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(NEW YORK) — As the omicron variant causes a surge in coronavirus cases, many long-term care facilities are facing challenges not seen in months, officials from around the country tell ABC News.
Many nursing homes are struggling with low booster rates and a growing staffing crisis, said industry executives and health care advocates.
“Nursing homes are on high alert right now,” said Terry Fulmer, president of the John A. Hartford Foundation, a nonprofit that works to improve care for older adults. “Omicron is highly transmissible and is spreading through communities like wildfire.”
In the week ending Jan. 2, nursing homes and long-term care facilities reported close to 15,000 cases across the country, three times the infection rate from just a month ago when facilities were reporting under 5,000 cases, data released by the Centers for Disease Control and Prevention shows.
Cases among staff members have shot up at an even higher rate, with facilities reporting upwards of 34,000 cases in the week ending on Jan. 2, compared to just over 5,600 a month ago.
In Sussex County, New Jersey, the National Guard was deployed last week to assist nursing home staff with infection control protocols and other duties as multiple facilities saw COVID-19 outbreaks.
“The staff at these facilities have been particularly hard hit by the latest COVID variant,” County Commissioner Anthony Fasano said in a statement. “We believed it was prudent to get them the help they needed before there was a crisis.”
In California, after more than 5,000 new cases were reported in skilled nursing facilities, the state’s public health officer, Tomas Aragon, announced that boosters will be mandatory for health care works and that visitors will require additional testing.
According to the CDC data, the recent spread of the virus among long-term care residents is occurring primarily among unvaccinated and twice-vaccinated residents, while the infection rate remains low for residents that have received a booster shot.
For most adults, two doses of currently authorized COVID-19 vaccines dramatically reduce the risk of being hospitalized or dying of the virus. But elderly adults, whose immune defenses fade with age, may still be at higher risk of serious illness from COVID-19, especially if it’s been more than five months since their last shot.
As of Jan. 2, more than 87% of residents at nursing homes nationwide had received two shots, and nearly 62% had been boosted, according to the CDC data.
For industry advocates, increasing the number of residents and staff getting boosters is a priority.
“We have been urging long-term care providers to get ready and to get ahead of the surge by ramping up their booster efforts,” said Cristina Crawford, a spokesperson for the American Health Care Association/National Center for Assisted Living.
Hartford told ABC News that she’s especially concerned that the rate of booster shots among staff is lagging behind.
“We have to increase our efforts to get boosters into the arms of both residents and staff,” she said.
In Ohio, where around 40% of nursing home staffers remain unvaccinated and the 21-day case average is above 14,000, omicron has “exacerbated” the growing staffing crisis, said Pete Van Runkle, executive director of the Ohio Health Care Association.
“Cases in long-term care in Ohio are about four times as many with omicron as during the height of delta,” Runkle told ABC News.
“The biggest problem with the incredibly high transmissibility is staff missing time from work,” he said.
The good news, said Runkle, is that despite the rising number of cases, nursing homes are reporting “very few” COVID-related deaths compared to last winter’s surge.
Across the country, death rates among long-term care residents and staff have remained flat throughout the spread of omicron. Nationally, facilities have reported 405 deaths among residents in the week ending Jan. 2, compared to 485 deaths in the week ending Dec. 5, according to data released by the CDC.
Pennsylvania state Health Care Association CEO Zach Shamberg said the good numbers are the result of a multi-pronged approach.
“This is a complete 180 from what we have seen last year and is a credit to providers and front-line workers who are doing everything they can to mitigate the spread of the virus now that they better understand the virus, have PPE and tests, and most importantly, access to a vaccine and boosters that help provide an additional level of protection for residents and workers,” Shamberg said.
(SAN FRANCISCO) — The San Francisco Department of Public Health said it is reducing hours at some COVID-19 testing sites due to staffing shortages.
The decision comes despite warnings from experts about the importance of COVID testing to keep up with the surge of the highly transmissible omicron variant.
“On Monday, some SFDPH-affiliated sites will temporarily reduce testing hours due to challenges beyond our control,” the department tweeted Sunday. “Please check your health system first for testing. Do not go to the ER for tests.”
In a statement released Monday, SFPDH said it expects testing capacity will only be reduced “by about 4%, or approximately 250 tests per day out of the current 7-day average of 6,000 tests per day at SFDPH-affiliated sites.”
