UPDATE: Following its original announcement, the CDC further updated its guidance to apply the 5 day quarantine rule to those who are asymptomatic but now also to those whose symptoms are resolving (without fever for 24 hours). The guidance now also includes a reminder that applicable local laws continue to apply and that the recommendations do not apply to healthcare workers (for whom the CDC has issued separate guidance). The CDC separately updated its definitions of “isolation” and “quarantine” and outlined additional recommendations regarding testing and masking procedures for individuals who test positive and those who are exposed to COVID-19. This post has been updated to reflect these changes.
The CDC announced changes on December 27, 2021 to its isolation and quarantine period recommendations for those who test positive or are exposed to COVID-19. It later further modified that guidance on (i) December 29, 2021 without any formal announcement; and (ii) again on January 4, 2022 with updates to its “isolation” and “quarantine” definitions. Our guidance for the workplace follows.
Updated CDC Guidance: This guidance applies to all individuals, including those who physically enter or are expected to enter a workplace, although separate guidance applies to those working in the healthcare industry.
1. Isolation Period May Be Reduced for Certain Individuals Who Test Positive.
a. The CDC reduced its recommended isolation period from 10 to 5 days for an individual who tests positive, regardless of vaccination status, where the individual: (i) is not immunocompromised or a member of a high risk congregate setting (like a homeless shelter, cruise ship, or detention facility); and (ii) is asymptomatic, or has symptoms that are resolving (without fever for 24 hours). After the 5-day isolation period, if the individual is not immunocompromised or a member of a high risk congregate setting and is still asymptomatic or their symptoms are resolving (without fever for 24 hours), the individual no longer needs to isolate but should wear a mask for an additional 5 days when in contact with others to minimize the risk of infecting people they encounter.
If, however, symptoms appear after testing positive, the 5-day quarantine period will restart from the date symptoms first appeared. And, if existing symptoms are not resolving, the individual should remain in isolation consistent with current CDC or local public health authority guidance. (The CDC currently recommends that individuals with COVID-19 isolate until at least 10 days has passed since symptoms appeared (or 7 days after receiving a negative test result), the symptoms improve, and the individual is fever free for 24 hours without the aid of fever-reducing medications.)
b. In its January 4th update, the CDC advised that the “best approach” is for an individual who is isolating, “wants to test,” and has testing access, to get re-tested with an antigen test at the end of the 5-day isolation period if they continue to be asymptomatic or they are fever-free without the use of fever reducing medications and symptoms (besides loss of taste or smell) have improved. Under this “best approach,” if the second test is positive, the individual should continue to isolate for the full, original 10-day period. If the second test is negative, the individual can leave isolation but should continue wearing a well-fitting mask around others until after 10 days have passed since the initial positive test. The CDC’s advice on re-testing seems intended to serve as an optional “best practice,” but falls short of the more direct rules given elsewhere throughout the guidelines.
c. Travel must be avoided during the 5-day isolation period and is not recommended during the subsequent 5-day period. If travel is essential on days 6-10, the individual should wear a well-fitting mask. Individuals who are unable to wear a well-fitting mask should not travel for 10 days after symptoms appeared or the initial positive test.
d. Isolating individuals who tested positive or who have COVID-19 symptoms should not go to places where they are unable to wear masks (the CDC gives the example of gyms and restaurants) and should avoid eating around others until a full 10 days have passed since the initial positive test or symptoms first appeared.
e. Isolation guidance differs for individuals in high-risk congregate settings and for people who were severely ill with COVID-19 or have a weakened immune system (immunocompromised). For individuals in high-risk congregate settings that have high risk of secondary transmission and where it is not feasible to cohort people (such as correctional and detention facilities, homeless shelters, and cruise ships), the CDC recommends a 10-day isolation period. During periods of critical staffing shortages, facilities may consider shortening the isolation period for staff to ensure continuity of operations. For individuals who were severely ill with COVID-19 or are immunocompromised, the CDC advises that isolation periods may be longer (at least 10 to 20 days), and that testing may be required to determine when such individuals can be around others. The CDC advises individuals with severe COVID-19 and immunocompromised individuals to consult with their healthcare provider about when they can resume being around other people.
