What updated Covid guidelines mean
Some experts disagree with new CDC guidelines, but the bottom line is clear: simple steps like ventilation, testing, masks and vaccinations allow most of us to carry-on our daily lives just fine.
While traveling in the past week, I had a chance to see how people from different places are adapting to “normal life” even though Covid continues to spread and settles in for the long term. What I saw was encouraging. We all want Covid to be over, but “over” more likely means “no longer a major health threat.”
As we’ve noted, most of us can go about daily activities without much fear, if we are fully vaccinated (3 doses of an mRNA vaccine, plus a booster in 2022 if the third shot was in 2021) and take reasonable precautions, such as putting on a properly fit N95 or KN95 mask when close to others and improving ventilation anytime indoors. Those with underlying health issues may be at much greater risk, however, so we must be careful around others.
Restaurants and many services were available outdoors or in places with plenty of open windows or other ventilation. Exceptions included elevators, but I’d estimate that at least half the people I encountered put masks on for the ride. The only place where I expected to see more masks was a grocery store, where only a few staff members were masked and most customers were not. (I kept my mask on.)
The other unexpected thing was that many people were wearing masks while walking out on the street. This seemed unnecessary to me, but I realized that some may have been tourists from Asian nations where masks have been socially accepted — or expected - for many years.
What was great was that each person was able to do what they felt was best for their own comfort level. Whether masked or not, people gave each other the same friendly greetings.
I remain in the camp of people who really wants to avoid getting Covid, both because of my own health and because I don’t want to bring it to others, such as friends or family who may be at higher risk.
Where things get confusing: there is a ton of outdated Covid information circulating. Signs at airports and even some “alerts” on airline websites or apps did not reflect the latest status or guidance. Does the “masks required” sign on the entry door to a store really mean it, or is that left from months ago? Must I stay home if I tested positive? It shouldn’t be so mixed up.
The latest CDC guidelines are an attempt to simplify Covid precautions, but quite a few prominent experts are criticizing both the guidelines and how the CDC is communicating about them.
First, let’s look at what the CDC is telling us:
Among the more significant changes is the recommendation that people can avoid quarantine even if they were exposed to a person with Covid, if they are fully vaccinated and wear a mask for 10 days. The CDC also allows a person who gets sick from Covid to end isolation after 5 days if symptoms have improved and there has been no fever for at least 24 hours.
Contrary to what many public health experts recommend, the CDC does not require negative testing before ending isolation, although the guideline suggests two sequential negative home tests before removing your mask.
Scripps Research Institute’s Eric Topol is among the experts criticizing CDC for basing guidance on “community level” instead of “transmission rates.” The community level is a flawed measure of Covid risk because it doesn’t reflect the actual number of cases in a community but instead focuses more on hospital capacity and metrics that don’t reflect whether you have a risk of getting infected yourself, say the critics. Now that self-tests are widely available and mild Covid cases frequently don’t require medical care, there are many cases that don’t get counted. But that doens’t mean the risk is low. In fact, cases are still rising nearly everywhere:
Here is Dr. Topol’s take:
Former Surgeon General Jerome Adams shared what he thinks the current guidance should say:
Because we have moved to an almost 100% voluntary Covid precautions mode, knowing your risk is important. This graphic illustrates how underlying conditions such as diabetes impacts your risk:
The bottom line: In many communities, your local county health department will have guidelines based on the situation around you, so that’s the first place to check. Generally, use antigen tests frequently - especially before going into an event or a home where there are vulnerable people. Wear masks whenever you think you might be around others in close quarters. Boost ventilation whenever possible. And if you aren’t already vaccinated and boosted, get that extra shot (don’t wait for the multivalent vaccine if you haven’t gotten a booster this year.)
How are you navigating Covid these days?
I am currently on Day 11 of COVID. We have been extremely isolated for the last 2.5 years and are very careful. However, someone I interacted with recently was not. I feel miserable and seem to have a rebound case after a course of Paxlovid. And I am trying desperately not to give this to my husband who is higher risk and my child who is supposed to start school this week. I am very, very frustrated that they left off the testing to exit isolation requirement. I know it is disruptive, but schools are going to LIGHT UP in the next few weeks, because kids will be sent back to school while contagious. We have a good day-to-day routine, honesty, which is a little lonely, but we have found an acceptable level of risk for our family. I feel like the CDC guidance, however, is just giving up. I see them pressured by schools and businesses — I get it. But I am terrified of brain damage, heart damage, and the like — not to mention long Covid. And I am not eligible for a 4th shot yet… there are still lots of worries, and it feels like the rest of the country has just decided “to hell with it! We want to have fun!” What will the long-term costs of this carelessness be? I am certain there will be many.