COVID Guidelines Changing (@ mentioned in replies)

[hermione]

www.washingtonpost.com/health/2024/02/13/covid-isolation-guidelines-cdc-change/

Basically shifting to fever free for 24 hours like many other illnesses.

[noodleoo]

@@@
Wow, that's huge! Our public schools still require 5 day isolation and our daycare still requires 10 days. As a working parent, I think this makes sense. Those isolation policies have resulted in people just not testing anymore, so they aren't effective anyway.

[erbear]

@@@

I'm all over about this. I am still pretty apprehensive about Covid (I haven't had it, so I think this is more generalized anxiety than anything else) and I really do worry about folks who could get very very sick from a Covid exposure, so I wish the guidelines would remain a little stricter, but I also see the value of allowing parents to be able to work -- five days home is a lot when a child is really not experiencing an illness more serious then another virus. And I agree that the guidelines have meant that people are just not testing anymore, which is probably more dangerous.

Not sure I'm adding anything to the conversation here. Covid is still such an unknown that fever free doesn't really seem to cover the risk, but 5 days of isolation feels like too much for most cases. I hope that people will be smart -- stay home with any symptoms, let people know you have Covid so they can make a choice about exposure to you, mask. But I don't really think most people will do this, and that sucks.

noodleoo, you should @@ your post.

[acr]

How interesting. I never had fever either time I had covid & my symptoms were mild, but seems like there is probably a range of ways to interpret "mild & improving symptoms" as a barometer.

[noodleoo]

Feb 13, 2024 10:09:48 GMT -5 erbear said:

@@@

I'm all over about this. I am still pretty apprehensive about Covid (I haven't had it, so I think this is more generalized anxiety than anything else) and I really do worry about folks who could get very very sick from a Covid exposure, so I wish the guidelines would remain a little stricter, but I also see the value of allowing parents to be able to work -- five days home is a lot when a child is really not experiencing an illness more serious then another virus. And I agree that the guidelines have meant that people are just not testing anymore, which is probably more dangerous.

Not sure I'm adding anything to the conversation here. Covid is still such an unknown that fever free doesn't really seem to cover the risk, but 5 days of isolation feels like too much for most cases. I hope that people will be smart -- stay home with any symptoms, let people know you have Covid so they can make a choice about exposure to you, mask. But I don't really think most people will do this, and that sucks.

noodleoo , you should @@ your post.

@@@
True, but people aren't doing that anyway. NYT newletter had an interesting piece today about the CDC vaccine recommendation for children and how when the CDC recommendations go against majority public opinion (and international experts), the public loses confidence in the CDC and basically just ignores them. I think that is the case with isolation too. It doesn't really make sense at this point to treat Covid differently than the flu or RSV.

I also don't think the isolation guidelines even really work anymore because most people I know who have had it recently haven't tested positive until after they've been sick for a few days.  So they've already been spreading it anyway.  It is a cost benefit analysis and the cost of requiring isolation is not worth the benefit anymore.

[Velar Fricative]

I’m sure that will mean farewell to my job’s covid isolation leave. I never had a fever during either of my covid illnesses but had a pretty firm idea both times of when I could be productive.

[Bad Dingo]

This is bullshit. Just because people don't want to be safe and live in a society where we protect the health of others doesn't mean public health guidance should bow to the pressure and ignore science.

"“Public health has to be realistic,” said Michael T. Osterholm, an infectious-disease expert at the University of Minnesota. “In making recommendations to the public today, we have to try to get the most out of what people are willing to do. … You can be absolutely right in the science and yet accomplish nothing because no one will listen to you.”"

[Bad Dingo]

Feb 13, 2024 10:17:20 GMT -5 noodleoo said:

Feb 13, 2024 10:09:48 GMT -5 erbear said:

@@@
It doesn't really make sense at this point to treat Covid differently than the flu or RSV.

@@ Link
"COVID vs. Flu vs. Common Cold vs. RSV: What You Need to Know"

"COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is more serious because of the higher mortality rate."

[tacokick]

Feb 13, 2024 10:27:36 GMT -5 Bad Dingo said:

This is bullshit. Just because people don't want to be safe and live in a society where we protect the health of others doesn't mean public health guidance should bow to the pressure and ignore science.

"“Public health has to be realistic,” said Michael T. Osterholm, an infectious-disease expert at the University of Minnesota. “In making recommendations to the public today, we have to try to get the most out of what people are willing to do. … You can be absolutely right in the science and yet accomplish nothing because no one will listen to you.”"

