MMWR: CDC Issues New Streamlined COVID Guidelines For The General Public

#16,938

COVID guidelines have changed often over the past 32 months, and will continue to evolve, as the pandemic threat changes.  Now that much of the population is vaccinated (and boosted), and doctors have better ways to treat patients, many of the stricter mitigation measures - used heavily in 2020 and early 2021 - are no longer seen as needed.

The pandemic isn't over, of course.  And should a new, more virulent variant come along, that could force the return of some of those measures.  But for now, the CDC believes that some of their guidance for the public can be relaxed. 

Yesterday the MMWR published an overview of these changes.  While this isn't a one-size-fits-all recommendation, it should reduce the impact of mitigation on a large segment of the population.  

Those who are at higher risk of severe illness - due to age, disability,  being moderately or severely immunocompromised, or who have other underlying medical conditions (including pregnancy) - may still want to use more protective measures, particularly when local levels of transmission are elevated. 

Due to its length, I've only reproduced the link, summary, and a brief except.  You'll want to follow the link to read it in its entirety.  I've also reproduced the CDC's press release/summary below. 

Summary of Guidance for Minimizing the Impact of COVID-19 on Individual Persons, Communities, and Health Care Systems — United States, August 2022

Early Release / August 11, 2022 / 71

Greta M. Massetti, PhD1; Brendan R. Jackson, MD1; John T. Brooks, MD1; Cria G. Perrine, PhD1; Erica Reott, MPH1; Aron J. Hall, DVM1; Debra Lubar, PhD1; Ian T. Williams, PhD1; Matthew D. Ritchey, DPT1; Pragna Patel, MD1; Leandris C. Liburd, PhD1; Barbara E. Mahon, MD1 (View author affiliations)View suggested citation

Summary

What is already known about this topic?

High levels of immunity and availability of effective COVID-19 prevention and management tools have reduced the risk for medically significant illness and death.

What is added by this report?

To prevent medically significant COVID-19 illness and death, persons must understand their risk, take steps to protect themselves and others with vaccines, therapeutics, and nonpharmaceutical interventions when needed, receive testing and wear masks when exposed, receive testing if symptomatic, and isolate for ≥5 days if infected.

What are the implications for public health practice?

Medically significant illness, death, and health care system strain can be reduced through vaccination and therapeutics to prevent severe illness, complemented by use of multiple prevention methods to reduce exposure risk and an emphasis on protecting persons at high risk for severe illness.

(Excerpt)

Protecting Persons Most at Risk for Severe Illness

Multiple nonpharmaceutical and medical prevention measures are available to substantially reduce the risk for medically significant illness and death among persons at particularly high risk for these outcomes because of older age, disability, moderate or severe immunocompromise (25), or other underlying medical conditions (including pregnancy) (26).

In addition to recommending that persons stay up to date with vaccination, public health strategies to protect persons at high risk include use of masks or respirators (i.e., specialized filtering masks such as N95/KN95s) that provide more protection for the wearer,¶¶¶¶ preexposure prophylaxis if indicated (e.g., for persons who are immunocompromised), and early access to and use of antivirals. 

At medium and high COVID-19 Community Levels, persons at high risk for severe illness and their contacts should consider wearing well-fitting masks or respirators that provide more protection to the wearer because of better filtration and fit to reduce exposure and infection risk. Persons who have household or social contact with persons at high risk should consider self-testing to detect infection before contact at medium and high COVID-19 Community Levels. 

Public health efforts should promote health equity by purposefully reaching out to all populations at high risk for severe illness to broaden access to preexposure prophylaxis, testing, and oral antivirals. Public health practitioners and organizations should consider the characteristics of their local or setting-specific populations when determining whether to strengthen or add prevention strategies that supplement disease control efforts and protect those persons at highest risk for severe illness or death. Strengthening public health communications and messaging can also help persons assess their personal level of risk for severe illness and use that knowledge to choose preventive behaviors to protect themselves and those around them.*****

(Continue . . . )

CDC streamlines COVID-19 guidance to help the public better protect themselves and understand their risk
Press Release

Embargoed Until: Thursday, August 11, 2022, 3:00 PM ET
Contact: Media Relations
(404) 639-3286


Today, CDC is streamlining its COVID-19 guidance to help people better understand their risk, how to protect themselves and others, what actions to take if exposed to COVID-19, and what actions to take if they are sick or test positive for the virus. COVID-19 continues to circulate globally, however, with so many tools available to us for reducing COVID-19 severity, there is significantly less risk of severe illness, hospitalization and death compared to earlier in the pandemic.

“We’re in a stronger place today as a nation, with more tools—like vaccination, boosters, and treatments—to protect ourselves, and our communities, from severe illness from COVID-19,” said Greta Massetti, PhD, MPH, MMWR author. “We also have a better understanding of how to protect people from being exposed to the virus, like wearing high-quality masks, testing, and improved ventilation. 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.”

In support of this update CDC is:

• Continuing to promote the importance of being up to date with vaccination to protect people against serious illness, hospitalization, and death. Protection provided by the current vaccine against symptomatic infection and transmission is less than that against severe disease and diminishes over time, especially against the currently circulating variants. For this reason, it is important to stay up to date, especially as new vaccines become available.
• Updating its guidance for people who are not up to date on COVID-19 vaccines on what to do if exposed to someone with COVID-19. This is consistent with the existing guidance for people who are up to date on COVID-19 vaccines.
• Recommending that instead of quarantining if you were exposed to COVID-19, you wear a high-quality mask for 10 days and get tested on day 5.
• Reiterating that regardless of vaccination status, you should isolate from others when you have COVID-19.You should also isolate if you are sick and suspect that you have COVID-19 but do not yet have test results. 

• If your results are positive, follow CDC’s full isolation recommendations.
• If your results are negative, you can end your isolation.

• Recommending that if you test positive for COVID-19, you stay home for at least 5 days and isolate from others in your home. You are likely most infectious during these first 5 days. Wear a high-quality mask when you must be around others at home and in public.

• If after 5 days you are fever-free for 24 hours without the use of medication, and your symptoms are improving, or you never had symptoms, you may end isolation after day 5.
• Regardless of when you end isolation, avoid being around people who are more likely to get very sick from COVID-19 until at least day 11.
• You should wear a high-quality mask through day 10.
• Recommending that if you had moderate illness (if you experienced shortness of breath or had difficulty breathing) or severe illness (you were hospitalized) due to COVID-19 or you have a weakened immune system, you need to isolate through day 10.
• Recommending that if you had severe illness or have a weakened immune system, consult your doctor before ending isolation. Ending isolation without a viral test may not be an option for you. If you are unsure if your symptoms are moderate or severe or if you have a weakened immune system, talk to a healthcare provider for further guidance.
• Clarifying that after you have ended isolation, if your COVID-19 symptoms worsen, restart your isolation at day 0. Talk to a healthcare provider if you have questions about your symptoms or when to end isolation.
• Recommending screening testing of asymptomatic people without known exposures will no longer be recommended in most community settings.
• Emphasizing that physical distance is just one component of how to protect yourself and others. It is important to consider the risk in a particular setting, including local COVID-19 Community Levels and the important role of ventilation, when assessing the need to maintain physical distance.

Actions to take will continue to be informed by the COVID-19 Community Levels, launched in February. CDC will continue to focus efforts on preventing severe illness and post-COVID conditions, while ensuring everyone have the information and tools, they need to lower their risk.

This updated guidance is intended to apply to community settings. In the coming weeks CDC will work to align stand-alone guidance documents, such as those for healthcare settings, congregate settings at higher risk of transmission, and travel, with today’s update.