2. Some Individuals Must Quarantine When Exposed to an Infected or Suspected Infected Person, While Others May Not.
a. Individuals who had a close contact with someone with COVID-19 or suspected to have COVID-19 should quarantine for 5 days from the date of the last contact and then mask for an additional 5 days when around others if the individual is:
(1) over 18 years old and completed the primary series of Pfizer or Moderna vaccine but have not received a recommended booster shot or an additional primary shot if immunocompromised, when eligible; or
(2) over 18 years old and completed the first shot of the Johnson & Johnson vaccine over 2 months ago and has not received the booster shot or an additional primary shot if immunocompromised; or
(3) between 5 and 17 years old and has not completed the primary series of Pfizer or Moderna vaccine; or
The CDC noted in its press release that if a 5-day quarantine is not feasible (without explaining what “not feasible” means), the individual does not have to quarantine – but that language is not included in the more recent guidance, suggesting that the CDC favors adherence to the shortened quarantine period. Nevertheless, the CDC emphasizes that it is critical that the individual wear a well-fitting mask at all times around others for 10 days after exposure. Individuals who are unable to wear a mask around others should continue to quarantine for 10 days.
b. Individuals who (i) have received their booster shot and/or additional primary shot (if immunocompromised); (ii) are between 5 and 17 years old and have completed a primary series; (iii) had a confirmed case of COVID-19 using a viral test within the last 90 days; or (iv) are within the 6-month and 2-month vaccination periods do not have to quarantine, but should wear a mask for 10 days after their exposure.
c. The CDC recommends, however, that exposed individuals who do not develop symptoms should get tested on the 5th day after close contact to the extent possible and cautions that, if the individual tests positive or develops symptoms, the individual should isolate for at least 5 days from the date symptoms began or, if asymptomatic, from the date of the positive test. If testing is inaccessible, the individual can leave quarantine if symptoms have not appeared and masks are worn for the additional 5 days.
d. The CDC also recommends that exposed individuals not travel until they are able to get tested on the 5th day after close contact and only resume travel upon receipt of the negative test and upon confirmation that no COVID-19 symptoms have appeared. If exposed individuals cannot get tested, they should avoid travel for 10 days. If travel is essential, well-fitting masks should be worn for the entire 10 day period. If masks cannot be worn, the CDC recommends that the exposed individual not travel.
e. Like isolation guidance, quarantine guidance is different for individuals in high-risk congregate settings. The CDC recommends a 10-day quarantine for individuals in certain congregate settings with a high risk of secondary transmission (such as correctional and detention centers, homeless shelters, or cruise ships) regardless of vaccination and booster status. During periods of critical staffing shortages, facilities may consider shortening the quarantine period for staff to ensure continuity of operations.
f. Finally, the CDC recommends that exposed individuals try to avoid other people (including those in their own home), avoid going to places where masks are unable to be work (e.g., restaurants, gyms, etc.), and to avoid eating around others until 10 days have passed since exposure.
What This Means for the Workplace:
- These changes reflect the CDC’s recommendation based on current science developed around COVID-19 and the Omicron variant, including currently known information regarding the COVID-19 booster shot’s ability to restore effectiveness against infection and the currently understood period of when individuals are most infectious. The CDC also acknowledged that the shortened isolation and quarantine periods were aimed at alleviating the staffing and economic burdens imposed on employers by the lengthy employee isolation/quarantine periods required for asymptomatic individuals or individuals who were only mildly ill. But, as discussed below, the new recommendations may have a limited impact without enforcement of employer masking and COVID-19 reporting policies.
- Employers may update their existing COVID-19 isolation and quarantine protocols and policies to reflect these new recommendations and should send appropriate communications to their workforce. However, employers should also remember to confirm whether any stricter state or local requirements are still in effect – a point the CDC made in its recently updated guidance. Further, unless prohibited by applicable law, employers may adopt their own more rigorous isolation and quarantine requirements, including testing conditions before an exposed or infected individual may return to the workplace.
- The CDC’s updated recommendations underscore the importance of enforcing masking and COVID-19 reporting policies in the workplace. Infected or exposed employees may be returning to work early or not quarantining at all, and the risk of infection can only be further minimized by diligent enforcement of these policies. The failure to do so could result in additional workplace exposures and COVID-19 cases.
- Employers implementing OSHA’s vaccine rule (see our previous post on that rule here) or other applicable state or local vaccination rules should also consider the impact of the CDC’s updated recommendations on their reporting and return to work requirements for infected and exposed employees. While the OSHA vaccine rule permits employees to return to work if the employee meets the CDC’s criteria outlined above, it also provides that individuals can return to work if they have a negative COVID-19 NAAT test or receive a “return to work” recommendation from a licensed healthcare provider. It remains to be seen whether OSHA will further update its existing interpretative rule guidance in light of these recommendations, including ahead of the hearing in front of the U.S. Supreme Court regarding its enforceability.
We will continue to provide updates on the CDC’s recommendations as we receive them.