For real. I expected this but it is a new low.

[DotAndBuzz]

Feb 13, 2024 10:27:36 GMT -5 Bad Dingo said:

This is bullshit. Just because people don't want to be safe and live in a society where we protect the health of others doesn't mean public health guidance should bow to the pressure and ignore science.

"“Public health has to be realistic,” said Michael T. Osterholm, an infectious-disease expert at the University of Minnesota. “In making recommendations to the public today, we have to try to get the most out of what people are willing to do. … You can be absolutely right in the science and yet accomplish nothing because no one will listen to you.”"

I'm hesitant to lay blame on the individual and their "willingness" to abide by the guidelines.

@@@@@@@@@@@@@

Most workplaces aren't supportive of people who need to miss work when they or their kids are sick for 24 hours, let alone 5 days. If you've got 2 kids, and covid hits your house, you're looking at a LOT of time away from in-person work. Limited sick days and the inability to work from home (some jobs truly require one to be there in person - you can't run a 2nd grade classroom from home, or do floor rounds as a nurse from your living room), force people to come to work when they should be home. Lots of workplaces no longer see covid as a different type of illness that requires you to miss work. Hell, even H's employer (a HEALTHCARE ORGANIZATION) no longer allows covid to "not count" towards your sick day usage. 

I'm mostly blaming businesses for this, not individuals just wanting to go on with their life, spreading covid around. ETA - and public health officials shouldn't have bent to that pressure. Force businesses to say "we're going against public health guidelines and requiring you to come in." not the other way around.

[hermione]

I edited the title for @.

I do wonder what this means for those without fevers. Would I have just sent my 10yo to school after one day? Her symptoms were improving and she never had a fever. I’m interested to see what they say about masks.

[Bad Dingo]

DotAndBuzz, I totally agree. The government should be working on making it easier for people to stay home when they are sick or their family members are sick. They have the money and the means but not the will.

[aurora]

Feb 13, 2024 10:27:36 GMT -5 Bad Dingo said:

This is bullshit. Just because people don't want to be safe and live in a society where we protect the health of others doesn't mean public health guidance should bow to the pressure and ignore science.

"“Public health has to be realistic,” said Michael T. Osterholm, an infectious-disease expert at the University of Minnesota. “In making recommendations to the public today, we have to try to get the most out of what people are willing to do. … You can be absolutely right in the science and yet accomplish nothing because no one will listen to you.”"

I think it's more nuanced than that, honestly. If the data shows that a 5-day isolation period disincentives testing, then public health might actually be served by shortening the period and promoting more people to test. The article later says

Strict isolation requirements can act as a disincentive to test when testing should be encouraged so people at risk for serious illness can get treatment, she said.

I get that health organizations can change public opinion, but in the case of smoking that took decades. What do we do in the short term to protect the most vulnerable?

And I say this as someone who does test and did isolate for each of my positive tests (10 days and a disrupted vacation the first time, t days the second per guidance). I take COVID very seriously. But the fact is that for any major issue you can't just ignore where people are and expect to get results. You have to start with where they are.

[DotAndBuzz]

Feb 13, 2024 10:47:15 GMT -5 hermione said:

I edited the title for @.

I do wonder what this means for those without fevers. Would I have just sent my 10yo to school after one day? Her symptoms were improving and she never had a fever. I’m interested to see what they say about masks.

My kid just had it last week. SO SICK, and never spiked a fever. So should I have just....sent her to school? I mean, she powered through for 3 days, masked, because she kept testing negative, and had legit assignments/meetings she didn't want to miss, but COME ON. Had the faintest of faint positive tests the evening of day 3. 

[tacokick]

Feb 13, 2024 10:40:33 GMT -5 DotAndBuzz said:

Feb 13, 2024 10:27:36 GMT -5 Bad Dingo said:

This is bullshit. Just because people don't want to be safe and live in a society where we protect the health of others doesn't mean public health guidance should bow to the pressure and ignore science.

"“Public health has to be realistic,” said Michael T. Osterholm, an infectious-disease expert at the University of Minnesota. “In making recommendations to the public today, we have to try to get the most out of what people are willing to do. … You can be absolutely right in the science and yet accomplish nothing because no one will listen to you.”"

I'm hesitant to lay blame on the individual and their "willingness" to abide by the guidelines.