Additionally, only four sites are being impacted by reduced hours and the department insists the change is temporary.
It’s unclear how many workers are out sick. San Francisco Mayor London Breed revealed last week that more than 400 city employees were out due to either COVID-19 infections or isolation after potential exposure.
It comes as San Francisco is recording an average of 1,245 new cases per day, which is the highest ever since the pandemic began and a 1,600% increase from one month ago, city data shows.
Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, told ABC News he is worried the reduced hours will mean that COVID-19 cases are missed.
“It’s going to have a terrible impact,” he said. “It reminds me of early March 2020 when we didn’t have enough testing. Of course we have a lot more tests numerically, but the proportion seems to be the same because the percentage of those needing testing is definitely not met by the number of available tests.”
Matt Haney, a member of the San Francisco Board of Supervisors, said reducing the hours of operation at COVID-19 testing sites is unacceptable.
“It was already hard to get a test in San Francisco and now it just got harder and that’s unacceptable,” he told ABC News. “Our department of public health had expanded capacity at a number of sites. But it wasn’t enough. Now they’re cutting back because of staffing shortages.”
Testing capacity has been stretched to an all-time high, according to SFDPH.
Haney, however, argued that testing sites need to make sure they are consistently meeting demand.
“The level of demand for tests exceeds anything we had seen,” he said. “Health officials also feel the private providers need to do more testing. I think all of those things are true, yet our residents need our public health department to step up and get the job done.”
Haney wants to call a hearing on testing to get more answers on why it’s been so difficult for residents to get tests.
“You may have heard that people are calling 911 to get tested,” he said. “When people get exposed or they’re not feeling well, if the county tells them go to get a test and then they can’t get tested, that’s freaking them out and they’re calling 911 — and our 911 lines are overwhelmed because what people are being told to do can’t be done.”
There are ways to prevent the staffing shortages from having a large impact, according to Chin-Hong, such as deploying the National Guard to sites, which Gov. Gavin Newsom did over the weekend.
“There are also some creative strategies like utilizing student volunteers who are in health professions, like medicine, nursing, pharmacy, to go out,” he said. “They have some medical background. It’s kind of an all hands on deck perspective. It doesn’t take a lot of training to do a swab; people do that at-home after all.”
He also recommended that testing sites become more diverse and be expanded to offices, community centers and banks.
(NEW YORK) — Explosive COVID-19 surge strains hospitals and schools around the nation
The number of hospitalized Americans who are positive for COVID-19 soared to more than 138,000.
For nearly two years, day after day, under exhausting and often dangerous conditions, health care workers across the country have continued to care for the nation’s sickest Americans who have fallen victim to coronavirus.
As the highly infectious omicron sweeps through the country, the United States is now facing its most significant coronavirus infection surge to date, putting additional pressure on an overtaxed health care system.
“We have seen an incredible proliferation of the virus in hospitals, such that we went from a place where virtually no county in the country was at risk of exceeding its capacity to well over half are now. I don’t like to make predictions, but things could get very bad in the coming couple of weeks,” Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston, told ABC News.
Although preliminary global studies indicate that the omicron variant may cause less severe illness than prior variants, health officials say that the sheer numbers of infections caused by the new variant could still overwhelm the health care system.
The burden on the health care system is made worse by nationwide staffing shortages and hospital capacity at elevated levels as many other patients seek care for non-virus related reasons.
“Due to the tsunami of omicron cases, the volume is affecting our health and community service,” said Dr. Rebecca Weintraub, assistant professor of Global Health and Social Medicine at Harvard Medical School. “While we are very lucky hospitalizations have decoupled, the vast spread is alarming.”
Late last month, Dr. Anthony Fauci, chief medical adviser to the White House, pointed to the disparity between cases and hospitalization as a “strong” indicator that omicron is less severe, as the U.S. has not experienced a concomitant increase in the relative percentage of hospitalizations.
Even so, Fauci warned that there will still be many virus-positive Americans who will seek medical care, creating further strain on hospitals.
“Even if you have a less of a percentage of severity, when you have multi-multi-multi-fold more people getting infected, the net amount is you’re still going to get a lot of people that are going to be needing hospitalization. And that’s the reason why we’re concerned about stressing and straining the hospital system,” Fauci told ABC News’ George Stephanopoulos during an appearance on This Week, earlier this month.
