Why public health agencies have shortened quarantine recommendations and what the new guidelines mean • Long Beach Business Journal

A man lines up for a vaccine as workers set up the vaccination site on the Pacific Coast campus of Long Beach City College on Tuesday, Dec. 21, 2021. Photo by Brandon Richardson.

As the world faces the third year of the coronavirus pandemic, guidance from public health agencies continues to evolve, but experts have differing opinions on what those changes will mean in the fight against COVID-19.

One of the most recent examples was an announcement from the Centers for Disease Control and Prevention that it was shortening the recommended quarantine and isolation period for people who contract or are exposed to COVID-19.

Rather than the previous recommendation to stay home for 10 days, the CDC’s position now is that people should stay home for five days if they test positive. The same goes for those who are exposed to the virus and who have not been recently vaccinated or who have not received a booster. Recently vaccinated and asymptomatic people, however, do not need to stay home. But anyone exposed to the virus should wear a mask around others for 10 days, according to the CDC.

The California Department of Public Health followed with its own set of similar, but slightly stricter, guidelines earlier this month. Although the CDC does not include testing in its recommendations, the CDPH asks anyone who tests positive or is exposed to COVID-19 to get tested after five days to determine how to proceed. This includes people who were recently vaccinated or received a booster shot, although they do not need to stay home after exposure.

The Long Beach Health Department, for its part, followed Califorina’s lead with its own health order, which also shortens quarantine and isolation periods while calling for testing.

City of Long Beach health worker Dr. Anissa Davis said in a phone interview that Long Beach’s updated health order was based on the CDC decision and the data behind it. .

“My understanding of what [the CDC] said is that they felt you are most contagious early in the course of your disease,” Davis said, “so you are most contagious a day or two before you start showing symptoms, until a day or two later.

“So that information, coupled with the huge impact that omicron was having in the workplace, kind of guided them to change the isolation and quarantine guidelines at that time,” Davis added. “So we’ve adjusted all of our guidelines to reflect that.”

The announcement of the new guidelines was welcome news to many industries that have faced labor shortages amid the recent omicron surge. But medical professionals seem divided on what the new recommendations will mean for the public.

“I’m actually concerned that there’s no more transmission,” said Dr. Timothy Brewer, professor of medicine and epidemiology at UCLA. “So among the recommendations there is a reduced amount of [quarantine] time for asymptomatic people, but given the data showing that omicron is more likely to cause asymptomatic infection, this means there will be more people potentially able to spread this virus to others. And while most people will have mild to moderate disease, some people will be very severely affected. »

But Dr. Jeffrey Klausner, a clinical professor of population and public health sciences at USC, sees it differently.

“There’s a combination of factors that come into play,” Klausner said when asked how he felt about the changes in guidance. “One is obviously the recognition that efforts to control the spread of infection have failed, and it’s actually good to update one’s strategy when one sees the failure of the initial strategy. If you continue doing the same thing over and over again, expecting a different result, that’s the definition of insanity.

“Community-level infection prevention hasn’t worked,” he continued. “It’s time to pivot and do something new. And second, since there is a fair amount of population-level immunity that protects people from serious disease, it also means that many efforts to reduce the spread of infection are neither cost-effective nor worthwhile. . And finally, with the advent of the increasing availability of new therapies, the focus has shifted to treating people early.

As for what the new guidelines look like on a practical level, in a health care setting, Long Beach Memorial Medical Center’s lead COVID-19 physician, Dr. Graham Tse, said testing is still in progress. paramount importance.

“We absolutely want to keep our patients and staff safe, and to that end we are taking a stricter approach in that we require testing before we allow anyone to return to work, and we do not allow them to return to work now. if they are asymptomatic and untested,” Tse said of Memorial’s current approach. “We have a set practice to make sure we minimize the chances of anyone passing it on.”

Tse said the CDC’s decision to exempt anyone exposed to COVID-19 — even those who are asymptomatic and have recently been vaccinated or given a booster — from quarantine recommendations has been controversial in the medical field. Even California’s approach, which requires testing but not quarantine, allows for further transmission of the virus, he said.

“Allowing someone who is asymptomatic to return to work without testing – how does that fit in terms of omicron infectivity and transmissibility?” said Tse. “So we’ve taken a stricter approach.”