@@@@@@@@@@@@@

Most workplaces aren't supportive of people who need to miss work when they or their kids are sick for 24 hours, let alone 5 days. If you've got 2 kids, and covid hits your house, you're looking at a LOT of time away from in-person work. Limited sick days and the inability to work from home (some jobs truly require one to be there in person - you can't run a 2nd grade classroom from home, or do floor rounds as a nurse from your living room), force people to come to work when they should be home. Lots of workplaces no longer see covid as a different type of illness that requires you to miss work. Hell, even H's employer (a HEALTHCARE ORGANIZATION) no longer allows covid to "not count" towards your sick day usage. 

I'm mostly blaming businesses for this, not individuals just wanting to go on with their life, spreading covid around. ETA - and public health officials shouldn't have bent to that pressure. Force businesses to say "we're going against public health guidelines and requiring you to come in." not the other way around.

It is truly a failure of the CDC and government not to value public health over profits. They 100% should be making science-based recommendations and encouraging businesses, schools and hospitals to follow them. The CDC shifting the blame to the public when the CDC are the ones who have been minimizing COVID since the beginning is shameful.

But as an individual, you can make the decision to do simple things like decide to mask in public spaces and encourage your workplace to increase air quantity and covid protections. Just because the government has failed you, you don’t need to fail yourself or your community.

[wanderingback]

I can’t read the article and don’t have time to type all my thoughts, but this seems like horrible timing as we’re still in covid/flu/rsv season. We need to prioritize health and staying home when sick over profits

[Bad Dingo]

Here's a gift link: wapo.st/3wosNqL

[noodleoo]

I think people are missing the point.  They are not saying don't stay home if you are sick!  They are saying you no longer HAVE to stay home if you AREN'T still sick.  

From the article:

The CDC plans to recommend that people who test positive for the coronavirus use clinical symptoms to determine when to end isolation. Under the new approach, people would no longer need to stay home if they have been fever-free for at least 24 hours without the aid of medication and their symptoms are mild and improving, according to three agency officials who spoke on the condition of anonymity to share internal discussions.

@@@
DotAndBuzz , no one is saying you should send your sick kid to school. But DD1 tested positive for Covid asymptomatically and she missed 5 days of school because of it even though she wasn't actually sick. The only reason we knew she had Covid was because we tested before seeing her grandparents.  Which we are obviously glad we did, but her missing school for 5 days was not necessary.  

Honestly, the people who are sending their sick kids to school are the same ones who aren't testing anyway.

Also from the article for those who didn't read it:

The federal recommendations follow similar moves by Oregon and California.
...

After Oregon made its change, the state has not experienced any disproportionate increases in community transmission or severity, according to data shared last month with the national association representing state health officials.

[Susie]

This feels kind of inevitable to me, on the trajectory we've been on.  In my family's experience, fever free for 24h doesn't really "fit" the covid experience, but that can be said of so many viruses.  24h fever/puke/diarrhea free still seems to be the universal standard, with no real accounting for respiratory symptoms.

 @@
So often, one of my kids will catch some virus at school, spike a 101-103 fever for 2-3 days, and then be ok.  They go back to school with a negative covid test when they're 24h fever free and they are asymptomatic enough that they won't be disruptive or gross in class.  Absolutely symptom free is unattainable with young kids in winter.  They are almost never without some kind of sniffle, post nasal drip cough, etc. from Nov to Apr.  I either won't catch it, or if I do, it manifests completely differently.  I'll get congestion and headaches with no fever.  

It was the same with covid.  When 3/4 of us had covid (all overlapping), one of us had a 102 fever for 2 days, the other two of us had cold symptoms, headaches, cough, but no temp above 99, and it lasted for up to 9-10 days.  DS would have gone back on like day 4 instead of staying home through day 10 or 14, or whatever it was at the time.  H and I would never have been required to stay home.  I likely would have WFH, but with the headaches it was a struggle.  

OTOH, I would have kicked it faster, and probably been less ill, if I had not gone into having covid completely wrecked.  DS (almost 3 at the time) was quarantined twice that month, coming down with covid during the 2nd one.  I spent most of the month parenting all day and working all night due to lack of childcare in quarantine, so I was wrecked before I even tested pos.  Obviously that approach was not good either.
 @@

I have empathy and no good answers for people for whom a covid infection would be seriously medically damaging, in this world where this is how we approach flu, RSV, adenoviruses, other coronaviruses, etc. etc.  

[hermione]

In my most recent example, my daughter woke up with a head cold on Wednesday, December 20. Tested positive. By the evening of Thursday December 21 she was almost symptom free - they were definitely mild and improving at that point. She never had a fever. Under these guidelines, I would send her to school Friday, December 22 and still host Christmas Monday, December 25? That feels really wrong to me.

