A Blog by Jonathan Low

 

Dec 25, 2021

Calls Mount For Shorter Quarantines For Vaccinated Covid Patients

There is a growing belief among healthcare experts that shorter quarantines make sense for those suffering breakthrough infections, especially as the milder omicron variant wreaks havoc with essential work in hospitals, airlines and public service. 

Doctors increasingly believe that 4 or 5 days may be sufficient for those already vaccinated who test positive, are exposed or who suffer mild break throughs. JL 

Nidhi Subbaraman and colleagues report in the Wall Street Journal:

Pandemic-response measures may be shifting, as new tools for fighting the virus take hold and fatigue with restrictions grows. A vaccinated person with no symptoms or mild ones could end a four- or five-day isolation period if two rapid tests indicate they don’t have the virus. For hospitals and businesses with essential workers, shorter quarantines could help limit employee shortages that disrupt operations, especially as the Omicron variant races across the U.S.

More health experts, business people and government officials are questioning how long people infected with Covid-19 should quarantine if they are vaccinated and no longer testing positive.

The U.S. Centers for Disease Control and Prevention has recommended that people with Covid-19 should isolate for 10 days from the first day symptoms develop or from a positive test, to prevent spreading the virus. On Thursday, the agency issued new guidelines for healthcare workers, reducing their recommended isolation time.

The move comes as some researchers and business leaders have started calling for a shorter timetable for all fully vaccinated people who have cleared their infections, saying it is supported by a growing body of research and rising numbers of vaccinations and rapid tests.

The U.K. changed its quarantine rules on Wednesday, cutting the quarantine time to seven days for vaccinated people who twice test negative, to allow them to return to work faster, easing the burden on overstretched public services and businesses, the government said.

The debate suggests pandemic-response measures may be shifting, as new tools for fighting the virus take hold and fatigue with restrictions grows.

A vaccinated person with no symptoms or mild ones could end a four- or five-day isolation period if two rapid tests indicate they don’t have the virus, said Dr. Saad Omer, director of the Yale Institute for Global Health. “That would be my recommendation to go in that direction, and I would urge the CDC to reconsider this and make that recommendation,” he said.

Unvaccinated people should follow the CDC’s recommended periods of isolation and quarantine, Dr. Omer said, as should vaccinated people who show symptomatic infections.

For hospitals and businesses with essential workers, shorter quarantines could help limit employee shortages that disrupt operations, especially as the Omicron variant races across the U.S.

“Healthcare workers, first responders, airline professionals and many other essential employees across the economy who are fully vaccinated may no longer need a full 10-day isolation,” JetBlue Chief Executive Robin Hayes said in a letter to the CDC Wednesday.

Delta Chief Executive Officer Ed Bastian, along with the airline’s chief medical officer and a medical adviser, sent a letter on Tuesday asking the CDC to consider five days of isolation and a testing protocol.

“With the rapid spread of the Omicron variant, the 10-day isolation for those who are fully vaccinated may significantly impact our workforce and operations,” they wrote.

Dr. Anthony Fauci, in white mask, said the administration was discussing adjusting the CDC’s recommended quarantine period in some scenarios.

PHOTO: SUSAN WALSH/ASSOCIATED PRESS

Thursday, Delta cited the variant’s impact on its workforce as a factor behind some flight cancellations, as did United Airlines Holdings Inc. “Delta teams have exhausted all options and resources—including rerouting and substitutions of aircraft and crews to cover scheduled flying—before canceling around 90 flights for Friday,” the airline said in a statement.

Under the CDC’s new guidelines, healthcare workers can resume work within seven days following a negative test, or potentially even sooner in a staffing crunch. Also, healthcare workers who are fully vaccinated and who got a booster wouldn’t need to quarantine after high-risk exposure to the virus.

“As the healthcare community prepares for an anticipated surge in patients due to Omicron, CDC is updating our recommendations to reflect what we know about infection and exposure in the context of vaccination and booster doses,” CDC Director Rochelle Walensky said.

The CDC technically distinguishes between isolation, which is for people who have a confirmed infection, and quarantine, which is for people exposed to the virus.

The U.K. shortened the isolation period for fully vaccinated people who test positive for the virus to seven days from 10, provided they test negative using a rapid antigen test on the sixth and seventh days of their stretch in isolation. The tests must be taken 24 hours apart.

“We want to reduce the disruption from Covid-19 to people’s everyday lives,” Health Secretary Sajid Javid said Wednesday.

Under the U.K.’s new rules, people still showing symptoms, especially fever, after seven days should keep isolating even if their tests are negative. It advised people leaving isolation after seven days to work from home, wear a mask indoors with others and avoid contact with vulnerable people for a few days longer.

Unvaccinated people who are close contacts of a Covid-19 case are still required to isolate for 10 days.

The changes were based on an analysis by the U.K. Health Security Agency that found a regime of seven days of isolation and two negative test results has nearly the same effect at reducing the spread of the virus as 10 days.

Current CDC guidelines recommend people infected with the virus isolate for 10 days from the day symptoms develop or from a positive test result, while anyone who is a close contact of someone infected and isn’t fully vaccinated should quarantine for seven to 14 days, depending on whether they got tested and if the result was negative.

The CDC recommends fully vaccinated people quarantine only if they have symptoms but should get tested five to seven days after exposure and wear a mask for 14 days until their test result is negative.



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