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Have COVID-19? Here’s How Long You Need to Isolate

Vaccines, treatments remain highly important for older adults


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Paul Spella (Getty Images, 2)

It’s been more than four years since the coronavirus started circulating in the U.S., and in that time, the official guidance on what you should do to avoid catching and spreading it has changed — and it's changing again.

The Centers for Disease Control and Prevention (CDC) announced on March 1 that people with COVID-19 can return to work, school and other activities if their symptoms are mild and improving, and they’ve been fever-free for at least 24 hours without the help of fever-reducing medicine.

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Once normal activities resume, additional prevention steps are recommended for at least five days to help curb disease spread.

These steps — wearing a mask, improving air quality in your home, keeping up with handwashing, and keeping a distance from others — are especially important for older adults and people who spend time around older adults, the CDC says. Seeking treatment for COVID-19 and staying up to date on vaccines is also key for older adults and others who are at higher risk for a severe case of COVID-19.

Previous COVID guidelines called for people to isolate for at least five days from the start of symptoms or a positive test, and to wear a mask though day 10 in order to avoid spreading the illness to others.

The CDC says the new guidance “brings a unified approach to addressing risks from a range of common respiratory viral illnesses, such as COVID-19, flu, and RSV, which can cause significant health impacts and strain on hospitals and health care workers.” A unified approach makes recommendations easier to follow, the public health agency says, and it makes it more likely that people will adopt them.

The change also “reflects how the circumstances around COVID-19 in particular have changed," the CDC said in a statement. “While it remains a threat, today it is far less likely to cause severe illness because of widespread immunity and improved tools to prevent and treat the disease.” At this point, the majority of people in the population have built up some sort of immunity to COVID-19, either through vaccination, infection or both, health experts say.

The updated guidelines are just for community settings; the CDC says; there are no changes to respiratory virus guidance for healthcare settings.

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Jodie Guest, a professor and senior vice chair in the department of epidemiology at Emory University’s Rollins School of Public Health, says it’s important to not dismiss the virus and to remember that “COVID is still a very significant burden of long-term illness and death.”

The latest federal data shows that more than 17,300 Americans are still being hospitalized each week from COVID-19; more than 1,500 people in the U.S. died from COVID-19 the week of Feb. 3.

“We still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses — this includes vaccination, treatment and staying home when we get sick,” CDC Director Mandy Cohen, M.D., said in a statement.

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Paul Offit, M.D., an infectious disease physician at Children’s Hospital of Philadelphia and author of the book Tell Me When It’s Over: An Insider’s Guide to Deciphering COVID Myths and Navigating Our Post-Pandemic World, told AARP that when it comes to COVID-19, “at least half of the hospitalizations and deaths in people who are at high risk are in people who never [got treated].”

recent study published in January found that only 12.2 percent of 309,755 patients eligible for Paxlovid received a prescription. Another study, yet to be peer reviewed, found that only 9.7 percent of more than 1 million high-risk patients received the treatment.

Paxlovid and other antiviral medications, such as Lagevrio and Veklury, are recommended for older adults — who make up the majority of COVID-19 hospitalizations and deaths — and people with underlying health conditions, like heart disease or lung disease.

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These medications “work extremely well at mitigating symptoms and shortening the amount of time that people are sick, and how sick they feel while they have it,” Guest says.

The key is starting these antiviral medications right away — within the first five days of symptom onset, says William Schaffner, M.D., a professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine.

“We tend to say ‘Oh, I’ll see if it gets better tomorrow. I don’t want to bother the doctor with this,’” Schaffner says. “Do this as quickly as possible, because if you have either flu or COVID, instituting the treatments early gives you the best benefit. The longer you wait, the less effective the treatments are.”

Another tool available to older adults is a spring vaccine. Health officials said on Feb. 28 that adults 65 and older should get another COVID-19 vaccine this spring “to provide added protection that may have decreased over time for those at highest risk.”

The vaccine that’s being recommended for the spring shot is the same vaccine that was made available in the fall of 2023. Three versions of this vaccine are available in doctors’ offices and pharmacies: an mRNA vaccine from Moderna, an mRNA vaccine from Pfizer-BioNTech and a protein-based vaccine from Novavax.

Another important point, Offit says, is to remember that it’s not just COVID-19 that can cause people to get seriously ill. Flu and RSV send hundreds of thousands of people to the hospital each year, too. Like COVID, there are also vaccines to help prevent severe illness from these infections.

Offit says the key message is to stay home if you’re sick. “Or if you can’t stay home because your work doesn’t allow you to stay home, then wear a mask,” he says.

“The bottom line is that when people follow these actionable recommendations to avoid getting sick, and to protect themselves and others if they do get sick, it will help limit the spread of respiratory viruses, and that will mean fewer people who experience severe illness,” National Center for Immunization and Respiratory Diseases Director Demetre Daskalakis, M.D., said in a statement. “That includes taking enhanced precautions that can help protect people who are at higher risk for getting seriously ill.”

Editor's note: This story, first published Feb. 16, 2024, has been updated to reflect a change in guidelines.  

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