[tacokick]

Feb 13, 2024 11:18:20 GMT -5 noodleoo said:

I think people are missing the point.  They are not saying don't stay home if you are sick!  They are saying you no longer HAVE to stay home if you AREN'T still sick.  

From the article:

The CDC plans to recommend that people who test positive for the coronavirus use clinical symptoms to determine when to end isolation. Under the new approach, people would no longer need to stay home if they have been fever-free for at least 24 hours without the aid of medication and their symptoms are mild and improving, according to three agency officials who spoke on the condition of anonymity to share internal discussions.

@@@
DotAndBuzz , no one is saying you should send your sick kid to school. But DD1 tested positive for Covid asymptomatically and she missed 5 days of school because of it even though she wasn't actually sick. The only reason we knew she had Covid was because we tested before seeing her grandparents.  Which we are obviously glad we did, but her missing school for 5 days was not necessary.  

Honestly, the people who are sending their sick kids to school are the same ones who aren't testing anyway.

Also from the article for those who didn't read it:

The federal recommendations follow similar moves by Oregon and California.
...

After Oregon made its change, the state has not experienced any disproportionate increases in community transmission or severity, according to data shared last month with the national association representing state health officials.

The problem is that COVID is not the flu where you get obvious symptoms at some point. Plenty of people are testing positive and are contagious and do not have obvious (or any) symptoms like you would with the flu. We have known for years that asymptomatic COVID is contagious and can lead to long COVID. It is much more dangerous than the flu.

There is already pressure not to test or isolate so telling people they can go into work/school when they feel okay after testing positive and not when they’ve more likely to have cleared the virus and are no longer contagious is not in the interest of public health.

The CDC and most states have stopped tracking Covid data to it is hard to get any real numbers so we will have to wait and see the waste water numbers if this goes into effect to get a better picture but we were just in the second highest wave. It’s still everywhere even if “only” 9,000+ people are dying each month.

[curbsideprophet]

This is rage inducing! This also ignores asymptomatic transmission. You don’t need to feel sick to be contagious.

Immunocompromised people are already struggling to access society in any safe way. This will make it even harder.

It is not the same as flu and rsv, the potential for long term damage increases with each infection and we are doing nothing to stop transmission or clean the air.

The answer to people struggling with lack of sick time is to give them more sick leave, not allow their sick co-workers to come into work.

[agnes]

Yeah my work already started with the new guidelines. Pretty sure I got covid at work because of them.

[neverfstop]

I've got nothing to add that hasn't already been said, except I wish we had more at-home testing for flu & strep (@ as one who was just at the urgent care with DD this morning).

[fortnightlily]

Flu and RSV absolutely can and do spread asymptomatically, pre-symptomatically, or while symptoms are 'mild and improving' too (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646474/). The 24-hour fever/vomit/diarrhea free rule was always one of expedience, not because illnesses are magically not contagious at that point. Stomach bugs can be spread via fecal transmission for weeks after recovery from symptoms. Let's not forget that the initial Omicron wave still spiked tremendously in areas like mine when mask mandates and isolation guidelines were in place with wide compliance. And conversely, transmission did not worsen when those things were relaxed.

Reducing long covid, hospitalization, and death by promoting vaccination is both a more achievable goalpost for the CDC and one that has far more concrete evidence behind it than trying to prevent transmission.

[StrawberryBlondie]

On the one hand, this makes sense to me.

On the other, I only had a fever for about an hour when I had covid, so... 🤷

[wanderingback]

Feb 13, 2024 11:54:02 GMT -5 tacokick said:

Feb 13, 2024 11:18:20 GMT -5 noodleoo said:

I think people are missing the point.  They are not saying don't stay home if you are sick!  They are saying you no longer HAVE to stay home if you AREN'T still sick.  

From the article:

@@@
DotAndBuzz , no one is saying you should send your sick kid to school. But DD1 tested positive for Covid asymptomatically and she missed 5 days of school because of it even though she wasn't actually sick. The only reason we knew she had Covid was because we tested before seeing her grandparents.  Which we are obviously glad we did, but her missing school for 5 days was not necessary.  

Honestly, the people who are sending their sick kids to school are the same ones who aren't testing anyway.

Also from the article for those who didn't read it:

The problem is that COVID is not the flu where you get obvious symptoms at some point. Plenty of people are testing positive and are contagious and do not have obvious (or any) symptoms like you would with the flu. We have known for years that asymptomatic COVID is contagious and can lead to long COVID. It is much more dangerous than the flu.

