Rationale for the changed CDC Guidelines for Respiratory Viral Illness

Town of Greenwich Department of Health

Community Health Education Memo

Dr. Stephanie Paulmeno, Public Health Education Specialist

3-8-24

For several weeks in early 2024 we heard that the CDC was considering changing its recommended guidance for people who had suffered exposures to COVID-19, or worse yet, became ill with a COVID-19 infection. Opinion pieces/blogs like NextDoor have held interesting discussions about the merits or detriments of the changing guidance. Both were thoroughly contemplated & discussed by learned CDC members with epidemiologic, medical, public health, & viral disease know-how. The changes referred to the COVID-19 isolation period then in effect. That is now changed to a more unified approach that applies to several respiratory viruses, (i.e.: COVID-19, RSV, & Influenza). Some wondered how such a change would be justified when SARS-CoV2 still had the same incubation period & period of contagiousness as before, which included several days before one knew they were infected, that one could be contagious to others with/without any symptoms, that infected people were shown to continue to shed the virus for up to 5 days after being ill, as well as because we are still experiencing high hospitalizations & deaths from all three. Well, the guidelines did change on March 1, 2024, & the rationale was explained (https://www.cdc.gov/media/releases/2024/p0301-respiratory-virus.html). The new guidance is only for people in community-settings. No healthcare facility changes were recommended. This is the new CDC Guidance for COVID-19, Influenza, & RSV:

• Stay up to date with recommended vaccines to protect/immunize yourself against COVID-19, influenzas, & RSV.
• Continue to practice good respiratory hygiene, sanitizing frequently touched surfaces, & good hand sanitizing measures.
• Ventilate your indoor locations.
• Stay home/away from others when sick (return to normal activities when symptoms have been improving for 24 hours, & when you are fever-free for 24 hours without fever-reducing medications.
• When returning to work, school, or activities, the use of a good-fitting mask & maintaining social distancing is advised for the sake of others that you could contaminate.

The CDC’s rationale for the changed protocol was multifold (Respiratory Virus Guidance Update FAQs | CDC):

• We have improved treatments (antivirals/symptomatic relief, & techniques) to combat the infection.
• We have improved immunizations (vaccines) to protect against COVID-19 in those who use them.
• 3 + years after the pandemic began, the CDC feels that about 98% of people in this country have some degree of COVID-19 immunity from vaccines, from having gotten ill, or from a combination of both.
• Those who become infected now have fewer complications than was previously the case.
• Fewer COVID-19 infected people become as ill as previously, thus hospitalizations and deaths, while still high, are considerably reduced from the prior pandemic years.
• CDC experts concluded that while COVID-19 remains a serious health threat, especially to those at higher risk, it is now more like the other respiratory viral illnesses that we deal each year, such as the flu.

The CDC’s Advisory Committee on Immunization Practices (APIC) is also recommending that people 65 and older get another dose of the newest 2023-2024 COVID-19 mRNA vaccine this Spring (Older Adults Should Get Another COVID Booster, CDC Advisors Say | MedPage Today)

With these now reduced isolation measures for those who have become contaminated &/or ill, those amongst us who are at high risk for Respiratory Viral Illnesses need to be proactive in protecting their own health. Experience has shown us that not all among us will look out for their fellow man. Consider this when in crowded indoor places, especially if they are not well documented.