Late last week, the Centers for Disease Control and Prevention relaxed COVID isolation guidelines, signaling a move by government agencies to issue public health policies that stand the greatest chances of actually being followed by a population that is growing COVID-weary.
Under the new recommendations, the onus of mitigation lies with individuals to take measures to prevent serious infection, easing requirements such as isolation for those exposed to the virus regardless of vaccination status.
The new guidelines boil down to a shift in preventative measures that move away from curbing overall transmission, rather focusing on severe health outcomes like hospitalization and death.
These new guidelines come as more than 100,000 San Diego Unified students prepare to head back to school at the end of August, prompting the district to roll back many of its safety precautions — measures that were previously regarded as some of the most robust in the county.
The announcement also came on the heels of San Diego County's move back into the "medium-risk" level of the CDC's community level tracking system given slowing transmission rates in the region.
Experts say that these changes are an attempt to allow people to adapt in a way that allows them to move past pandemic-era restrictions, while accepting that COVID will continue to be around for the foreseeable future.
"This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives," Greta Massetti, an epidemiologist with the CDC, said in a press release announcing the modification.
‘Being realistic about what people will do'
The updated guidelines released last Thursday are the latest action by the CDC to move away from early-pandemic safety measures, shifting the responsibility for mitigation from government agencies to the individual.
The recommendations build on previous recommendation changes from February that shortened isolation time for most Americans.
The new guidelines, which the CDC said "streamlines" existing COVID instructions, include:
- Regardless of vaccination status, those exposed to COVID wear a high-quality mask, such as an N95, for 10 days — getting tested on day five.
- Isolation from others is recommended when a person, regardless of vaccination status, tests positive for COVID, or if a person is sick and suspects they have the virus without a positive test result yet.
If a person tests positive for COVID, they're required to isolate themselves for at least five to 10 days.
- After five days, if a person is fever-free for 24-hours, improving from symptoms or asymptomatic, they can leave isolation, while continuing to wear a mask for an extra five days and avoiding large groups of people until day 11.
- If a person has moderate illness due to the virus or has a weakened immune system, they should remain isolated for the full 10 days.
The strategies also no longer differentiate instructions based on whether a person is up to date with their COVID vaccinations, rather using a person's potential risk for severe illness as a metric for how a person should approach prevention.
The CDC continues to stress with these guidelines the importance of getting vaccinated and taking other measures to prevent these severe outcomes as opposed to transmission at-large — a more pragmatic approach to long-term COVID precaution, according to experts.
The CDC's guideline change was announced shortly after San Diego County was lowered back into the "medium-risk" level of the CDC's community level tracking system given slowing transmission rates, after moving into the "high-risk" tier in mid-July.
Recent numbers from the county show cases beginning to dip following a summer of high transmission given the spread of fast-moving omicron subvariants propelled by high levels of activity with minimal public health precautions.
Approximately 6,262 confirmed cases were recorded by the county during the week of August 8, with as many as 1,206 cases recorded on a single day. In July, the highest number of confirmed positive cases in one day was 2,620.
While these numbers may still be an undercount due to the prevalence of at-home testing, wastewater sampling data has shown a decrease of the county's overall viral load by about 30% since the surge's peak recorded earlier this month.
Experts predict that the transmission will not completely die down before an expected fall or winter surge — a pattern that will most likely continue over time.
"The CDC is moving into (a state of) things being more chronic," said Dr. Robert Schooley, chief of the UC San Diego Health Division of Infectious Diseases. "We're gonna have this roller coaster, where (cases are) not gonna go down to zero, but we'll (have) periods where viral loads are lower than they have been in the past and then they'll heat up again."
However, experts like Schooley, are unsure of how these new CDC guidelines will be enforced by local health agencies, given their focus on personal responsibility and changing attitudes toward the pandemic that rationalize not taking precaution given notions of inevitability.
"We are in a stage that we have to be realistic about what people will do," Schooley said. "We're not gonna be able to enforce these things anymore."
"Many things that happen in public health have to do with compromises and trying to figure out how to get the maximum protection out of the population by coming up with guidelines that they're most likely to follow," he continued.
San Diego Unified lifts indoor mask mandate
The district emailed families and staff Monday, providing updated guidelines for the return to school — removing the indoor mask mandate.
Under the new COVID guidelines, masks will no longer be required districtwide for students, employees and visitors as of Monday.
Before the first day of school, the district said that students and staff should test within 48 hours of stepping onto campus, utilizing at-home antigen tests that will be available to them. Students that test positive for COVID-19 or are experiencing symptoms of the virus should stay home.
Students feeling ill can return to campus once they no longer have a fever, have been free of fever-reducing medication for 24 hours and take two tests at least 12 hours apart that produce negative results.
The district asks individuals that test positive for COVID-19 to notify their school and stay home, adding that plenty of at-home testing kits will be made available to families and staff during the first week of school.
The county's move into the "medium-risk" tier of the CDC's transmission tracking system paired with accessible at-home COVID-19 testing, vaccinations, available therapeutic treatments and districtwide mitigation strategies have allowed the district to adjust its guidelines, said Maureen Magee, communications director for San Diego Unified.
Retrofitted district spaces have also allowed the district to no longer require masking on-site according to Magee, as all classrooms and offices have HVAC systems and air purifiers that help remove any harmful particles from the air.
While previous masking policies in the district have been triggered by the county's transmission level, these new guidelines from SDUSD are moving away from that practice, instead using school-site metrics — like accounting for absences and individual school cases — and county data to determine if masks are needed at each school.
If within a period of two weeks at least three outbreaks have been identified and more than 5% of students and staff are infected, the district guidelines say individual schools will then require masking again for a minimum of two weeks.
Despite the district's move to lift the mask mandate, it continues to strongly recommend masking for all students and employees, especially indoors moving into the school year. Masks will remain available to those that want one at each district site.
Weekly testing for students and vaccinated staff that are symptomatic will continue on a voluntary basis throughout the year at each school site. Parent consent will be required for a student to be able to get tested for COVID-19.
Students who develop symptoms or become ill while at school will be required to wear a mask in the health office while being treated and waiting to get picked up. A test to return to school will also be required for students experiencing symptoms, which will be up to the student whether they want to take it at school or using an at-home testing kit.
Unvaccinated staff will be required to undergo weekly asymptomatic testing. CalOSHA regulations instruct staff to test before returning to school if they come in close contact with a person who has tested positive for the virus or is showing symptoms of COVID-19.
Employees who are eligible for shortened isolation must continue to wear a highly protective mask at all times for 10 days after testing positive for the virus, except when eating and drinking.
"The health and safety of our students, staff, families and communities remain a top priority," Magee said.
While no countywide mandates remain in place outside of schools, officials continue to stress the importance of continuing to follow public health safety measures, such as getting vaccinated and wearing a mask.
"COVID remains unpredictable," said San Diego County spokesperson Sarah Sweeny in an email. "(The virus) is still solidly throughout the region and San Diegans should continue taking precautions to slow the spread of the virus."
Thousands of students returned to San Diego County schools Wednesday, and between COVID-19 safety measures and new laws affecting public school districts, there's a lot to talk about.
Congressman Adam Schiff talks about his book on the Donald Trump impeachment trial and how congress and politics in America has changed in recent years. In other news, more on the accuracy of at-home COVID-19 tests.