Experts say the baseline for hospitalizations is already higher than it was a year ago, with hospitals described by some experts as “relatively quiet” last winter for ailments other than COVID-19, which provided a “much bigger buffer zone,” to care for the most critically ill. In addition, hospitals were already struggling with patients from the delta wave.
“We entered this wave, with hospitals at a higher capacity than they were in previous waves, from non-COVID [health issues],” Faust explained. “That’s the real problem.”
Highly localized surges a pain point for many communities
An ABC News analysis of federal data found that in recent weeks, total hospitalizations — COVID-19 and non-COVID-19 related — have seen an uptick. The number of COVID-19-positive Americans who are hospitalized is now nearing a pandemic high, with more than 138,000 Americans hospitalized, and an average of 17,000 being admitted to hospitals each day.
Most of the patients who are requiring intensive care are still unvaccinated, according to top health officials, including U.S. Centers for Disease Control and Prevention Director Rochelle Walensky.
Experts say there is no overarching experience for how COVID-19 is now affecting the country, as surges are asymmetric, and the impact of COVID-19 will look different for every community.
“Ground conditions matter beyond belief,” Faust said, explaining that while one area can see an uptick in COVID-19 infections, hospitals may not become overwhelmed, because they have adequate staffing or a highly vaccinated and younger population, hospitals in other areas with lower vaccination rates and fewer resources could find themselves completely overwhelmed.
“There are places where incidental infection is a higher proportion of admissions than others. The reverse is true in other areas. And there are places with higher vaccination rates than others. When an unvaccinated person gets admitted to the hospital, they are going to be sicker and require more care and take up more resources. Every place is different,” Faust added.
Even within a state, the timing of surges is also highly localized, experts say, varying by areas and even by hospital. Thus, even if hospital capacity nationwide or on the state level looks relatively stable, “micro surges,” seen in individual facilities or communities may still be occurring and threatening care.
Even virus-positive patients who are not admitted primarily for COVID-19 are adding a strain
Nationwide, it remains unclear as to how many patients are being admitted to the hospital for coronavirus-related care, and how many patients are coincidentally tested positive for the virus, after they were admitted for other reasons and subsequently checked for positivity as a routine check.
In New York, state officials reported on Friday that 42% of COVID patients were admitted for non-COVID reasons, and in Florida, Gov. Ron DeSantis cited data from three of the state’s major hospitals, which reported that half, or more, of their COVID-19 positive patients are getting treated for other conditions, not the virus.
However, some experts and hospital officials have cautioned that the proportion of patients seeking care specifically for COVID-19 likely varies widely community by community. In addition, health officials say a COVID-19 diagnosis can cause additional strain on a health system, as virus-positive patients in many hospitals are required to be treated differently.
In a series of tweets last week, Dr. Ashish Jha, dean of the Brown University School of Public Health, stressed that both patients “with COVID-19” and those admitted “for COVID-19,” have an impact on care, utilization, and can stress the health care system.
Patients, who may have come in for another ailment, such as a broken leg, and are found to be positive for the virus must stay in a COVID-19 isolation room, explained Jha, who added that there are already a limited number of such rooms available.
In addition, every time a health care worker enters a room with a COVID-19 positive patient, they must be wearing full PPE, which in turn, prolongs wait times for many patients.
“Admissions with COVID is still very disruptive to the health care system, at a time when it can’t afford more disruption,” Jha said.
Federal data shows the emergency department visits with diagnosed COVID-19 cases are currently at their highest point of the pandemic — a figure that has more than doubled over the last month.
“People are in the ER for hours and days, creating gridlock for new patients that need emergency services every day,” said Dr. Jay Bhatt, an internist and adjunct faculty at the UIC School of Public Health and an ABC News Med Unit contributor.
Other hospital officials have noted that even if patients are admitted for a reason other than COVID-19, a COVID-19 infection on top of another condition may only exacerbate an individual’s original illness.
At Cincinnati Children’s Hospital Medical Center, hospital officials told ABC News that they have seen their COVID-19 positive patient totals “skyrocket” in recent weeks. Some of these patients happen to test positive while admitted for other concerns, while others are primarily sick with COVID-19.
