Confused by CDC’s guidance on testing during isolation? You’re not alone, experts say
The Centers for Disease Control and Prevention on Tuesday, Jan. 4, clarified its stance on testing in its new COVID-19 isolation guidelines — prompting criticism from experts who say the agency’s update further muddles its guidance.
On Dec. 27, the CDC overhauled its isolation guidelines, saying people who are infected with the coronavirus now need to isolate for five days instead of 10 if they are asymptomatic or if their symptoms are “resolving.” But the agency said the five-day isolation period should be followed by five days of wearing a face mask around others.
The CDC’s new guidelines do not include a requirement to test negative for COVID-19 to end isolation — a sticking point among some experts who have questioned the safety of the guidance as the new omicron variant spreads.
Despite the pushback, the CDC stood by its decision to not include a testing requirement. On Jan. 4, the agency clarified that those who have access to a test and who want to take it before ending their isolation may do so, but it stopped short of recommending it.
The guidelines now say that, for those who want to take a test, the “best approach” is to use an antigen test at the end of the five-day isolation period. If it’s positive, continue isolating for five more days, the CDC says. If it’s negative, you can end isolation but must continue to wear a mask around others for five days.
Experts weigh in
Experts have largely been critical of the CDC’s clarification.
“Listen, I’m all for testing-out-of-isolation. No reason to keep people at home unnecessarily,” Dr. Megan Ranney, the academic dean for the Brown University School of Public Health, tweeted. “But this new guidance is so convoluted that I’m having trouble providing a succinct tweet about it. Which doesn’t bode well for our being able to follow it.”
Dr. Céline Gounder, an infectious disease expert and professor at the NYU Grossman School of Medicine, agreed that the change is confusing.
“It does feel like a bit of a ‘choose your own adventure:’ if this, then this; if this, then this,” she said Wednesday, Jan. 5, on “CBS Mornings.” “I think that kind of complicated algorithm might work in the ICU in a hospital but it doesn’t really work well as public health guidance.”
Dr. Shikha Jain, a hematology and oncology physician, made similar comments on Twitter.
“I feel like the person who writes ‘Choose Your Own Adventure’ books wrote these...I am SO confused,” she wrote.
Dr. Leana Wen, professor of health policy and management at George Washington University, said on CNN that the CDC’s clarification “made things worse” and disincentivizes testing.
“Now they’re saying if you somehow get your hands on a test and you test positive by day five then you have to extend your isolation for five days until day 10,” she said. “So essentially they are making it a disincentive to get tested. Who’s going to want to get tested so they can stay in isolation for longer?”
She said she thinks the CDC should be upfront and “say they can’t do this because we just don’t have enough tests to test out of isolation.”
Gounder also pointed out that the guidance comes during a shortage of rapid tests.
“That’s really about availability of these rapid antigen tests, and they do remain in short supply across the country,” she said on CBS when asked why the CDC stopped short of recommending a test to end isolation. “If you have access to one of those tests then you should definitely make use of them as part of your decision making. But unfortunately too many people still don’t have access.”
Dr. Ashish Jha, third dean of the Brown University School of Public Health, weighed in on what an ideal isolation would look like, in his opinion.
Dr. Anthony Fauci, the nation’s top infectious disease expert, previously said on Sunday, Jan. 2, that the CDC was considering updating its guidance again following the original pushback on its recommendations.
“Wow I did not see this coming — the updated CDC guidance just says if you want to test, go ahead,” Dr. Walid Gellad, professor of medicine at the University of Pittsburgh, tweeted. “That’s not at all what I was expecting when Fauci said this weekend there is a way to include testing in the isolation guidance.”
About the CDC’s isolation guidelines
The agency updated its guidelines following a push from some experts to shorten the isolation period. The concern was that as omicron — which seems to be able to transmit and evade COVID-19 vaccines more easily — spreads, more people will become infected, making a 10-day isolation unsustainable and disruptive to society.
But when the agency shortened the isolation period to five days and left out a testing requirement, some experts casted doubt on the safety of the guidelines.
The CDC, however, said its guidance is “motivated by science” that shows the majority of coronavirus transmission usually occurs early in an infection: one to two days before symptoms start and two to three days after.
CDC Director Dr. Rochelle Walensky previously said on CNN’s “New Day” that the agency also took into account what period people would “tolerate” as some evidence has shown that few people isolate when they need to.
Fauci explained on MSNBC that the CDC did not include a testing requirement because, while the antigen tests that are used are good at determining whether or not a person is infected, they don’t have a “good predictive value as to whether or not you’re transmitting” the virus.
This story was originally published January 5, 2022 at 10:48 AM with the headline "Confused by CDC’s guidance on testing during isolation? You’re not alone, experts say."
