Aug. 12, 2022 – After more than 2 years, 90-plus million cases, and more than 1 million deaths, the United States is entering a new, potentially less scary, phase of the COVID-19 pandemic.
The CDC on Thursday said most Americans no longer need to social distance or quarantine, and kids no longer need to “test to stay” in school. The change in federal policy toward the virus is a key moment in what had seemed to be a crisis with no end. And, while this latest move is far from the finish line, it is an acknowledgment that COVID-19 is no longer the frightening killer it once was.
Many health care providers, experts, and school administration officials applauded the CDC’s announcement easing its recommendations for controlling the spread of COVID-19.
Most support the move as realistic at this point in the pandemic, with some caveats.
The CDC said it made the move because COVID-19 now poses less risk of “medically significant” infections. The new recommendations reverse the agency’s earlier stance on social distancing, quarantining, and testing children for COVID-19 while allowing them to stay in school – a strategy known as test-to-stay.
Perhaps the largest group affected by the new CDC guidelines are K-12 schools. A spokesperson from Chicago Public Schools says it's reviewing the updated guidelines to determine whether any changes need to be made before its schools open there on Aug. 22.
But many U.S. schools have already opened their doors and will likely continue following COVID-19 guidelines that appeared to work over the past year, says Noelle Ellerson Ng, associate executive director of advocacy and governance at the School Superintendents Association.
“Because vaccines, boosters, and testing have been widely available for some time now, we had not planned on requiring masks this school year,” says Jason Stanford, chief of communications and community engagement at the Austin Independent School District in Texas.
“The CDC's new guidance doesn't change what we were going to do anyway, which was to encourage people to stay current on their vaccinations and stay home if they feel sick,” he says.
But most importantly, the new CDC recommendations will allow teachers and other school staff to focus on their main role of being educators, instead of “enforcers of medical guidelines,” says Mary Valvano, MD, an emergency room doctor.
“Even though they [schools] are traditionally caregivers of students, it's really put them in this really difficult situation, to try and keep track of guidelines, keep track of changes, interpret new information, and then bring it into the school on a day-to-day basis,” says Valvano, who is the founder of SchoolMD, an organization that brings medical professionals into schools to help keep students and faculty safe from COVID-19 and other illnesses.
“It will be good because the schools won't have to take on this role that was really never theirs appropriately to begin with, even though they embraced it so that they could keep going with their educational mission,” she says.
The National Association of Secondary School Principals agrees the updated CDC protocols will better allow educators to fulfill their duties while still keeping kids safe.
“As another school year begins, districts should work with their local health departments to implement the new guidelines and respond appropriately during high COVID-19 community levels,” says Jen Silva, the association’s director of external relations.
Know Your Risk
“COVID-19 remains an ongoing public health threat,” CDC COVID-19 Emergency Response Team members said in the new recommendations. People who know they have a high risk for severe COVID-19 should continue to practice a multi-layered approach to keeping themselves safe, the agency stated.
Because the new guidelines shift responsibility for preventing the spread of COVID from the society to the individual, “Do everything you can to protect yourself,” Bruce says: Get vaccinated, as fully boosted as possible, and vaccinate your kids.
“If you're worried about your own risk,” she said, “avoid crowds and wear a mask indoors.”
Advice for Concerned Parents
For parents who remain worried, Berger says, “It is pretty safe to say approach this you like you do for the flu.”
For example, don't send your kids to school or have them around other people if they are sick. Also be vigilant about symptoms, and seek medical advice when necessary.
Berger agrees with the CDC decision to end test-and-stay protocols. One reason is the higher chance of false negative results with rapid antigen tests. He believes that “when it’s positive, it’s positive,” but he remains less confident about negative findings.
Another task for parents and students: Know what’s happening in your community. If the spread of COVID-19 is high in your area, take extra precautions, says Larry Blosser, MD, chief medical officer at Central Ohio Primary Care.
