Chronicle of Dr. Richard Sternberg
New COVID recommendations from the CDC
Vaccines and infection-induced immunity and the availability of effective treatment and prevention methods have reduced the risk of symptomatic COVID infection, hospitalizations and death. Therefore, on August 11, the Center for Disease Control released a new set of guidelines to minimize the impact of COVID on people, communities, and healthcare providers. This takes into account the psychological and economic effects of the various actions. It allows much more freedom than previous directives.
Below is a summary of the recommendations, but I highly recommend reviewing the original article in MMWR, Morbidity and Mortality Weekly Review, which is published weekly by the CDC, online. The August 11, 2020 edition contains the article. You can go to www.cdc.gov/mmwr to find it. In addition to containing the information in more detail, the article contains a table that lists actions to minimize the impact based on the effects on different people, communities and health system and a figure that lists recommendations for isolation, masking, testing and other precautions for people who are sick with symptoms of COVID and/or have tested positive. I think the figure and the article may be easier to understand than in narrative form.
Efforts to expand access to vaccination and treatment must be intensified to reduce the risk of severe disease and post-infectious symptoms. In order to protect those at high risk, it is important that everyone understands prevention and treatment strategies not only for themselves but also for others, especially those at high risk. All people should understand their risk, protect themselves and others, undergo testing and wear masks if exposed, and test according to protocol and wear masks for five days or more if infected. The figure in the article is very specific for how long to hide and when to test if exposed or affected.
It is important to know the community level of COVID cases to determine what precautions to follow. At all community levels (low, moderate, and high), keeping up to date with vaccinations and boosters, improving ventilation, testing symptomatic and exposed people, and isolating infected people is recommended. Others who are asymptomatic and don’t have high-risk people to protect don’t have to routinely wear a mask. At medium levels, protection for those at high risk should be added. At high levels, all people must wear masks indoors. On August 15, the Otsego County level was low. Knowing the local levels provides a framework for knowing when to add or reduce prevention strategies.
Screening for current infections can be used so that individuals can take steps to reduce their risk of infecting others, especially those at high risk, and to determine when they should be treated. Everyone should be tested when they have symptoms or have been exposed to others with active disease. Testing strategies must include everyone, regardless of vaccination status, because vaccination does not seem to prevent disease but improve it although it is still contagious.
Isolation is another area where the new guidelines are more specific. They help bring people back to the community earlier, but at a generally safe time. If a symptomatic or infected person needs to self-isolate immediately for 5 days or more, properly wear a well-fitting mask, preferably N-95 or equivalent. They can end isolation after 5 days when they are fever-free (without anti-fever medication) for 24 hours and other symptoms have improved. People who want to use tests to determine when to come out of isolation should start no earlier than day 6 (day zero being the first with symptoms). Two negative tests, 48 hours or more apart, improve reliability. Routine quarantine of non-symptomatic exposed individuals is no longer recommended although surveillance is reasonable.
As I said at the beginning, the referenced figure and graph are much clearer and more specific.
The CDC has reduced the restrictions on many of us and we can still return to more active social interactions and contact with reasonable security.
Dr. Richard Sternberg offers his professional perspective during the threat of COVID-19.
Also a village administrator, he lives in Cooperstown.