01/06/2022

CDC updates general population guidance

On January 4, the Centers for Disease Control (CDC) again updated the general population guidance for quarantine and isolation. Although the general population guidance does not apply to residents of congregate care settings, staying abreast of the current guidance and the rationale is recommended, so that the difference between the two approaches can be communicated to visitors, residents, and staff. Visitors should understand that they cannot visit a nursing home or other high-risk setting for the full 10 days even if they end their quarantine or isolation period after 5 days. That means that family and friends should not visit until 10 days after the date of exposure, first day of symptoms if positive or the day of the positive test for individuals that are asymptomatic. When counting out the 10 days, the first day of exposure, symptoms, or positive test is counted as day zero. 

The January 4 update includes the following recommendations:

After the end of the 5-day quarantine or isolation period, continue to wear a well-fitting mask around others at home and in public for 5 additional days (day 6 through day 10). If you are unable to wear a mask when around others, you should continue to isolate for 10 days. Avoid people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days. 

If an individual has access to a test and wants to test, the best approach is to use an antigen test towards the end of the 5-day isolation period. If your test result is positive, you should continue to isolate until day 10. If your test result is negative, you can end isolation, but continue to wear a well-fitting mask around others at home and in public until day 10.

To limit spread to other people you are in close contact with (e.g., co-workers or people you live with, especially if there are individuals who are unvaccinated or immunocompromised), CDC recommends always wearing a well-fitting mask for 10 days following your positive test result (if asymptomatic). If you are symptomatic with COVID-19, CDC also recommends wearing a well-fitting mask for 10 days following your onset of symptoms to limit spread to others in the home or other close contacts.

Tests for SARS-CoV-2 are best used early in the course of illness to diagnose COVID-19 and are not authorized by the U.S. Food and Drug Administration (FDA) to evaluate duration of infectiousness. Some people may remain positive by Nucleic Acid Amplification Tests (NAATs) (e.g., RT-PCR) long beyond the period of expected infectiousness. The significance of a positive or negative antigen test late in the course of illness is less clear; while a positive antigen test likely means a person has residual transmissible virus and can potentially infect others, a negative antigen test does not necessarily indicate the absence of transmissible virus. As such, regardless of the test result, wearing a well-fitting mask is still recommended.