There is already pressure not to test or isolate so telling people they can go into work/school when they feel okay after testing positive and not when they’ve more likely to have cleared the virus and are no longer contagious is not in the interest of public health.

The CDC and most states have stopped tracking Covid data to it is hard to get any real numbers so we will have to wait and see the waste water numbers if this goes into effect to get a better picture but we were just in the second highest wave. It’s still everywhere even if “only” 9,000+ people are dying each month.

Just to clarify, you can be asymptomatic with the flu and transmit just the same as covid.

I’m not disagreeing with what people are saying in this thread but did want to point that out since people like to compare the flu and covid and in that aspect they are the same in that you can have no symptoms and it can be transmitted (seems like a few people have mentioned this).

[StrawberryBlondie]

Feb 13, 2024 10:51:54 GMT -5 DotAndBuzz said:

Feb 13, 2024 10:47:15 GMT -5 hermione said:

I edited the title for @.

I do wonder what this means for those without fevers. Would I have just sent my 10yo to school after one day? Her symptoms were improving and she never had a fever. I’m interested to see what they say about masks.

My kid just had it last week. SO SICK, and never spiked a fever. So should I have just....sent her to school? I mean, she powered through for 3 days, masked, because she kept testing negative, and had legit assignments/meetings she didn't want to miss, but COME ON. Had the faintest of faint positive tests the evening of day 3. 

I don't think "fever free for 24 hrs" means "send obviously sick people to school if they don't have a fever." I've never interpreted it that way for school or daycare for other illnesses and don't know anyone who did either - it means if you're otherwise fine, you can come back when you've been fever free for 24 hrs.

[tacokick]

Feb 13, 2024 13:17:59 GMT -5 wanderingback said:

Feb 13, 2024 11:54:02 GMT -5 tacokick said:

The problem is that COVID is not the flu where you get obvious symptoms at some point. Plenty of people are testing positive and are contagious and do not have obvious (or any) symptoms like you would with the flu. We have known for years that asymptomatic COVID is contagious and can lead to long COVID. It is much more dangerous than the flu.

There is already pressure not to test or isolate so telling people they can go into work/school when they feel okay after testing positive and not when they’ve more likely to have cleared the virus and are no longer contagious is not in the interest of public health.

The CDC and most states have stopped tracking Covid data to it is hard to get any real numbers so we will have to wait and see the waste water numbers if this goes into effect to get a better picture but we were just in the second highest wave. It’s still everywhere even if “only” 9,000+ people are dying each month.

Just to clarify, you can be asymptomatic with the flu and transmit just the same as covid.

I’m not disagreeing with what people are saying in this thread but did want to point that out since people like to compare the flu and covid and in that aspect they are the same in that you can have no symptoms and it can be transmitted (seems like a few people have mentioned this).

That is true! It’s disappointing that the CDC keeps making that comparison so it is constantly in the conversation.

[tacokick]

Feb 13, 2024 13:18:00 GMT -5 StrawberryBlondie said:

Feb 13, 2024 10:51:54 GMT -5 DotAndBuzz said:

My kid just had it last week. SO SICK, and never spiked a fever. So should I have just....sent her to school? I mean, she powered through for 3 days, masked, because she kept testing negative, and had legit assignments/meetings she didn't want to miss, but COME ON. Had the faintest of faint positive tests the evening of day 3. 

I don't think "fever free for 24 hrs" means "send obviously sick people to school if they don't have a fever." I've never interpreted it that way for school or daycare for other illnesses and don't know anyone who did either - it means if you're otherwise fine, you can come back when you've been fever free for 24 hrs.

But if you test positive for Covid you are “obviously sick” even if you may never or only briefly get a fever or have physical symptoms. That’s why the recommendations for a positive test were a blanket 10 then 5 day isolation periods followed by masking in public past that.

As the proposed recommendations read now, you can test positive and if you think you feel okay the CDC isn’t encouraging you to stay home or mask at all. Test positive at lunch, return to work or school that day as long as you feel “fine”. Not only are you spreading it around but there is evidence that rest is one of the best and easiest ways to avoid long covid after infection even if it is mild or asymptomatic.

Since businesses generally follow the CDC’s guidelines it’s likely it will put pressure on people to return to work with a positive test if they don’t have outward signs of illness.

I guess we will see the exact wording when it’s released. I see a lot of backlash online so maybe they will walk it back or clarify.