“Even the children who are not admitted primarily for COVID have hospital courses that are further complicated because of COVID. Having cancer, heart issues, appendicitis, and COVID is never a good thing,” one hospital representative said.
A growing shortage of hospital staff ‘wreaking havoc’ on the health care system
Surge after surge, nurses, doctors and respiratory technicians have led the fight against the virus, many forced to leave their families for weeks to months at a time in order to avoid a total collapse of the health care system during the pandemic.
Since the onset of the pandemic, the already existing staffing shortage has only grown worse, and now experts say they are concerned there will not be enough front-line workers to care for the influx of patients in need as many of them are forced into isolation and quarantine after testing positive.
“I am worried we don’t have enough health care workers to care for patients flooding hospitals,” said Bhatt. “[The] unprecedented numbers of sick clinical staff [are] wreaking havoc on hospitals and health systems as they do their best to care for patients in this current surge. I have not seen a workforce issue as serious as this, and is deeply concerning.”
As of January 2022, there have been at least 819,000 coronavirus cases among health care personnel, and more than 3,100 virus-related deaths.
Late last month, the CDC shortened the isolation time for COVID-19-positive health care workers in anticipation of the potential shortages that might occur amid the latest surge.
Many health care workers say they are exhausted as they train to keep their facilities running.
“There are wait times in the emergency department that are running six to eight hours, in the trauma center. [In the] emergency room sometimes it runs greater than 24 hours. So you know we … the nursing staff is tired, we have burned out. We’re working 12- to 14-hour shifts, on Sundays up to 16-hour shifts,” Thomas Mapplebeck, a nurse in the Emergency Department at Baystate Health told ABC News.
Staffing shortages are also preventing some people from receiving the critical care they need, added Bhatt, who said that some patients in need of hospice are struggling to receive placement because of the shortages.
The unknown of what’s to come
Many health officials and experts have tried to forecast what Americans can expect from the virus in the months and weeks to come, and when COVID-19 will finally enter an endemic phase. However, Faust explained he is reluctant to make predictions as there is still so much unknown surrounding the virus.
“Five weeks ago, we’d never heard about omicron because it didn’t exist as far as we know, and now we were in the worst part of this pandemic,” Faust said.
With many younger Americans becoming infected, Faust said it is possible intenstive care unit bed capacity may not be overrun. It is also possible the virus could reach the millions of Americans who are still unvaccinated, as well as many at-risk people who remain vulnerable for severe illness.
An additional roadblock for some hospitals has been delays in returning patients to nursing rooms, further exacerbating the shortage of beds.
“Patients who are ready for discharge are having trouble getting back to long-term care, nursing home facilities, short-term rehab and home without social support as resources are strained and this creates a logjam that strains the system and workforce even further,” Bhatt said. “We can’t have situations where we are having trouble getting patients back to the community so that others that really need hospital care can get it. We can and need to do better.”
The worst-case scenario, said Faust, will be if nursing homes see significant spikes.
“If that happens in places that are already on the edge, we will see horrifying scenes that we’ve been warning against for a long time,” Faust said.
Health officials have stressed it will be critical for Americans to modify their behavior by wearing masks, avoiding mass gatherings and getting vaccinated.
“I hope people can do their part to get vaccinated, decrease the number of people who need hospital beds so that these other folks who are really sick have a chance to get the care that they need,” said Dr. Jeff Pothof, an emergency medicine physician at UW Health in Madison Wisconsin. “It’s really bad right now,” he added.
Benjamin Rader, a research fellow at Boston Children’s Hospital, contributed to this report.
(ATLANTA) — The Centers for Disease Control and Prevention issued a warning Thursday about the risk of rabies after three Americans — including a child — died from the disease over a six-week period last year.
All three patients contracted rabies after being exposed to bats.
This brings the total number of rabies cases in 2021 to five, which officials say is concerning considering there were no cases reported in the U.S. in 2019 and 2020.
“We have come a long way in the United States towards reducing the number of people who become infected each year with rabies, but this recent spate of cases is a sobering reminder that contact with bats poses a real health risk,” Dr. Ryan Wallace, a veterinarian and rabies expert in the CDC’s Division of High-Consequence Pathogens and Pathology, said in a press release.
