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CDC isolation guidance: Do you need a negative test to return to normal?

Changes in the CDC's guidance about isolating after exposure to COVID-19 are causing confusion.
Credit: AP
US tourist Lina Kozenko gets a nasal swab at a mobile COVID-19 testing site, in Paris, France, Wednesday, Jan. 5, 2022. (AP Photo/Francois Mori)

INDIANAPOLIS — Last week, the Centers for Disease Control and Prevention changed its isolation guidelines to help employees get back to the workforce quicker, citing data that people are most contagious in the first few days of COVID-19 symptoms. 

But the new guidelines are causing confusion among the general population.  

"I get it. It's confusing to me and this is what I do for a living," said Shandy Dearth, principal investigator for contact tracing for Marion County and director of the Center for Public Health Practice at the Richard M. Fairbanks School of Public Health. "So, I completely understand why the general public has had the reaction they have had. A lot of us in public health have shared the same reaction."

Here is what the current CDC guidance says: 

  • If you test positive for COVID-19, you can isolate for five days instead of 10. After that, if you don't have symptoms, you can return to normal, but you need to wear a mask at all times for at least another five days.  
  • If you do have symptoms on day five, stay home until you feel better. 
  • If you are a close contact with someone that has COVID-19, but you are boosted, you can skip quarantining and wear a mask for at least 10 days. If you are not boosted, you need to quarantine for five days and see if symptoms occur.  

Right now, a negative test is not required for any of this. It is only suggested by the CDC. 

Since the new guidelines came out, the American Medical Association has criticized the guidelines, calling them "confusing and counterproductive." 

"A negative test should be required for ending isolation after one tests positive for COVID-19. Re-emerging without knowing one's status unnecessarily risks further transmission of the virus," said Dr. Gerald E. Harmon, president of the American Medical Association. 

RELATED: Yes, CDC exposure guidelines are the same for the unboosted and unvaccinated

The CDC director defended her decision on Friday and also said the testing suggestion is not due to the shortage of available tests. 

"We are now standing on the shoulders of years of science that has demonstrated that if you are infected, you are most contagious in the one-to-two days prior to your symptoms and the two-to-three days after your symptoms," said Dr. Rochelle Walensky. "So we know that the vast majority of your contagiousness by day five is really behind you." 

So what should you do if you test positive? Do you isolate for five or ten days? Do you get tested? 

Most experts say to keep following the CDC guidance and get tested if a test is available. 

It's something Dearth highly recommends, since you can still spread the virus if you are asymptomatic. 

"I really encourage you to get tested, even if it's just with the home test kit," Dearth said. "If you are able to do remote work and stay at home, I would actually encourage you to stay at home a little bit longer. At least give it seven days if you can't give it the full ten." 

New data also shows the omicron variant can still spread through certain masks, including cloth masks

RELATED: Yes, surgical masks offer better protection against COVID-19 than cloth masks

"We don't see great mask use already, and then to shorten that time frame is making a lot of the public health people worry," Dearth said. "I do think it is a little bit early. This would've been better if this came out for the general public in, let's say, March." 

Dearth said it's still important to notify coworkers, friends and family that were exposed since contact tracing systems are currently bombarded with cases. 

"You should also notify your close contacts that they have been in contact with COVID, too, because honestly, a lot of these contact tracing systems are overwhelmed and having a hard time reaching everyone," she said. 

As a reminder, the CDC guidance is a recommendation, so it's ultimately up to employers to make a final decision.