Atlanta—The CDC says it streamlined COVID-19 guidance to make it easier for the public to understand. Rampant confusion on the quarantine and isolation guidelines continues, however, and pharmacists find themselves fielding a lot of questions.

Part of the impetus for the guideline change was that with vaccination and new therapies, the danger has been somewhat reduced. "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," the CDC said in a press release.

"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," explained Greta Massetti, PhD, MPH, the lead author of an article on the new guidelines in the CDC's Morbidity & Mortality Weekly Report. "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."

The most well understood of the changes is probably that those who are up-to-date on vaccines and those who are not were put on equal footing if they are exposed to someone with COVID-19. Instead of quarantining, they are urged to wear a high-quality mask for 10 days and get tested on Day 5.

Nothing has changed, however, regarding the recommendation that anyone who has COVID-19—regardless of vaccination status—should still isolate. That is the case when someone has symptoms and suspects that they have COVID-19 but do not yet have test results.

If test results are negative, isolation can end. If they are positive, the CDC's full isolation policies should be followed.

Essentially, those testing positive for COVID-19 are recommended to stay home for at least 5 days and isolate from others in their home. Understanding that the risk of infecting others is greater during the first 5 days, a high-quality mask is recommended when in contact with others at home or in public.

Here is where the confusion increases. The CDC states:

• If after 5 days, the patient is fever-free for 24 hours without the use of medication and symptoms are improving—or no symptoms ever appeared—isolation can end after Day 5.
• Those patients still should avoid being around others who are at high risk of severe COVID-19 until at least Day 11.
• They also should wear a high-quality mask through Day 10.

The recommendations are different for those with moderate illness (e.g., symptoms including shortness of breath and difficulty breathing, severe illness requiring hospitalization, or with weakened immune systems). They must isolate through Day 10.

In fact, for those falling into the severe illness or weakened-immune system categories, a consultation with a medical provider is urged before ending isolation.

"Ending isolation without a viral test may not be an option for you," the CDC noted. "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."

If COVID-19 symptoms worsen after ending isolation, it should be restarted at Day 0.

In other changes, the CDC no longer recommended testing of asymptomatic people without known exposures. It also emphasized that "physical distance is just one component of how to protect yourself and others." Public health officials now advise that taking local COVID-19 community levels and ventilation into account when assessing the need to maintain physical distance.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.