America's COVID Rules Are a Dumpster Fire

[Celerity]

Last edited Sat Jan 8, 2022, 07:19 AM - Edit history (1)

If you’re confused by the CDC’s new isolation guidelines, you’re not the only one.

https://www.govexec.com/workforce/2022/01/americas-covid-rules-are-dumpster-fire/360518/





On Tuesday, the CDC officially dropped the detailed, 1,800-word version of its new isolation guidance for people who have been infected by the coronavirus. So far, the best way I’ve got to sum it up is this: Hunker down for five days instead of the typical 10, then do what you want. Okay, sorry, that’s overly simplistic. Here’s the slightly longer version: You can leave isolation after five days, without a negative test, if you’re not severely sick; you’re not immunocompromised; you’re not in a correctional facility, in a homeless shelter, or on a cruise ship; and you feel that your symptoms are mostly gone, if you had any at all.

Sorry, sorry. There’s actually more. If you do leave isolation after day five, the CDC would like you to, please, until you’re past day 10, still wear a mask everywhere you go, and not eat inside of restaurants, and not mingle with high-risk people, and not travel. Okay, fine, you may travel if you must; just don’t forget that mask. You can test out of isolation, by the way, if you like. First, though, you have to find a test—make sure it’s a rapid antigen test—and take it “towards the end” of your five-day isolation. Just please, still wear that mask until day 10, though remember that negative results can’t rule out infection, and that antigen tests tend to perform best when they’re taken repeatedly over a couple of days, and also, you don’t technically have to test at all.

If you’re overwhelmed, you’re not the only one. In the week and a half since the CDC said that it was planning to update its isolation guidance, I’ve heard almost exclusively harsh reactions from experts, who have criticized the recommendations as convoluted, wishy-washy, and even unscientific. The guidance reads like a nightmarish choose-your-own-adventure book, they’ve told me. It lacks crucial caveats, can’t seem to make up its mind on the role of testing, and asks people to do so, so much before they can get back to daily life. “It’s a hot mess,” one researcher told me. “Unnecessarily confusing,” someone else decreed. “Of all the communication stumbles since February 2020, this one ranks in the top three,” another said.

Such a mess has, unfortunately, become par for the course in the CDC’s handling of the pandemic. The agency is yet again punting the responsibility of infection control to the masses; allowing people’s fates to splinter by timing, by testing, by … whatever, is hardly good incentive for the public to read the instructions, much less follow them to a T. At a time when Omicron cases are already shattering records nationwide, the costs of muddled messaging are extraordinarily high. I asked Alison Buttenheim, who studies the intersection of vaccines and human behavior at the University of Pennsylvania, if she thought people would just give up on trying to parse the guidelines and simply improvise their own end-of-isolation rules. “I think people already have,” she said.

snip





The American Medical Association: CDC quarantine and isolation guidance is confusing, counterproductive



https://www.ama-assn.org/press-center/press-releases/ama-cdc-quarantine-and-isolation-guidance-confusing-counterproductive

“Nearly two years into this pandemic, with Omicron cases surging across the country, the American people should be able to count on the Centers for Disease Control and Prevention (CDC) for timely, accurate, clear guidance to protect themselves, their loved ones, and their communities. Instead, the new recommendations on quarantine and isolation are not only confusing, but are risking further spread of the virus.

“Living during a pandemic is challenging, and what we learn along the way—and data we collect—will necessarily change our course of action at times. According to the CDC’s own rationale for shortened isolation periods for the general public, an estimated 31 percent of people remain infectious 5 days after a positive COVID-19 test.

With hundreds of thousands of new cases daily and more than a million positive reported cases on January 3, tens of thousands—potentially hundreds of thousands of people—could return to work and school infectious if they follow the CDC’s new guidance on ending isolation after five days without a negative test. Physicians are concerned that these recommendations put our patients at risk and could further overwhelm our health care system.

“A negative test should be required for ending isolation after one tests positive for COVID-19. Reemerging without knowing one’s status unnecessarily risks further transmission of the virus. “Test availability remains a challenge in many parts of the country, including in hospitals, and we urge the administration to pull all available levers to ramp up production and distribution of tests. But a dearth of tests at the moment does not justify omitting a testing requirement to exit a now shortened isolation.”

snip

[bamagal62]

1. The orange one caused such chaos

That now we can’t get out from under it.

[Ms. Toad]

2. Simplified version of the rules

https://coronavirus.ohio.gov/static/docs/covid-19-guidance-quarantine.pdf

The point this chart makes (which I really have not seen talked about) is that fully vaccinated is much more limited than most of us understand.

Fully vaccinated =

1. Any booster OR
2. An mRNA series less than 6 months ago OR
3. J&J less than 2 months ago.

If you don't meet one of the above criteria, you are considered unvaccinated under the guidelines.

What the guidelines don't expressly address is exposure. As to exposure the guidelines are: If you are not vaccinated (see the above) isolate for 10 days, test at 5. If you are vaccinated no isolation required, test at day 5, wear a mask for 10 days.

(Not saying I agree with them - and I'm certainly not arguing that they are NOT a dumpster fire, but enforcing them is part of my job, so I had to get up to date immediately.)

[madville]

5. Guess I'm not fully vaccinated then even though I have had a booster

And am not eligible for another one. Good thing being “fully vaccinated” isn’t required at work!

[Ms. Toad]

6. Any booster is fully vaccinated. n/t

[Hugin]

12. Many Americans are hopeless with nuance.

They only hear what they want to hear. The essence of propaganda. It's probably an offshoot of confirmation bias.

Its why millions are made off of diet plans when eat less and exercise is the key. Drawn from another thread.