The deaths occurred between Sept. 28, 2021 and Nov. 10, 2021 with one case each in Idaho, Illinois and Texas, according to a report published by the CDC.
Two of the deaths were described as “avoidable exposures.” One involved a bat roost in a person’s home and the other involved a patient picking up the bat with bare hands.
None of the three patients, all male, received post-exposure shots that can prevent the rabies virus from infecting a person and causing symptoms to develop.
According to the CDC, one patient refused the shots due to a “long-standing fear of vaccines” and the other two did not realize they were at risk for rabies due to their exposures.
Once a person starts to develop rabies symptoms, which include fever, vomiting, difficulty swallowing, confusion and hallucination, it means the disease has progressed to the point where it is almost 100% fatal.
All three patients died between two and three weeks after their symptoms began.
In its report, the CDC suggested that the uptick in rabies deaths is because people may not be aware of the risks of the disease.
The CDC also warned people to never touch or handle bats, which are the leading cause of rabies in people — accounting for 70% of infections in the U.S. Raccoons, skunks, and foxes are other common causes in the U.S.
Infected bats spread the virus through their saliva, typically from a bite. However, the saliva can also enter the body through a cut or break in the skin.
If a person has come into contact with a bat, the CDC recommends calling the state or local health department so the animal can be trapped for testing. They should also immediately wash wounds with soap and water
The person should also not delay speaking to a health care professional or seeking urgent medical to determine whether or not they need post-exposure shots. Post exposure shots are highly effective in preventing death if given soon after exposure.
(ATLANTA) — Most American adults are not getting enough of their fruits and vegetables, according to a new study from the Centers for Disease Control and Prevention, with even greater disparities found for those living in poverty.
The report, published Thursday, found that only 10% of adults are eating the recommended daily serving of vegetables, and slightly more — 12.3% — are consuming enough fruit.
The recommendations are based on dietary guidelines from the U.S. Department of Agriculture and Health and Human Services, which advise that adults incorporate 2 to 3 cups of vegetables and 1 1/2 to 2 cups of fruit into their diet each day. Eating sufficient fruits and vegetables “can help protect against some chronic conditions that are among the leading causes of mortality in the United States,” the study noted.
Researchers identified notable regional and demographic differences.
Some 16% of Connecticut adults met fruit recommendations while only 8% of West Virginia adults did. Meanwhile, 16% of Vermont adults met fruit recommendations but only 6% of Kentucky adults did.
Women met the recommendations more often than men, while people over 50 met them more often than their younger counterparts, researchers found. Additionally, Black people reached the vegetable goal less often than white or Hispanic people.
Those living below or close to the poverty level were the least likely to meet vegetable recommendations, at 6.8%, the study found.
“Additional policies and programs that will increase access to fruits and vegetables in places where U.S. residents live, learn, work, and play, might increase consumption and improve health,” the study stated.
The study was conducted through the Behavioral Risk Factor Surveillance System, which has been collecting information on American fruit and vegetable consumption for over 30 years, and included 294,566 participants.
The survey included data from 2019, before the start of the COVID-19 pandemic. The researchers noted that barriers to healthy foods, such as cost and limited availability and access, “might have worsened during the COVID-19 pandemic.”
Among its recommendations, the CDC advised that states and communities can support community retail programs “to attract grocery stores and supermarkets to underserved communities to improve community food quality,” as well as promote participation in federal nutrition assistance programs that help low-income people buy healthy foods.
Pandemic-related supply chain issues have particularly impacted people in food deserts, Geri Henchy, director of nutrition policy for the Food Research & Action Center, told ABC News.
“People who live in communities that had issues around the availability of quality, affordable produce, those issues have gotten worse during COVID because of the supply chain problems,” she said.
MORE: How to help feed your community with virtual food drives, donations this holiday season
Henchy also agreed that promoting participation in federal food assistance programs, such as the Supplemental Nutrition Assistance Program, or SNAP, and the Special Supplemental Nutrition Program for Women, Infants and Children, or WIC, will be key, especially after boosts to both during the pandemic.
This past fall, the average SNAP benefit increased by $36.24 per person each month, and the government extended increased fruit and vegetable WIC benefits through March. Those measures should have a positive impact on food and vegetable consumption, though “of course we have a lot of people who are eligible who aren’t in the programs,” said Henchy.
