You’ve gotten your vaccine, you’ve gotten your booster, and you’ve been doing all the right things to keep yourself and others around you as healthy as possible during the pandemic.
But as the highly contagious Omicron variant surges in the U.S., public health experts say it’s inevitable there will be more breakthrough cases of COVID-19. For the vaccinated and boosted, many of those cases are expected to be mild or asymptomatic.
So, what does that mean for isolation periods that may be disruptive to everyday life and work?
On Wednesday, the U.K. reduced its COVID-19 isolation period from 10 days to 7 days for individuals who receive a negative result on a rapid lateral flow test 2 days in a row. The move reflects the latest evidence on how long infected individuals who are vaccinated can transmit the virus, the U.K. Health Security Agency said in a statement, and “supports essential public services and supply chains over the winter, while still limiting the spread of the virus.”
The CDC is weighing whether to follow suit in shortening the recommended 10-day isolation period.
Currently, cutting the isolation time is under consideration for individuals who are fully vaccinated or boosted, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told CNN‘s John Berman on Tuesday.
However, at this point in the pandemic, the concept may not be best suited for a blanket approach.
“From a national perspective, now is not the time to be reducing isolation time or quarantine regulations for everyone,” John Swartzberg, MD, clinical professor emeritus at UC Berkeley’s School of Public Health, told MedPage Today. “But, now may be the time to do that for select groups.”
The first group for priority should be healthcare workers, he said.
“It doesn’t do us any good to have hospital beds if there are no healthcare workers taking care of people,” Swartzberg said.
That could be especially relevant if Omicron causes increased hospitalizations.
Swartzberg said he could see the argument for lowering the isolation period for healthcare workers who are fully vaccinated and boosted, and could also see it — though a little less so — for healthcare workers who are fully vaccinated but not boosted. He said that he could not see the argument for healthcare workers who are not vaccinated.
The reason he said he believes it isn’t the right time to cut the isolation period for everyone is because “we are in the midst of an explosion of cases right now.”
“I think it might be taking a little bit too much of a risk,” Swartzberg said.
Asymptomatic people who have tested positive are shedding less virus and for a shorter duration of time, he said. However, it isn’t necessarily known for how much shorter a period of time, and both concepts are for the aggregate, not the individual.
In general, someone who is asymptomatic the entire time would be someone who could come out of isolation sooner, he added. Someone who is symptomatic should not be doing so until their symptoms have abated.
Annette Regan, PhD, MSc, MPH, an epidemiologist at the UCLA Fielding School of Public Health, also highlighted the relevance of decreasing isolation periods for healthcare workers and other members of the workforce.
“Lowering the quarantine period allows individuals to return to work earlier, which can be a game-changer for healthcare professionals — especially during surges of the pandemic where healthcare professionals are in critical need,” Regan told MedPage Today in an email. “But it also means that other essential workers can return to work earlier, which has impacts on many other aspects of life.”
Aaron Carroll, MD, chief health officer at Indiana University in Bloomington, said he couldn’t emphasize that point enough. “We really need alternative guidance for mildly symptomatic or asymptomatic vaccinated and boosted people testing positive for COVID. Mandatory 10 day isolation is going to make things really difficult for essential service,” he tweeted.
Swartzberg told MedPage Today that he believes, from a timing standpoint, it would be wise to identify workers who are most critical for society to function, and allow those individuals to be the first to come out of isolation sooner. The goal would be to evaluate that process and then expand it to a “larger swath of the population.”
Until then, or any other announced changes from the CDC, individuals who test positive for COVID-19 are left to follow the 10-day isolation period.