Concerns Grow as CDC Considers Dropping Covid Isolation Recommendation
As the Centers for Disease Control and Prevention (CDC) prepares to drop its recommendation that those with Covid isolate for five days, concerns are growing among medically vulnerable individuals. People with compromised immune systems fear that their co-workers will return to the office while still contagious. Additionally, the few remaining policies guaranteeing paid leave for employees with Covid are coming to an end. New York, the only state that still requires paid leave for Covid isolation, is considering ending that benefit this summer.
The forthcoming change in isolation guidance has sparked a debate among experts. Supporters argue that it reflects the reality that many people with Covid are not isolating and that the threat of severe illness has diminished due to vaccination, prior infections, and antiviral treatment. However, critics argue that Covid should not be treated like other respiratory viruses because it currently hospitalizes and kills more people than the flu and can cause long-term complications that scientists are still trying to understand.
The new guidance, expected to be released in the spring, would align Covid-19 recommendations with those for other respiratory viruses. Individuals would be able to return to school and work if they have been fever-free for at least 24 hours without medication and have mild and improving symptoms. However, it is important to note that someone who tests positive for Covid can still be infectious beyond five days, and people without symptoms or fever can transmit the virus early in their illness.
The potential change in isolation recommendations raises concerns about increased risks for immunosuppressed individuals. While some argue that the risks must be weighed against the downsides of lengthy isolation, others believe there is a middle ground between living in fear and ignoring the virus. Pediatric infectious-disease specialist Paul Offit suggests that people should focus on isolating when sick rather than which virus they have, as all respiratory viruses can cause hospitalization or death.
Public health experts emphasize that easing measures to limit Covid transmission should not sacrifice the immunocompromised and elderly. They argue that there is a need to strike a balance between protecting public health and minimizing economic disruptions. However, long-Covid activists argue that easing restrictions neglects the chronic impact of the virus, which can cause lingering symptoms with no clearly defined cure.
The potential change in isolation guidance also has implications for paid leave policies. Many companies have already scaled back on paying employees to stay home when infected with Covid-19, and fewer employers now offer any sort of paid leave for Covid. This puts workers in a difficult position, as they may have to return to work while still sick or use traditional sick time benefits, if available.
The issue of paid leave is further complicated by the fact that almost 1 in 4 workers do not have a single paid sick day. The United States required businesses with 50 to 499 employees to offer paid time off to workers with Covid in 2020, but the rule expired at the end of that year. Some states and cities enacted similar protections, but they have also expired. New York Governor Kathy Hochul has proposed ending the state’s law requiring paid leave for Covid isolation, citing the need to wind down special Covid benefits.
The potential change in isolation recommendations also poses challenges for healthcare systems. While some argue that a 24-hour fever-free approach makes sense for determining contagiousness in workers, activists are concerned about the impact on low-wage earners and individuals at risk of severe illness.
Pediatricians are facing a dilemma as parents decline Covid tests for sick children to avoid extended absences from school. Many schools have increased pressure on parents to send their children to school, even when they are sick with Covid. This puts pediatricians in a difficult position as they try to balance public health concerns with the negative consequences of extended absences from school.
Overall, the potential change in isolation recommendations by the CDC has sparked a debate about the appropriate response to Covid. While some argue that it is time to treat Covid like other respiratory viruses, others believe that the unique characteristics of Covid warrant continued caution. The decision will have implications for medically vulnerable individuals, paid leave policies, and the education system. As the CDC prepares to release the proposed revisions and seek public feedback, it is clear that finding a balance between public health and societal needs remains a challenge.