Just over 80% of eligible Americans participate in SNAP, while about half of those eligible for WIC participate, according to the most recent federal data.
ABC News’ Sony Salzman contributed to this report.
Myung J. Chun / Los Angeles Times via Getty Images
(NEW YORK) — In the midst of a new pandemic surge, another seemingly new ailment is now grabbing headlines: flurona.
Despite the catchy name, “flurona” is not new. It is a term coined to describe what happens when a person tests positive for the flu and COVID-19 at the same time.
“Both are common, so it is not unexpected that some people would be infected at the same time,” said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.
Flurona is not a new disease, experts stress, nor is it a new variant of COVID-19. The flu virus and COVID-19 virus are from two very different virus families. Scientists are not concerned about the two viruses mixing to create a new virus.
There are many different types of viruses that are capable of infecting people. Viruses that cause the flu and COVID-19 are two examples, but there’s also HIV, the chicken pox virus, rabies virus, the common cold and many others.
It has always been possible for one person to be infected with two or more different viruses at once. And with flu season coinciding with a new COVID-19 surge, there’s a greater chances that a handful of people will test positive for both viruses at the same time.
Doctors call these instances co-infections. Though uncommon, last year’s flu season also saw a handful of cases of flu and COVID-19 in the same person at the same time.
“It has not been a big issue for us because of the low levels of influenza circulating in the community,” Dr. Jonathan Grein, director of Hospital Epidemiology at Cedars-Sinai Medical Center in Los Angeles, told the hospital’s website. Cedars-Sinai said it had recently seen one mild case of the co-infection.
“It’s obviously not good to be infected with two viruses rather than one, but there’s no clear indication that this is a particularly bad combination,” Grein added.
With the flu and COVID circulating at the same time, people can reduce the risk of becoming severely ill with either virus by getting vaccinated against the flu and COVID, wearing a mask in crowded spaces and washing your hands.
(NEW YORK) — As U.S. COVID-19 cases continue to surge, some health care facilities have been forced to shut down facilities or departments as staffing shortages worsen.
Holy Cross Health in Fort Lauderdale, Florida, was forced to close labor and delivery units, while keeping open, at least for now, NICU and postpartum units.
“Holy Cross Health has reached critical staffing levels in Labor and Delivery,” the hospital said in a statement to ABC News. “In the best interest of patient safety, the Labor and Delivery unit is on diversion until further notice.”
The Centers for Disease Control and Prevention updated guidance last month for health care workers, reducing their isolation periods to align with “understanding of the disease trajectory,” which affected staffing measures.
Three Aurora Urgent Care facilities in Wisconsin were forced to close last week until at least Jan. 26.
“Managing the COVID surge combined with staffing shortages have contributed to temporary closures at three lower volume urgent care centers in Menomonee Falls, Brookfield and on River Center Drive in Milwaukee,” a representative for Advocate Aurora Health told ABC News in a statement. “This allows those team members to be deployed to busier urgent cares in the area. All other non-urgent care services offered at these three facilities are currently open.”
Pulaski Memorial Hospital in Indiana also told ABC News it’s closing its OB/Maternity department in mid-January due to staffing shortages.
“With so few maternity nurses available, our medical staff and senior leadership felt it best to close the OB/Maternity Department instead of trying to operate at less than optimal staffing levels,” hospital CEO Tom Barry said in a statement. “Over the past several months, we have had significant difficulty recruiting additional staff to our OB/Maternity Department in order to maintain the high-quality standards that all patients deserve and expect from PMH.”
(ATLANTA) — The Centers for Disease Control and Prevention on Tuesday clarified its guidelines around what to do when you get COVID-19, a move that comes after criticism last week that their newest guidance to shorten the isolation down to five days without calling for a negative test was confusing and lax.
The latest update still does not include a recommendation for people to get a negative COVID test before leaving isolation, but gives guidance for people who “have access” and “want to test” — language that reflects the challenges many Americans have faced in recent weeks trying to get their hands on them — while still holding ground that a negative rapid test isn’t an all-clear.
People who test positive after five days should isolate for another five days, the CDC says, while people who test negative should still follow the guidance for those who don’t test: until day 10, wear a mask, avoid high-risk people, don’t travel and don’t eat or drink around others.
