In new recommendations, the CDC says COVID patients can end isolation 24 hours after symptoms improve

The CDC issued new guidance Friday saying people with COVID-19 and other respiratory viruses can return to their daily lives if they have improved symptoms and no fever for at least 24 hours. After ending their isolation, people are still encouraged to wear a mask and distance from others for at least five days to prevent the spread of the virus, the CDC says.

The update lets people respond to a COVID infection with steps similar to how they would limit the spread of the flu. It’s another reduction in the recommended amount of time that a person with the once novel coronavirus should isolate from others. In 2021, over a year into the pandemic, the CDC announced that people with COVID-19 should stay home for five days after their symptoms started — instead of the 10-day isolation period that was previously recommended.

Now, under the latest guidance, the agency recommends that people with COVID-19 should stay home if their symptoms are not improving or if they have a fever that hasn’t broken without the aid of medicines like ibuprofen or acetaminophen. Once their symptoms begin improving, they can end their isolation within 24 hours.

People whose symptoms are not improving, or have a fever that hasn’t yet broken, should still isolate themselves from others, the CDC says. The guidance also applies to other respiratory viruses like influenza and respiratory syncytial virus (RSV).

The guidance does not apply to people who work in health care settings. Health care personnel who test positive for COVID must wait at least seven days and test negative for the virus before returning to work, and cannot go back to work until 24 hours after their symptoms have improved and their fever has broken.

The move comes as more people have developed immunity to the virus, the CDC says. Rates of COVID infections have not declined, but hospitalizations and deaths have, the agency said. And more than 98% of the country has some immunity from the virus, either because they were vaccinated, had already been infected, or both.

Still, the CDC noted, uptake for the latest COVID-19 vaccine, released last fall, has been low. Just 22% of adults have received the latest vaccine, and only 42% of people 65 and older, who have a higher risk of serious complications from COVID, have gotten the shot as of early February. Additionally, just 40% of nursing home residents, where the virus can spread easily because of the communal setting, had received an updated vaccine as of Feb. 11.

The CDC said 95% of people hospitalized for COVID during October and November of 2023 had not received an updated vaccine.

In developing the new guidance, the agency said it took into consideration the “personal and societal costs of extended isolation” — since many people may have limited paid time off from work when they’re sick. In 2021, the Washington Post reported that national health officials also shortened the recommended isolation time from 10 to five days in part because of fears that too many essential employees would leave work and that society would not be able to function.

In a report outlining the new guidance, the CDC said that weekly hospital admissions for COVID-19 have decreased by 75%, and deaths have decreased by more than 90% compared to January 2022, when the Omicron variant gripped the country. In addition, the agency said that COVID-related health complications like long COVID and multisystem inflammatory syndrome among children have also decreased.

The agency also noted that Oregon, which also relaxed its isolation guidance, has not seen higher hospitalization rates compared to national COVID-19 hospitalization rates since changing its recommendations.

Some health advocates have criticized the move, telling the Washington Post earlier this month that since COVID is “deadlier than the flu” and comes with a higher risk of complications like long COVID, health officials should take it more seriously than other respiratory illnesses.