March 1, 2024 – The CDC has updated its guidance for how long people should isolate when they are sickened by COVID-19. The new stay-at-home instructions now match those for people sickened with other viruses like the flu or respiratory syncytial virus (RSV).
Previously, the CDC had urged people with COVID to stay home for at least five days. But the new instructions suggest staying home until at least 24 hours after a fever and symptoms have subsided.
“Today’s announcement reflects the progress we have made in protecting against severe illness from COVID-19,” CDC Director Mandy Cohen, MD, MPH, said in a statement Friday. “However, we still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses—this includes vaccination, treatment, and staying home when we get sick.”
Leading up to the announcement, which has been rumored for days, experts expressed concern that the shortened isolation would prompt people to take COVID less seriously and put immunocompromised people at greater risk, and that the change isn’t based on any new scientific understanding of virus transmission.
The new guidelines state that people who catch a virus should stay home and away from others until 24 hours after being fever-free and once symptoms are improving. The 24-hour fever-free period counts only once someone stops taking fever-reducing medication such as Tylenol.
“This advice is similar to what has been recommended for flu for decades and will help reduce the spread of COVID-19 and other respiratory viruses during the most contagious period after infection,” the CDC advisory stated. “Not all respiratory virus infections result in a fever, so paying attention to other symptoms (cough, muscle aches, etc.) is important as you determine when you are well enough to leave home. If your symptoms are getting better, and stay better for 24 hours, you are less likely to pass your infection to others and you can start getting back to your daily routine.”
In its new guidance, the CDC acknowledged that some people may remain contagious after the end of isolation. So for the first five days of resuming normal activities, people should wear a mask, increase hygiene like hand-washing, keep a distance from others, and take “more steps for cleaner air.” Special precautions should be taken to stay away from people with poor immune systems and those age 65 and older, who are at increased risk of severe cases of COVID, the CDC advised.
Most people in the U.S. have some antibodies against COVID, but staying up-to-date on vaccinations is the agency’s continued No. 1 precaution to take. People who get COVID should also consider antiviral medication options. This past season, 95% of hospitalizations for COVID occurred among people who were not up-to-date on vaccines and did not take antivirals, the CDC’s advisory stated.
“The updated guidance change will not significantly increase COVID-19 community spread and severe disease,” the CDC predicted in its announcement of the change. “Real-world experience in states like Oregon and California and countries like the UK, Australia, Denmark, France, Norway, and Canada found no significant change in spread or severe disease after implementing similar guidance updates.”
Just over 7% of all COVID tests reported to the CDC were positive during the week ending Feb. 24, and about 17,000 people were newly hospitalized with the illness during that same period, according to the CDC COVID Data Tracker.