A Step Toward Normal
When asked if the timing of the CDC changes seems appropriate, Blosser said, “As we get ready to have students begin school, it seems like this is a good time to review and update the CDC recommendations for community transmission and how individuals and communities can protect themselves.”
“Eventually we need to get back to normal,” says Pedro Piedra, MD, a professor of molecular virology and microbiology at Baylor College of Medicine in Houston. “We are not going to stay forever in pandemic mode,” and we’re in a transition phase.
In contrast to earlier in the COVID-19 pandemic, the fear of overwhelming hospitals with COVID-19 has been reduced significantly, Piedra says, and it makes sense the CDC would now focus more on protection of people at higher risk.
“Vaccination remains the cornerstone” of protection for everyone, he says.
Rachel Bruce, MD, called the CDC’s actions “appropriate,” as it’s clear COVID-19 will be with us for the foreseeable future.
Because of the pandemic’s length, the 90 million-plus cases in the United States, as well as immunity granted millions more from vaccinations, “The levels of immunity in the general population are the highest they've ever been,” she says.
That, coupled with treatments now available that lower the risk of hospitalization and death, means a loosening of guidelines is warranted, she says.
“Given that most people now experience a mild illness, we have to ask, as a society: How much disruption should each infection cause? Does it make sense to continue to close camps and classrooms for every positive test?” says Bruce, interim chair of emergency medicine at Long Island Jewish Forest Hills in Queens, NY, part of Northwell Health.
“The CDC has decided that the answer is no, and I agree with them,” she says.
Despite all that, COVID-19 is still killing hundreds of Americans a day.
With transmission rates higher than 20% in much of the country, "we cannot let our guard down,” Daniel P. McQuillen, MD, president of the Infectious Diseases Society of America, said in a statement.
But others are not as sure.
James Hamblin, MD, a public-health policy lecturer at Yale School of Public Health, says federal health guidelines are always a delicate mix that isn't always just based in science.
"Remember CDC guidelines always reflect a mix of science, politics, and public attitudes. They’re not synonymous with ideal medical advice and shouldn’t be regarded as such," he says. "Just because a practice is no longer formally recommended doesn’t mean it’s not still a good idea."
Epidemiologist Thoai Ngo, PhD, sees the new CDC guidance as an example of the agency ‘’throwing in the towel” when it comes to controlling infections. Ngo, who is also the vice president of social and behavioral science research at the Population Council, credits the FDA, on the other hand, with citing new research as the basis for changing its guidance on home testing.
Agencies must communicate a shared public health message to avoid confusion, agrees Wandi Bruine de Bruin, PhD, Provost Professor of public policy, psychology and behavioral science at the Schaeffer Center for Health Policy and Economics at the University of Southern California.
During the pandemic, it was expected that the messaging would be harder than for an established disease, she says. As facts about the virus change, cases rise and fall, and variants arrive, ‘’what you say one day may not be true the next,” Bruine de Bruin says.
Uché Blackstock, MD, founder of Advancing Health Equity, is less than enthusiastic about the changes.
"The CDC is relaxing COVID guidelines and saying it’s because we have a high percentage of population immunity when only 10% of people age 50-64 and 25% age 65+ have received their 2nd booster," she says. "This is embarrassing."
One of the most concerning possibilities with the new, relaxed guidelines is the potential danger to populations most vulnerable to severe COVID-19, particularly amid rising reports of long COVID and lackluster booster turnout, says Eric Topol, MD, editor-in-chief at Medscape.
“Our booster rate in the U.S. is pitifully low,” he says.
The new guidelines more accurately reflect what most Americans are already doing, says David Berger, MD, a board-certified pediatrician at Wholistic Pediatrics & Family Care in Tampa, FL. “We're moving into this living-with-COVID part of the pandemic.”
Most people “are already starting to ease up their concerns,” says Guillermo De Angulo, MD, a pediatric oncologist at KIDZ Medical Services in Miami. “But you do have some pockets of people that are worried, and most of the time, they're worried because they know of someone or have a close relative that had a really difficult bout with COVID.”
Reporter Kathy Doheny contributed to this report.