CDC updates its COVID-19 guidelines in sweeping overhaul

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The Centers for Disease Control and Prevention unveiled significant changes Thursday as part of a sweeping effort to overhaul the agency’s COVID-19 guidance.

“This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives,” CDC’s Greta Massetti said in a statement announcing the changes.

Among the biggest differences in the new recommendations:

The CDC’s COVID-19 prevention guidance will no longer differentiate by whether people are up-to-date on their vaccinations.Testing to screen for COVID-19 will no longer be recommended in most places for people who do not have COVID symptoms. The CDC says people who have tested positive for COVID-19 can stop wearing masks if their symptoms have improved and they test negative twice in a row — initially on the sixth day after their infection began, and then again on the eighth day.And the CDC says that “to limit social and economic impacts, quarantine of exposed persons is no longer recommended, regardless of vaccination status.”

Massetti told reporters Thursday that the recommendations are being revised to simplify the myriad of federal COVID-19 guidance into an easier “framework.”

“It’s really about kind of how people can understand how all of these components fit together. It starts with people understanding their own personal risk, for serious illness, and that of their loved ones,” Massetti added.

Web pages posted Thursday by the agency include new descriptions and illustrations “to help you assess the likelihood that you were infected when you were around a person with COVID-19” and a simplified guide to “what to do if you were exposed” to someone with COVID-19.

The agency also trimmed out several specific COVID-19 recommendations for schools, including removing guidance around “cohorting” and “test to stay” strategies where students exposed to the virus could remain in school as long as they continued to test negative.

“The key changes in the school guidance are in those sections that would parallel the changes in the community guidance. So, for example, we are no longer recommending quarantine. And so in the school guidance, there is no more section on quarantine,” Massetti told reporters.

Other tweaks to the school guidance, which was last updated in May, include clarifying that all people should be masking in school nurses’ offices — the same as is already recommended for other health care settings — and removing a recommendation that classrooms need to be disinfected after a positive case is spotted.

A summary of the guidance was published Thursday in the agency’s Morbidity and Mortality Weekly Report.

Detailed recommendations are expected to be updated and “streamlined” over the coming days, including for travel, nursing homes, and other high-risk congregate settings.

Nursing and health care settings will continue to rely on the agency’s old community transmission framework, Massetti said, which is based on counts of reported COVID-19 cases.

The rest of the agency’s guidance will continue to be pegged to the CDC’s COVID-19 Community Levels benchmarks, which incorporate hospitalization figures into determining whether counties are at “low,” “medium,” or “high” levels of the disease.

Massetti said the agency is continuing to reassess the performance of those metrics, but for now the agency has not “gotten any results that suggest a substantial change is warranted at this time.”

The CDC’s COVID-19 officials have telegraphed plans to significantly revise and simplify the guidelines for months, acknowledging growing fatigue with measures aimed at curbing the virus and the changing threat posed by it more than two and a half years into the pandemic.

“We have high levels of vaccine and infections-induced immunity in the country, we have highly effective treatments and prevention tools, we’ve greatly reduced the risk of medically significant illness, hospitalization, and death,” Dr. Ian Williams, head of the agency’s COVID-19 response, said this week at a meeting of the agency’s outside advisers.

Williams said the CDC has also moved over recent months to wind down a substantial share of its standalone pandemic response, integrating its COVID-19 activities into the agency’s regular teams.

The shift comes as the latest COVID-19 wave appears to now be subsiding, after hospitalization rates reached some of the worst levels seen since the winter Omicron surge.

Figures published Thursday by the CDC now show less than half of all Americans are currently living in counties at “high” COVID-19 Community Levels, for the first time in a month.

Deaths remain around 400 per day on average — far lower than some of the worst peaks during previous waves, though still a level that makes it one of the nation’s leading causes of death.

“This is about pivoting our public health focus on sustainable efforts to minimize the impact of COVID-19 on health and society,” Williams added.

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