Public Health Madison & Dane County

The CDC recently issued new guidance about when to stay home when you are exposed to COVID. In case you missed it, one of the main changes has to do with quarantine, a tool that is commonly used to prevent the spread of disease. In the new guidance, if you come into close contact with someone who has COVID, you no longer need to stay home, even if you’re not up to date on your vaccines. Instead, you should wear a high-quality mask for 10 days and get tested for COVID on day 5.

Some people might welcome this change, while others might not. Regardless, it is a confusing time to think about COVID. In some ways, our lives are very similar to before the pandemic—we can go places and do things. In other ways, our lives are still greatly affected by COVID. When we have any symptoms, or when our kids have any symptoms, it can be incredibly disruptive to work and school. And people who are immunocompromised, have chronic conditions, or are over 65 still can get very sick from COVID. So where does that leave us?

Does this mean that COVID is endemic?

There is regular talk about COVID becoming “endemic.” When COVID is endemic, cases should be somewhat predictable and stable. There may be seasonality to cases—meaning, we get more cases in the winter and less in the summer. We would likely treat COVID like any other disease—public health likely would only contact trace certain cases, we wouldn’t have mass testing clinics, and people wouldn’t have to follow strict isolation rules, instead just staying home while they are sick.

There are signs that COVID is still not endemic. It is mutating rapidly—hello, new Omicron subvariants!—and case spikes are not yet predictable. People are still being hospitalized and are dying from COVID at levels much higher than endemic diseases like the flu. But vaccines have also prevented many deaths and hospitalizations—while our peak in cases was January 2022, our peak in deaths was pre-vaccine, in December 2020. We are moving toward an endemic future, and these new guidelines reflect that.

Moving from Collective to Individual Action

When COVID was first spreading rapidly in March 2020, the majority of the world responded together. Most of us stayed home to curb the spread and flatten the curve, and wore masks to protect each other when we left the house. We didn’t have the tools to protect ourselves as individuals, so we took action to curb the spread of COVID for our communities as a whole.

As vaccines became widespread, that approach changed for a lot of people in the U.S. As we got vaccinated and became protected from severe disease and death, many people’s risk calculations shifted. People had individual protection and were tired from over a year of pandemic life, and so many people started making decisions based on their individual risk instead of the risk to the community. That meant people became more comfortable with activities that could spread COVID, like indoor dining.

There are pros and cons to taking an individual approach. It’s often simpler for people to navigate daily life. It allows for less community pandemic restrictions. It also leaves people behind—people who are most affected by COVID, including people who are immunocompromised, disabled, or over 65. Even when people at high risk are fully vaccinated and boosted, they can still experience severe outcomes from COVID, and therefore don’t have the ability to fully protect themselves.

So What Can We Do?

Stay home when you’re sick, even if you don’t test positive. As we covered in a previous blog, people often don’t test positive right away when they have COVID, especially when using an antigen test. If you have symptoms, especially multiple symptoms, don’t assume you’re good from one negative test. Be sure to test multiple times. And if you’re sick, even if you don’t have COVID, staying home prevents the spread of illness in our community. (Of course, a big barrier to staying home is a lack of paid sick leave—something we should all advocate for!)

Masks are still a helpful tool. Are you spending time around people who aren’t vaccinated, who are immunocompromised, or who are otherwise at high risk of severe outcomes? Are you at high risk yourself? Consider making the individual choice to put on a high-quality mask. This is more important in crowded, indoor settings with poor ventilation, and less important in settings that are outside, not crowded, or well-ventilated.

Follow guidance if you test positive. When you test positive, you should stay home for at least 5 days (or more, depending on your situation—learn more on our website). After your 5 days are up, you should wear a high-quality mask in public for 5 more days. Following this guidance is important to stop you from spreading COVID to someone who would get very sick.

Stay up to date on your vaccines and boosters. We’re tired of saying it, and you’re tired of hearing it—but vaccines are the easiest and best tool we have to prevent severe outcomes. They also can prevent mild illness for several months after your shot or booster, which prevents you from spreading it to others. It’s especially important to get your bivalent vaccine this fall, which will give you protection against the more recent Omicron subvariants.

Nationally, we have moved to an individual mindset, for better or worse. We see this reflected in current CDC guidance, as well as CDC’s community levels. But that doesn’t mean we have to completely forget about community protection. There’s a balance we can find between enjoying life and being considerate of others.