Throughout this pandemic, as we’ve learned more and more about the virus, the guidelines for how we are supposed to live with it have evolved too. This has led to public health advice that changes frequently and is often hard to incorporate into our lives and plans—take, for example, the guidance to not travel for Thanksgiving delivered mere days before Thanksgiving. Now, as we head into another holiday season, the Centers for Disease Control and Prevention has an update to their quarantine guidance. You might have some questions. We’ll do the best we can with answers.
What is the CDC’s quarantine guidance?
“CDC continues to recommend quarantining for 14 days as the best way to reduce the risk of spreading COVID-19,” Henry Walke, the CDC’s COVID-19 incident manager, told journalists at a press conference Wednesday morning. So far, same old. But Walke went on to explain that the CDC has come up with two “acceptable alternative quarantine periods:” if you don’t have any symptoms, you can end quarantine after 10 days (and then still continue to monitor symptoms for four days, after that), or, if you get a negative test on the fifth day, you can end quarantine after seven days.
Hmm. Those are big catches!
Considering the fact that so much as a cough is a COVID-19 symptom, and also that tests can take several days to turn around (and getting them can involve breaking quarantine)…yes.
Wait, if a 14-day quarantine is still “best”… was the guidance actually updated?
Yes. The CDC is essentially recognizing that a 14-day quarantine is onerous and requires extensive resources. Walke said the CDC’s aim is “reducing the economic hardship associated with a longer period, especially if [the person quarantining] cannot work.” He also noted that a shorter period “can lessen stress on the public health system and communities,” for example, by getting quarantined doctors and essential workers back to work sooner. Another argument is that a slightly shorter quarantine will just feel more doable to people, hopefully making them more likely to quarantine in the first place.
You know what would really help make quarantining more feasible? Government support.
Yeah. If we lived in a country with ample sick time, stimulus checks, child care, a robust medical system, etc., that would really help people quarantine for the amount of time that we are certain works for this virus. But we aren’t devoting many resources toward that, an issue that we—as individuals, and also as a country—keep running up against. It’s hard for individuals to make the best, most stringent choices to stay safe when there’s not a broader system of support, particularly for people who can’t, for example, work from home. In changing the guidance here, the CDC is recognizing not just that people are human, but also that America is America.
What kind of additional risk does the shortened quarantine pose?
There is a “small residual risk” to the shortened quarantines, noted John Brooks, chief medical officer for the CDC’s COVID-19 response, at the press conference. For the 10-day timeline that’s about 1 percent, for the seven-day timeline, it’s about 5 percent, Brooks noted. This might sound really small, but, as science journalist Roxanne Khamsi noted on The Gist, even a small percentage chance of spreading a deadly virus can be pretty consequential when you’re talking about the risk over a large population. (She’s also written about research suggesting that an eight-day quarantine with a PCR test on Day Seven is as effective as a 14-day quarantine, scientifically speaking. That’s stricter, and requires a faster testing turnaround, than the option to test out of quarantine presented by the CDC.) On the other hand, decreasing quarantine (at least, in some cases) might make people more likely to comply with quarantine in the first place, thereby reducing the spread more than a stricter quarantine would. So, like so much about this virus, it’s sort of unclear how things will shake out once you put the unpredictable factor of human behavior into the mix.
Who will the new guidance affect?
It depends on where you live, as regulations work on a state or local level. “I want to stress that we are sharing these options with public health agencies across the country,” said Walke, “so that they can determine how long quarantine periods should last in their jurisdictions based on local conditions and needs.” This makes sense because testing out of quarantine can depend on the availability of testing, and the risk posed by people leaving quarantine a little early can depend on how many cases are circulating (and therefore causing people to quarantine) in the first place.
That aside, it’s worth noting what “quarantine” actually means. We throw around the term “quarantine” a lot to refer to the general concept of staying home due to the deadly virus circulating. But the technical definition is pretty narrow, as even the CDC’s website seems a little exasperated of explaining: “quarantine is used to keep someone who might have been exposed to COVID-19 away from others” (italics theirs).
The CDC currently considers exposure—or “close contact”—to include anyone who has hugged, been coughed on by, or spent 15 minutes within six feet of someone with COVID-19. A month ago, the CDC expanded that definition to include shorter intervals over a period of 24 hours that add up to a total of 15 minutes. As epidemiologists have argued in Slate, even this definition might mean that kids diligently spaced six-and-a-half feet apart in a poorly ventilated classroom do not, according to the rules, need to all quarantine if one of them has COVID-19. Which is all to say: when to quarantine—and now, for how long—is something of an art.
So if I want to go home for the holidays, what should I do to be safe?
Well, the CDC is basically saying, once again, don’t travel. So that’s the safest thing. The advice Walke gave at the press conference was to get a test a few days before traveling, then again a few days after you return—while also limiting yourself to essential activities for a full week. But, that’s all in concert with the CDC advice to stick to socializing within your own household. It also, like all the plans to reduce quarantine through testing, assumes that you can go to a testing site where you don’t risk exposure, and can get your results in time to travel. If you are bubbling, going to work in person, or otherwise interacting with other people, then things get more complicated, and the safer thing to do, experts say, is quarantine before and after. For the full 14 days.