In what some viewed as a surprise move, the Centers for Disease Control (CDC) recently updated their COVID-19 quarantine and isolation guidance. The new guidelines recommend that those who have contracted the virus isolate for five days before returning to ‘normal life’, albeit with a well-fitting mask for an additional five days.

This shortened isolation period from 10 to five days applies to those patients who are asymptomatic or whose symptoms are improving but do not require a negative test.

Dr Farley Cleghorn, Palladium’s Chief Medical Officer, spoke with prime-time UK Sky News on the updated guidelines. “With the knowledge of how the omicron variant differs from delta, the CDC made this change. We can even call this public health policy in action,” he observed.

The decision was based heavily on evidence and data accumulated over the past weeks from the United States, South Africa, and the United Kingdom. “We now know more about the viral dynamics in the population and more about the period of infectiousness in the body,” he explained. According to Dr. Rochelle Walensky, the CDC Director, evidence shows that most people are no longer contagious five days after symptoms appear.

And while the CDC has not updated these guidelines to include testing, Cleghorn adds that their inclusion would’ve allowed for a more accurate interpretation of the guidance. “If you test positive with the antigen test, it’s still likely you’re contagious, but due to the sensitivity of the PCR tests, you can be PCR positive and non-infectious and possibly PCR negative and still infectious.”

But without the additional layer of testing, he notes, there’s a potential gap where some patients may remain infectious after the five days or if they’re asymptomatic. The idea of these guidelines, he adds, is looking at the totality of the data. “Remember, that public health guidance is to cover the majority of the population, and we think that the majority of the population will be adequately covered by these guidelines.”

Balancing Mitigation Measures

Critics have been quick to note that the guidance appears to be fuelled by economic pressures, including the welfare of businesses that have struggled with employees and workers placed under quarantine amidst the recent spike in cases. “The balance of mitigation measures that any government has at its disposal is just that, a balance, between the spreading of an infectious disease and the impact that disease has on its people,” Cleghorn told Sky News.

“The economy is a huge part of people’s lives. We depend on it to continue with our lives, and I think it’s prudent that the new evidence be taken into consideration.”

For those left wondering why the CDC recommends continued masking after the isolation period, Cleghorn explained that masking is a proven effective measure in stopping the spread of COVID-19. “When enough people do it, particularly those exposed or infected, we know that we can reduce transmission to other people.”

This is critical for those who may be asymptomatic and returning to normal life after the five-day period.

“If you’re going to be in contact with other people, you can significantly reduce the likelihood of transmission if you’re still infectious by continuing to mask,” Cleghorn recommended.

He conceded that rapidly changing public health guidance will always lead to some confusion, and that over the next few weeks, it will be clear how practical these new guidelines are and how individual states across the U.S. will interpret and implement them.

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