The CDC said the decision was based on data that negative rapid tests do not necessarily mean someone has stopped spreading the virus, and PCR tests — the most accurate type — can’t be relied on either, because they continue to show positive results for weeks afterward even when someone isn’t contagious.
“As such, regardless of the test result, wearing a well-fitting mask is still recommended,” the guidance said.
While more detailed, the updated guidance is not significantly different from last week’s guidelines, which changed the recommended isolation period for a person with COVID from 10 days down to five, followed by five days of masking around other people. It applies to everyone, vaccinated or not, who gets COVID, so long as people are largely clear of symptoms by Day 5.
But the decision rankled public health experts who thought a shorter isolation without a negative test would lead to more spread.
“CDC’s new guidance to drop isolation of positives to 5 days without a negative test is reckless,” Dr. Michael Mina, an epidemiologist and chief scientific officer at eMed tweeted last week following the initial announcement. “I absolutely don’t want to sit next to someone who turned [positive] five days ago and hasn’t tested [negative].”
Federal officials pushed back in the criticism, insisting that the new recommendations were based on science and not on social pressure.
“You can get people safely back out in a five-day period so long as they wear a mask if they are without symptoms. That is the science,” Dr. Anthony Fauci, chief medical adviser to the White House, told ABC News last week. “The impact of that is to try and not be in a situation where we essentially have to shut down the entire country.”
CDC Director Rochelle Walensky also defended the guidance, saying it was based on behavioral studies showing that only one-third of people were following the previous guidelines, and data showing up to 90% of COVID spread occurs in the first five days that someone has it.
“It really had a lot to do with what we thought people would be able to tolerate,” she said in an interview last week with CNN.
And on Tuesday, the guidance largely stuck to that stance, though it further clarified what people should do in all scenarios, including if they decide to test.
Here’s the latest:
If you get COVID, you should isolate for five days, the CDC says.
Day 0 is the first day of symptoms and day 1 is considered “first full day after your symptoms developed.” For example, if you have symptoms on Monday, Tuesday is Day 1 and Saturday is Day 5.
If your case is asymptomatic, Day 0 is the day you tested positive. But the CDC’s guidance on Tuesday clarified that if people test positive without any symptoms, and then develop symptoms in the days afterward, they should reset their isolation clock back to zero on the day they have symptoms and isolate for another five days.
After five full days, you can leave isolation if you are mostly all better. What does that mean? Fever-free and on the mend.
“You can end isolation after 5 full days if you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved,” according to CDC guidance.
Loss of taste and smell, two common COVID symptoms, can last “for weeks or months after recovery” and do not qualify as symptoms that should keep you in isolation.
Then, after five days, you should wear a “well-fitting mask around others at home and in public for 5 additional days (day 6 through day 10) after the end of your 5-day isolation period,” the guidance says.
If you’re unable to mask, or if you can mask but will be around high-risk people, opt instead for the isolation, the CDC says.
“If you are unable to wear a mask when around others, you should continue to isolate for a full 10 days. Avoid people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days,” according to the CDC.
If you still want to test, and can find one
As for the testing component, the CDC recommends that people who can and want to test should do so around day five, if they have been fever-free for 24 hours.
“If your test result is positive, you should continue to isolate until day 10,” the guidance says.
And, importantly, a negative test is not an all-clear, according to the CDC.
“If your test result is negative, you can end isolation, but continue to wear a well-fitting mask around others at home and in public until day 10,” the guidance says.
The CDC recommends against traveling, going anywhere where you are unable to wear a mask like restaurants and gyms, and avoid eating around people — both at home and in public — “until a full 10 days after your first day of symptoms,” even with a negative test.
Walensky, asked about the guidance in an interview with “The Late Show” host Stephen Colbert on Monday night, said she would interpret even a negative test as possibly having “some transmissibility ahead of you.”
“If you have access to a test, and if you want to do a test at day five, and if your symptoms are gone and you’re feeling well, then go ahead and do that test,” Walensky said.
“But here’s how I would interpret that test. If it’s positive, stay home for another five days. If it’s negative, I would say you still really need to wear a mask. You still may have some transmissibility ahead of you,” she said.
“You still should probably not visit grandma. You shouldn’t get on an airplane. And you should still be pretty careful when you’re with other people by wearing your mask all the time.”
