CDC's Isolation Guidelines Are Inadequate

Judy Stone, MD


January 05, 2022

The CDC has just shortened recommended isolation times for COVID-19 for people who are asymptomatic from 10 days to 5. They still advise that masks be worn.

Similarly, they advise unvaccinated people exposed to COVID to only quarantine for 5 days, followed by wearing a mask for an additional 5 days.

Those who have received boosters no longer need to isolate but are still advised to wear masks for 10 days.

The CDC says that this is based on data that suggests "the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after." (They don't mention that this was based on Delta, not Omicron, which may behave differently.)

The CDC has also reduced isolation requirements for healthcare workers (HCWs) to 7 days if they are asymptomatic, but added that they could be further reduced in the case of staffing shortages. (When have there not been staffing shortages? Health systems, operating based on profit, have long had skeleton crews to increase their profitability). Hell, the CDC even allows for COVID-positive HCWs to care for COVID-negative patients.

New York has already reduced isolation for HCWs to 5 days following a positive COVID-19 test.

Some of us who are perhaps more cynical doubt that this was based on evolving science but rather suspect that it was in response to pressure from the airline and other industries. They had been lobbying the CDC to reduce the quarantine times to lessen disruption to business.

Here are the goods:

Scott Gottlieb, former FDA commissioner and now a Pfizer board member, told The Washington Post, "The new guidance reflects a growing reality that we're going to have to learn to live with COVID as a persistent risk, and can't let it shut down society."

Ashish K. Jha, dean of Brown's School of Public Health, is generally supportive of the CDC's move:">

I'm afraid that I disagree with Jha, tweeting that the "#CDC guidelines are NOT reasonable. There is no way I want a #Covid + HCW wearing a surgical mask caring for me or a loved one or--heaven forbid--an immunocompromised or unvaccinated child. This is big fail on @CDCDirector and @CDCgov's part, caving to business."

Amesh Adalja, MD, of Hopkins' Center for Health Security, said he welcomes the changes because it "removes some of the disruptions from people's lives that inevitable cases will cause." In this interview, Adalja added that the changes make it "easier to navigate a world where COVID is ever-present." At least he acknowledged that we lack the testing capacity. However, Adalja believes rapid testing will enable us to further reduce isolation in the future.

While few infectious disease physicians/epidemiologists support the CDC, more of us appear to be flabbergasted.

Michael Mina, MD, PhD, has a must-read thread on this poorly thought-out decision by the CDC. Start here:

As another example, Erin Bromage, PhD, an immunologist, said:

Describing the CDC guidance, Bromage added, "Reckless is an understatement. I realize we have a wave of infections coming that is unprecedented, but nope. This doesn't cut it."

I'm with them and Kim Prather, PhD, a prominent aerobiologist and #CovidIsAirborne advocate, who sums up my feelings nicely:

The CDC has botched this. I could have seen shortening the isolation period if it were based on data, as in one to two (preferably two) negative rapid tests and if they insisted that HCWs wear N95/KN95/KF94 masks. Surgical masks are better than nothing but are insufficient. If the problem is a lack of supplies, the CDC should be honest with the public. It's pretty bad when they are losing people who have been staunch allies until now.


What worries me the most is that Omicron is not apparently a particularly virulent pathogen, although it is very transmissible.

All of the lessons from pandemic planning exercises, eg, Event 201, appear to have been thrown out. One message was not to have travel bans. Another was vaccine equity.

South Africa immediately told us about Omicron's emergence. How did we respond? With a punitive and totally unnecessary travel ban, which exacted huge financial penalties. Why should another country be forthcoming in the future?

What happens when we have a deadly outbreak? Not if, but when.

Climate change and deforestation will likely precipitate it, as they have others, when we encroach on the habitats of bats and other animals.

After Hurricane Katrina, we even had critical shortages of sterile saline — salt water! And many of our antibiotics rely on key ingredients (API) from China that are then produced in India.

We need to learn our interdependence — with other countries and with nature — rather than emphasizing hubris and nationalism.

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About Dr Judy Stone
Judy Stone, MD, is an infectious disease specialist and author of Resilience: One Family's Story of Hope and Triumph over Evil and Conducting Clinical Research: A Practical Guide.

She survived 25 years in solo practice in rural Cumberland, Maryland, and now works part-time. She especially loves writing about ethical issues and advocating for social justice. Follow her at or on Twitter @drjudystone.


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