[Ms. Toad]

13. I know. I'm just providing it for people who

(1) want to know what the rules are or
(2) need to enforce them

[Hugin]

14. That's why I read them.

For a clear directive.

It is not as difficult as people seem to think it is. As you spell out in your original post.

[onecaliberal]

3. We were told today if we have any symptoms we are to quarantine for 5 days and

Get a rapid test, which they can get at our district. A negative test is required before you can return.

[TomCADem]

4. Meh. Seems Like a Standard Republican Bait and Switch...

...demand freedom, rather than have one size fits all rules, but when you are given flexibility, they complain about the complexity.

Here is the thing: There are two different pandemics. I know two people, anti-vax people who got laid out twice with COVID with the first time being pretty bad and the second time still being symptomatic. In our city, almost 90 percent of the people who are hospitalized are unvaccinated even the most of the population is vaccinated.

A second person I know was fully vaccinated, boosted and had a case of the sniffles that he thought was just an allergy, since it was mild. But, when it did not go away after a few days, he got tested, and it was COVID.

I do not see what is so hard to understand about CDC guidance. Get vaccinated. Wear a mask. Socially distance. Wash your hands. There. On the CDC website, you can get a poster that breaks this down.

It is not like the anti-vaxxers do not understand the rules. They just disagree with them and refuse to comply, particularly with getting vaccinated.

The fact of the matter is that COVID is not going to go away. Even the Spanish Flu that killed millions, also known as H1N1, is still around, but mitigated over time with flu vaccines and immunity developed over decades. So, do you shut down mainly to protect the folks who are refusing to be vaccinated, particularly when the US Supreme Court is in on the verge of outlawing vaccine requirements for large employers?

This is a complex issue and the disease is not running amok because people are confused by the CDC.

[Celerity]

7. The American Medical Association, to name just one of many, disagrees with your take on things

AMA: CDC quarantine and isolation guidance is confusing, counterproductive

https://www.ama-assn.org/press-center/press-releases/ama-cdc-quarantine-and-isolation-guidance-confusing-counterproductive

“Nearly two years into this pandemic, with Omicron cases surging across the country, the American people should be able to count on the Centers for Disease Control and Prevention (CDC) for timely, accurate, clear guidance to protect themselves, their loved ones, and their communities. Instead, the new recommendations on quarantine and isolation are not only confusing, but are risking further spread of the virus.

“Living during a pandemic is challenging, and what we learn along the way—and data we collect—will necessarily change our course of action at times. According to the CDC’s own rationale for shortened isolation periods for the general public, an estimated 31 percent of people remain infectious 5 days after a positive COVID-19 test.

With hundreds of thousands of new cases daily and more than a million positive reported cases on January 3, tens of thousands—potentially hundreds of thousands of people—could return to work and school infectious if they follow the CDC’s new guidance on ending isolation after five days without a negative test. Physicians are concerned that these recommendations put our patients at risk and could further overwhelm our health care system.

“A negative test should be required for ending isolation after one tests positive for COVID-19. Reemerging without knowing one’s status unnecessarily risks further transmission of the virus. “Test availability remains a challenge in many parts of the country, including in hospitals, and we urge the administration to pull all available levers to ramp up production and distribution of tests. But a dearth of tests at the moment does not justify omitting a testing requirement to exit a now shortened isolation.”

[TomCADem]

8. The AMA is just asking for more social distancing, quarantines and masking...

...again it is not that complicated. And you know what? In theory, that sounds great! But, let me ask you, what have you observed in terms of compliance with any prior guidance CDC or otherwise?

My personal experience seeing one blue state and one red state was that in the red state, it did not matter, because the red state was not taking any steps to enforce the measures and people were generally left to voluntarily comply.

Even in the blue state, California, a lot more people complied, but you still had a large number of people flouting the guidelines. This same group of people were often also the anti-vaxxers who were most at risk. So, you have the people who are vaxxed and boosted and least at risk complying while those who are most at risk refusing to comply. As a result, the restrictions mostly effect the people who are less at risk while not doing much to affect the behavior of those who are most at risk to catch, spread or die from the disease.

Finally, given the huge impact of Omicron, how could you implement the AMA's proposal at hospitals, which are short staffed to being with? The AMA itself has raised alarm about staffing shortages at hospitals, so you can imagine how they would react if their own requested measures were mandated in hospitals. So, in the abstract that sounds great, but the AMA is not laying out a comprehensive plan for implementing their proposal that works in the real world.

https://www.ama-assn.org/delivering-care/public-health/horrific-covid-19-surge-demands-readiness-crisis-standards-care

Horrific COVID-19 surge demands readiness on crisis standards of care

“We call on governors, health departments, hospitals and other health care sector partners to act immediately to be prepared to implement crisis standards of care,” says the statement, developed by the National Academy of Medicine. These stakeholders “all have a duty to prepare so that the death toll is as small as possible and clinicians are not forced to make agonizing decisions in a vacuum without guidance, training or a considered process.”

[Celerity]

9. Sorry, but we are going to have to just agree to disagree. I stand 100% behind what I posted.

Have a great day.

[TomCADem]

10. Are You Disagreeing with the AMA's Warnings About Severe Staffing Shortages?

It is odd that you cite the AMA as authority to insist on strict quarantines of folks who are exposed to COVID-19, yet disagree with the AMA's warnings about the severe staffing shortages that are affecting hospitals that would be devastated by the same quarantines on workers that you cite?

If you can cite to something from the AMA that reconciles these positions, I would love to see it.

[BannonsLiver]

11. Good news for you: you don't have to worry about it

I’m not sure which residence you’re living in right now or in which country but I’m sure the rules are tighter!