CDC stands by isolation guidance, skips on testing component

The CDC is standing by its newly updated isolation guidelines that state people with COVID-19 whose symptoms are improving and are fever-free may end isolation after five days without a negative test. 

On Dec. 27, the agency trimmed the recommended isolation time for the general public from 10 days to five for asymptomatic people and for people whose symptoms are resolving, followed by five days of wearing a mask around others. After facing criticism from health officials for not adding a testing component, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said the CDC was mulling a revision to recommend testing after the five-day isolation period. 

"There has been some concern about why we don't ask people at that five-day period to get tested. That is something that is now under consideration," Dr. Fauci told ABC News on Jan. 2. "The CDC is very well aware there has been some pushback about that. Looking at it again, there may be an option in that — that testing could be a part of that," he said, adding that the public can expect to hear more from the CDC on the guidance soon. 

In a Jan. 4 update to its isolation and quarantine guidance page, the CDC did not add the anticipated recommendation to seek a test at the end of the 5-day period; it stood by its original update that asymptomatic people or those whose symptoms are resolving and have been fever-free for 24 hours without the use of fever-reducing medication may end isolation, followed by five more days of wearing a mask around others. It did add guidance for people who want or have access to a test, noting "the best approach is to use an antigen test toward the end of the five-day isolation period." Samples should be collected only after a person is fever-free and other symptoms have improved, the CDC said. If positive, individuals should isolate until day 10. 

The CDC also shared an accompanying explanation of the recent guidance changes. 

"Data, including a review of 113 studies from 17 countries, show that most SARS-CoV-2 transmission occurs early in the course of infection," the statement said. "Infectiousness peaks around one day before symptom onset and declines within a week of symptom onset, with an average period of infectiousness and risk of transmission between two to three days before and eight days after symptom onset."

 

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