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Breaking Down the New CDC Guidelines

What Employers Need to Know - Shorter Quarantine, New Definition of "Fully Protected" & More

CDC Cuts Quarantine Time:


The CDC released new guidance last night that cuts quarantine and isolation time from 10 days down to 5 days for most COVID-related exclusions. 

See our updated Exclusion Chart here.

Everyone COVID positive or with COVID symptoms (regardless of vaccination status) must isolate for 5 days. We’ll require employees to be fever-free for 24 hrs, with no respiratory or GI symptoms, and other symptoms resolving in order to return on Day 6. 

We have posed several questions to the CDC’s Emergency Operations Committee and may modify exclusions and return to work practices further based on their additional guidance.

We know that staffing shortages are an issue. Most of our clients are moving ahead with allowing any employees currently excluded for 10 days to shorten their exclusion to 5 days as long as they’re symptom-free before returning. 

  • For our Wellness Check clients, starting on the 30th, any previously excluded employees on a 10-day exclusion can take a new survey to get a green checkmark after 5 days without having to chat with anyone! Between now and the 30th, we ask that you communicate to managers that they should ONLY chat in about employees who are ALREADY able to return earlier, meaning they’re already at least 5 days out from symptom onset and they’re fully symptom-free. Those employees can chat back in directly to be cleared by our clinical team today and tomorrow. 


New Definition of “Fully Protected”:

The CDC’s more significant change was in the definition of what makes someone “fully protected.”  People are now only considered fully protected if they:

  • Have been boosted, OR
  • Got 2 doses of Pfizer or Moderna vaccine within the last 6 months (More than 14 days, less than 6 months), OR
  • Got 1 dose of J&J vaccine within the last 2 months (more than 14 days, less than 2 months)

Anyone not fully protected will be out for 5 days after close contact exposure. More people will fall into this category than in prior close contact exclusions, but they’ll be out for a shorter time.  Anyone fully protected doesn’t need to quarantine, but should wear a mask for 10 days. 

FAQs:

Why these changes now?

Realistically, the change from 10 days to 5 days was made to help the US economy, and to prevent airlines and other corporations from halting operations based on staffing shortages amid a major Omicron-fueled outbreak. There’s also some new data on Omicron transmission that shows it peaks around Day 3 and starts to wane after Day 5, though there’s definitely still some risk that people will continue to shed virus after Day 5, which is why these new CDC guidelines include strict mask-wearing for an additional 5 days. Some public health experts lobbied for the shorter isolation to improve overall compliance, with the hope that people will be more honest about exposure or symptoms, and more likely to complete the full quarantine, if it’s only five days.


All of the new CDC guidelines require strict mask wearing for 5 additional days after a 5-day exclusion. How seriously should we take that? 

Short answer? Very seriously. These shorter exclusions are aimed to help keep everything from hospitals to airlines to restaurants open for business, but by slicing the isolation and quarantine time in half, they also increase the risk of transmission. While most people have a low viral load by Day 5 after their symptoms start (or after their test if they have no symptoms), there’s definitely some change that they’re still shedding some virus at that point, which is why the CDC’s new recommendations require strict mask wearing for 5 additional days once the person returns to work. It’s incredibly important that managers hold employees accountable for wearing a well-fitting mask (KN95 or N95, if available!) at all times on their shift. 


Why did the CDC change who’s considered fully protected now? 

The Omicron variant can infect vaccinated people more easily than previous versions of the virus. While some of their cases still tend to be milder, vaccinated people are getting breakthrough infections regularly now, and what we considered to be fully vaccinated in the past doesn’t do enough to stop infection from the new variant. To reflect this fact, the CDC changed what they consider “fully protected” with this latest guidance, saying that someone needs to be boosted to be considered fully protected, unless they’re within 6 months of their second mRNA dose, or 2 months of their one J&J dose. By updating this to reflect the real-life data about who can get and spread COVID, we’re hoping that will help curb some of the spread. 

Can we return employees who are currently out on a 10-day exclusion to work sooner?

Yes, as long as they’re at least 5 days out from their symptom start date (or positive test date if they’re asymptomatic), and they’re currently symptom free. We recommend requiring folks to be fever-free for at least 24 hours without fever-reducing meds, plus completely symptom-free of cough, vomiting, and diarrhea. This is both clinically sound and takes into account the optics of a sick person coughing as they interact with guests and clients. We know that staffing shortages are an issue, and you’re eager to get folks back to work, but we highly recommend being very careful to ensure that anyone coming back meets those criteria for symptoms. 


For our Wellness Check clients, starting on the 30th, any previously excluded employees on a 10-day exclusion can take a new survey to get a green checkmark after 5 days without having to chat with anyone! Between now and the 30th, we ask that you communicate to managers that they should ONLY chat in about employees who are ALREADY able to return earlier, meaning they’re already at least 5 days out from symptom onset and they’re fully symptom-free. Those employees can chat back in directly to be cleared by our clinical team today and tomorrow. 



How do we count 5 days from a symptom start date (or positive test)?

The symptom start date (or positive test date if asymptomatic) is Day 0. Here’s an example:

  • Jan 1 = Day 0 - Symptom Onset or Positive Test
  • Jan 2 = Day 1
  • Jan 3 = Day 2
  • Jan 4 = Day 3
  • Jan 5 = Day 4
  • Jan 6 = Day 5 = Earliest Return to Work Date

This is also the way that works with simple math - Jan 1 + 5 = Jan 6!

Will the new definition of fully vaccinated exclude more employees? What can we do about that?

Yes - employees who are not boosted will no longer be considered fully vaccinated if they’re more than 6 months from Pfizer and Moderna or two months from J&J.  You can encourage your employees to go get boosters and upload their updated cards ASAP.


The OSHA ETS still says boosters aren’t part of their definition of fully vaccinated. Will OSHA revise that to match the CDC?

This is one of the biggest question marks still out there about the new CDC guidelines that update the definition of “fully protected.” The currently published OSHA vaccine or test mandate says that boosters and additional doses aren’t part of the definition of fully vaccinated, so as of right now, employees who fall into the “not fully protected” category for purposes of exposure-related work exclusions might NOT be required to do weekly testing. We expect that OSHA will address this shortly, but until they do, we’re sitting tight and not making any changes to our own Vaccination and Test Tracking system.


Will 5 days be enough time, or are employees still sick at that point?

We are seeing a large number of employees who seem to be getting sicker after a few days of mild symptoms, and likely will not be ready to come back after just 5 days. For now, our clinical team is extending those folks for an additional 3 days and checking in after that. Employees should not return if they still have any cough, fever, or GI symptoms. 


Is there a testing option to get employees back sooner than five days?

Currently, we only recommend returning someone to work early if they have had no close contact with anyone sick with COVID-like symptoms or with confirmed COVID, if they have no symptoms, AND with a negative PCR-type test (not a rapid antigen test). Our team feels this option is relatively low risk for the small number of employees who are able to meet all 3 of those criteria within the 5 day window. Realistically, the chances of employees being able to return sooner than five days are very slim, since most people will have symptoms for most or all of that time or are also exposed to someone COVID+. 


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Disclaimer: This post is meant for general information and educational purposes only and does not constitute, and is not intended as, any form of medical, legal or regulatory advice or a recommendation or suggestion regarding the same.  No recipient of this information should act or refrain from acting on the basis of this information without first seeking legal advice from counsel in the relevant jurisdiction.