When to come out of Covid isolation in 2023, according to experts – NBC News
                            January 22, 2024
                                Covid symptoms may change, but the appearance of    a pink line on a rapid test means one thing for sure: five days    of isolation.  
    The guidance, from the Centers for Disease Control and    Prevention, has been in place since late 2021. At the moment,    the agency doesnt appear to be making any changes to the    policy.  
    But in some cases, telling people to isolate after a positive    test may have an unintended effect.  
    Dr. Victoria Valencia, interim director for the Health Center    for Student Care at Tulane University in New Orleans, said that    she and her staff saw an uptick in Covid when students returned    to campus in August. But that is no longer the case, as    students now tend to decline Covid testing.  
    Students are afraid of being diagnosed with Covid because    they dont want to isolate, Valencia said.  
    So is five days of isolation really best? Heres what experts    say.  
    The current recommendation to isolate for five days is a    hangover from when the CDC moved from a 10-day isolation    recommendation to five days in late 2021, just as the    first wave of omicron was taking hold in    the U.S., said Harvard University epidemiologist Bill Hanage.  
    It was not a reflection of evidence-based science, he said.    It was there to stop everything from falling apart.  
    At that time, a large chunk of the population was testing    positive all at once because of the highly contagious variant.    Recommending that everyone stay home  and out of work  for 10    days would have brought the country to a halt once again, so    the five-day plan was put in place.  
    If you look at the safety of the public, and the need to have    society not disrupted, this was a good choice, Dr. Anthony    Fauci, former scientific adviser to the Biden administration,    said at the time about the isolation    recommendation.  
    There was also evidence that people are most contagious during    those first five days of infection. That remains    the most reliable scientific data, experts say.  
    We know that most people with Covid-19 shed enough virus that    they are likely still contagious for at least five days,    Jennifer Nuzzo, director of the Pandemic Center at Brown    University School of Public Health, wrote in an email.  
    When the Covid public health emergency expired in May    2023, health officials in Oregon decided it was also time to    pull back on the five-day isolation recommendation. Instead,    the Oregon Health Authority suggested that people with Covid    stay home only until theyve gone without spiking a fever for    24 hours and are generally feeling better.  
    In January of this year, California health officials issued the same    guidance.  
    The ending of the public health emergency declaration doesnt    change biology, Nuzzo said when Oregon changed its isolation    recommendations. I dont see a biological reason to end the    five-day isolation period.  
    People with the flu are most contagious the first three or four    days after the illness begins, according to the CDC. People who    test positive for influenza are advised to stay    home until at least 24 hours after their fever is gone    without the use of fever-reducing drugs, such as Tylenol.  
    A common cold virus is most contagious within the first few    days but can continue to spread for up to two weeks, according    to Johns Hopkins All Childrens Hospital research.  
    Like other viruses, people with Covid have varying degrees of    sickness.  
    A set number of days to isolate is dumb if you think about it    from a medical perspective, said Dr. Peter Chin-Hong, an    infectious diseases specialist at the University of California,    San Francisco.  
    If youre feeling fine the entire five days and have    absolutely no symptoms, staying at home by yourself is not the    same as somebody whos had symptoms and then after five days,    theyre going out and coughing on everyone, Chin-Hong said.    The symptoms approach makes more sense, not just for Covid,    but for lots of other infectious diseases that people dont    normally isolate for.  
    Saskia Popescu, an assistant professor of epidemiology and    public health at the University of Maryland School of Medicine,    said that while a persons risk of spreading Covid is in the    first five days of infection, we know increasingly, that even    without symptoms, or upon their resolution, people can still    shed infectious virus.  
    Popescu said that means that while the risk is lower after Day    5, it doesnt mean theres zero risk. You should still try and    stay home, she said. And if you absolutely need to, you can    wear a mask.  
    Covid is a very unique infectious disease, Popescu added.    Forty to 50% of cases are asymptomatic, or have such mild    symptoms that people dont even realize they have symptoms.  
    In a study published in JAMA Pediatrics in October, researchers    found that children ages 7 to 18 were infectious for a median    of three days after a positive Covid test. By Day 5, the    majority of the kids were no longer infectious.  
    My personal view is that five days is more than sufficient    for isolation, said senior study author Neeraj Sood, a    professor of health policy, medicine and business at University    of Southern California. Based on the findings, maybe you could    go with something a little shorter for kids.  
    An earlier study, published in the New England Journal of Medicine in July 2022,    found that adults were infectious for a median of five or six    days.  
    Popescu, who wasnt involved with either study, said the    findings on children will probably be used moving forward for a    lot of school-based decisions.  
    Its helpful to see the three days, Popescu said.  
    On an individual level, common sense should rule, Hanage said.    If youre sick, stay away from people most at risk for severe    complications, such as older relatives.  
    You wouldnt want to give them something that would make them    badly ill  whether its Covid, flu or even food poisoning, he    said.  
    Popescu agreed.  
    From an infectious disease perspective, we want people to stay    home if they have symptoms, she said. And just because you    dont have Covid doesnt mean that you dont have another    infectious disease that could pose a risk to those around you.  
    Dr. Michael Mina, an immunologist and former assistant    professor of epidemiology at the Harvard T.H. Chan School of    Public Health, urged people to do the best they can and take    precautions where possible.  
    "Nobody's perfect," Mina said. "If you can decrease your    chances of spreading to others, that's really good. That alone    is very, very good. So if you can't isolate for five days, or    it's been five days, but you recognize that you might still be    infectious, wear a mask as much as you can, don't attend really    densely packed events, and stay away from vulnerable people."  
    CORRECTION (June 12, 2023, 11:15 a.m. ET): A    previous version of this article misstated Jennifer Nuzzos    title and employer. She is director of the Pandemic Center at    Brown University School of Public Health; she is not senior    scholar at the Johns Hopkins Center for Health Security.  
    FollowNBC    HEALTHonTwitter&Facebook.  
        Erika Edwards is a health and medical news writer and        reporter for NBC News and "TODAY."      
        Akshay Syal, M.D.,is a medical fellow with the NBC        News Health and Medical Unit.      
        Sara G. Miller is the health editor for NBC News, Health &        Medical Unit.      
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When to come out of Covid isolation in 2023, according to experts - NBC News