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


“I think they’re trying to thread a fairly 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 their COVID-19 guidelines. Officials dropped the recommendation that people quarantine themselves if they come into close contact with an infected person, and said people don’t need to stay at least 6 feet 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 from vaccination or prior infection, CDC officials said.

For some, these changes are seen as a reckless step that will only put more Americans at risk. Others think too many COVID-related guidelines are still in place.

A boost for practicality

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

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

Siedner characterized the CDC as more of a political organization, one that does not necessarily have the ability to mandate state-level practice. Yet its role in trying 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 being more aware of its complexities. New variants and the changing landscape of vaccination in America have added other wrinkles.

So Siedner sees these new guidelines as an attempt to take an enormous amount of information and condense it into digestible pieces for the average person who wants to do their best within their means.

Quarantine changes

One example, he said, is the change in quarantine recommendations. Especially with the spread of the highly contagious BA.5 variant, asking everyone who has been exposed to someone with the virus to self-quarantine is unlikely to succeed.

“Are people really going to follow a directive where they have to take time off from work or school for ten days? What this focuses on is saying “how can we ensure that those most at risk during the most risky times are protected?” How can we stop transmitting the most likely situations and focus on the things that people are really going to be able to accomplish in their day-to-day lives? ” did he declare.

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

Now the CDC says anyone who has been exposed to the virus can continue with their life regardless of their vaccination status, as long as they are asymptomatic. They still have to wear a mask for ten days, self-monitor for symptoms and get tested.

Siedner said that was reasonable. Through research, Siedner and his colleagues found that once a person is infected, the length of time they shed the virus does not differ based on vaccination status. If a person knows they are infected, they should completely isolate themselves, regardless of their vaccination status, he said.

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

“This should not be confused with the fact that vaccinations are overwhelmingly protective. It is the best protection we have against serious illness, hospitalization and death.

Masking measures

Notably, general mask guidelines have not changed. CDC officials still recommend that anyone age two and older wear a properly fitting mask in public indoor spaces when local COVID community levels are high. People at high risk of serious illness should also mask up when their communities are at an average level.

Currently, CDC data shows that just under 40% of counties in America have a community level classified as high. Just over 40% of counties have an average community level. Information on how community levels are calculated can be found on the CDC’s website.

Although many people may have stopped wearing masks, Siedner said they were still an indispensable tool in preventing transmission. They definitely need to be worn in places like nursing homes and hospitals, he said, but people also need to be aware that immunocompromised people can be anywhere and that masking helps protect them.

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

While easing CDC guidelines makes sense according to Siedner, the public shouldn’t 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 United States dying every day from COVID-19, which would make it the third or fourth biggest killer in the country next year if this continues,” Siedner said. “We know how to prevent that from happening. It’s vaccinate and boost. Our vaccination rates are quite good, our recall rates are moderate, and our childhood vaccination rates are extremely low. We have a lot of work to do, and the best way to protect ourselves is to make sure we stay up to date on vaccinations. »

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