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The period of being contagious with COVID is highly variable. Some research suggests that five days of isolation may not be even enough, since about two thirds of people continue to shed the virus five days after they first feel sick. Data from 2023 suggest that how infectious a person is has a median peak around day four, meaning that under the new guidance many people will go back to their daily lives at the point that they’re most likely to transmit the virus, so long as they don’t have a fever and are feeling better than they did when they first felt sick.
“Shortening isolation below five days supports economic interests and is not in the interest of protecting health, as the contagious period can vary with current variants,” Kaitlin Sundling, MD, PhD, director of cytology at Wisconsin School of Medicine and Public Health and member of the People’s CDC, tells SELF. She believes that the CDC’s updated recommendations are moving in the wrong direction. “COVID isolation should be expanded, not reduced or eliminated. There is no change in the scientific evidence around COVID transmission that would support reducing the recommended isolation period below five days,” she says. “Extending isolation beyond five days would be a safer approach, both to prevent viral spread and to allow people adequate time to recover.”
Despite what the CDC guidelines say, Dr. Sundling’s advice is to isolate for 10 to 14 days, if you have that option, and take two rapid tests with negative results at least 24 hours apart before going about your daily life as usual again. (Because Americans do not have universal paid sick leave, Dr. Sundling recognizes that many people will have to return to work or other responsibilities earlier than this. In that case, she says, people should be “wearing a well-fitting respirator and limiting in-person activities only to what is essential.”)
There’s still a lot we don’t know about long COVID.
Dr. Jirmanus stresses that SARS-CoV-2 is still a very new virus, and that eliminating preventative public health measures before we fully understand its long-term effects can have potentially devastating consequences. “None of us have a crystal ball. None of us know what COVID will be doing in five to seven years, what it even will mean for a person who is infected now, and what long COVID could look like,” she says.
“Every time you get infected with COVID, it increases your risk of having heart problems, strokes, blood clots, and many other issues,” says Dr. Jirmanus—for instance, an increased risk of diabetes, new-onset asthma, ME/CFS, POTS, MCAS, and a plethora of post-viral symptoms and chronic conditions, some of them very serious, that fall under the long COVID umbrella, including POTS, MCAS, brain fog, difficulty breathing, joint paindiarrhea, and post-exertional malaise, among other issues.
Estimates about the rates of long COVID vary, but one recent analysis suggests that each COVID infection carries a 10 to 20% risk of the chronic condition, most often after mild acute illness. Dr. Hoerger estimates that, in the US, between 38,000 and 152,000 people will develop long COVID every day this week, based on wastewater analysis. These are staggering figures, and each case represents a person with one or more of the above symptoms and conditions, all of which can have significant impacts on their quality of life.
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