Confused by the latest CDC guidelines on when to get out of isolation? Join the crowd. Many infectious disease experts are decrying the change while others support the new rules.
What do we know? People are most likely to spread the virus in the 1-2 days before they develop symptoms and for 3-4 days after the onset of symptoms. Vaccinated individuals do not seem to shed a lot of virus after 5 days of symptoms assuming they feel better and do not have a fever. This is not true for unvaccinated individuals, who may shed virus for 10 days or more; there is a wide range – some do not shed much after 3-4 days while others can shed virus for up to 2 weeks.
The practical political aspect of this decision is that with the much more transmissible Omicron variant, we are seeing a sharp rise in cases, with many only mildly ill, and we are seeing resulting shortages of workers. The numerous flight cancellations of the past holiday weekend were in large part due to so many pilots and other crew being COVID-positive. Hospitals are running low on doctors, nurses and other staff.
I think that it is reasonable to allow vaccinated individuals to come out of isolation 5 days after testing positive but that this should only be done when they have a negative antigen (rapid) test on the day they leave. Wearing a mask gives a little extra margin of safety.
Unvaccinated individuals should probably stick to the prior 10-day isolation. They shed virus longer (and are the people who are less likely to consistently wear masks).
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