While the rollout of the guidance has been met with much criticism, experts have noted that its ultimately a fast-paced environment with no easy one-size-fits-all solution.
“The CDC is sending a mixed message — but I don’t think there’s any way around that,” Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told ABC News.
“And I don’t think we should be too quick to judge mixed messages in the context of a rapidly evolving situation. We want our guidelines to reflect the most recent knowledge we have, meaning that those guidelines are going to change, sometimes quickly,” he said.
(WASHINGTON) — The Food and Drug Administration on Monday approved Pfizer boosters for 12- to 15-year-olds.
The moves comes as schools reopen after the holiday break.
In a release, the FDA said it has amended the emergency use authorization for the Pfizer vaccine to also shorten the time between the completion of primary vaccination of the Pfizer vaccine and a booster dose to at least five months, instead of six, and to allow for a third primary series dose for certain immunocompromised children 5 through 11 years of age.
This is a developing story. Please check back for updates.
(NEW YORK) — Amid pushback from some public health officials on new Centers for Disease Control guidance for individuals who have tested positive for COVID-19, which does not require a negative test to end isolation after five days, Dr. Anthony Fauci, the nation’s top infectious disease specialist, said changes to the guidance are being considered.
“You’re right there has been some concern about why we don’t ask people at that five-day period to get tested. That is something that is now under consideration. The CDC is very well aware that there has been some pushback about that,” Fauci told This Week anchor George Stephanopoulos on Sunday.
He continued, “Looking at it again, there may be an option in that, that testing could be a part of that. And I think we’re going to be hearing more about that in the next day or so from the CDC.”
The CDC issued new guidelines for those who test positive on Tuesday, recommending a five-day isolation period, if asymptomatic at that point, followed by five days of masking when around other people.
The CDC said in a statement: “The change is motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after. Therefore, people who test positive should isolate for five days and, if asymptomatic at that time, they may leave isolation if they can continue to mask for five days to minimize the risk of infecting others.”
Some prominent public health officials, including former U.S. Surgeon General Jerome Adams, criticized the new guidelines. The nation’s largest nurses’ union and a major flight attendant union also expressed dissatisfaction with the new guidelines.
“Regardless of what CDC says, you really should try to obtain an antigen test (I know – easier said than done) and confirm it’s negative prior to leaving isolation and quarantine. There’s not a scientist or doctor I’ve met yet who wouldn’t do this for themselves/their family,” Adams tweeted.
The revised guidelines come as the number of COVID-19 cases in the U.S. reaches record levels. The CDC recorded more than 580,000 cases in the U.S. on Thursday, a pandemic record. That number shattered Wednesday’s record of about 488,000.
However, Fauci said Sunday the time has come to focus less on case counts, as “infections become less severe.” Instead, he said, “it is much more relevant to focus on the hospitalizations.”
As cases have skyrocketed, hospitalizations and deaths have not apparently followed the trend. Fauci expressed optimism about emerging evidence that the omicron variant could be less damaging, although he cautioned “hospitalizations are often late, lagging indicators.”
Even with the rising case numbers, Fauci said he believes it’s the correct decision to return children to in-person schooling after the holiday break as “it’s very clear there are really serious effects about” children not having a physical presence — and because most teachers are vaccinated and children 5 and up are eligible for COVID vaccinations.
“I plead with parents to please seriously consider vaccinating your children, wearing masks in the school setting, doing tests to stay,” he added. “I think all those things put together, it’s safe enough to get those kids back to school, balanced against the deleterious effects of keeping them out.”
Despite some promising data on omicron, Fauci warned there remains a heightened potential for stress on the nation’s hospitals and health care workers.
“We’ve got to be careful about that. Because even if you have a less of a percentage of severity, when you have multi, multi, multifold more people getting infected, the net amount is, you’re still gonna get a lot of people that are going to be needing hospitalization. And that’s the reason why we’re concerned about stressing and straining the hospital system,” Fauci told Stephanopoulos.
Still, Fauci expressed hope that what he described as a “severe surge” will peak within a few weeks.
“One of the things that we hope for, George, is that this thing will peak after a period of a few weeks and turn around,” Fauci told Stephanopoulos. “We’ve seen that happen in South Africa with a head of major surge, but as quickly as the surge went up, it turned around.”
