead rely on symptoms.

“Oregon and California actually changed their guidelines a little while ago, and while there’s a fair amount of disease circulating, they’re not seeing increasing amounts of numbers of hospitalizations and deaths and so forth,” said Murphy. “The U.K. and Denmark, other Scandinavian countries, [and] Australia made changes to isolation recommendations.”

The possible changes come at a time when some healthcare professionals and health officials believe that the current guidelines are no longer as effective or necessary as they once were.

In the last month, the U.S. was seeing, on average, just shy of 2,000 deaths from COVID weekly, which were some of the highest death counts in a year. However, in the year prior—even after the spike in cases and deaths due to the original Omicron wave in late 2021 and early 2022—the U.S. was still regularly seeing between 1,900 and 3,600 weekly deaths.

Wastewater data reflects similar findings—even the holiday rise in COVID activity over the last few months pales in comparison to activity levels in early 2022, right after the CDC last updated its isolation guidelines.

Also, at this point, COVID treatments are accessible for people who do get sick and may be at high risk, Murphy said, adding that practicality is another argument for loosening the isolation guidelines for COVID.

“The reality is, I think many people are not really following the current guidelines,” Murphy said. “It’s kind of a 10-day hit, if you will, if you have COVID now.”

The fact that getting COVID can be so disruptive to someone’s schedule may actually disincentivize them from following the guidelines, or from testing in the first place, Murphy added. In this way, a more relaxed isolation policy could make it easier for people to not spread the virus.

Though there may be upsides to getting rid of blanket isolation requirements, the CDC’s decision would still be controversial.

“My initial opinion was, it’s probably a good idea,” said Murphy. “But recognizing there is disagreement about that, there are pluses and minuses.”

Most obviously, even though COVID deaths are down as comparatively, the virus is still killing thousands of Americans each week. Especially for those who are immunocompromised, elderly, or have underlying conditions, the virus is a serious threat, Murphy said.

Even those who aren’t at high risk of hospitalization or death from COVID can still develop long COVID, Murphy added, which is a major concern.

And even though nationwide immunity is high, loosening isolation guidelines could be a concern considering just how few people have an updated COVID vaccine. But on the positive side, Murphy said, knowing you may have a higher chance of being exposed to COVID could spur people to get vaccinated.

“[Vaccination uptake] is disappointingly low,” he said. “This is an opportunity, I think, for us...to encourage people to get vaccinated.”

If COVID guidelines do become more lax, people should still take COVID infections seriously to keep themselves, their family, and their neighbors safe. At this point in the pandemic, it just comes down to common sense preventative action, Murphy said.

The end of mandated isolation wouldn’t necessarily mean that people should go out and about if they’re ill, Murphy added. It’s just about doing what makes the most sense for your health and community.

“If you’re able to stay home, in fairness to coworkers and those around you, I think when you have a cough and a significant runny nose, you should stay home,” he said.

Additionally, even if they’re not staying home, people should consider “strategic mask wearing” in the days after a mild COVID infection, Murphy said.

“If you know you have COVID, if you are recovering from an illness, or [you’re] ill and you’re going to work, wear a mask when you’re in the subway or in a crowded meeting room, and then take it off for the rest of the day,” he explained. “Just being mindful and strategic about those things can really help reduce transmission.”