Amid widespread COVID-19 cases from a rapidly spreading subvariant of the virus, California health officials have shortened isolation recommendations for those who test positive if the infected person is fever-free.
The California Department of Public Health says the new guidance — shortening the isolation period from five days to one — aligns COVID-19 recommendations with those for other circulating respiratory viruses such as influenza while acknowledging the disease poses a lower risk today with so many people having been vaccinated or recovered from past infection.
“The reason for these changes is that we are now at a different point in time with reduced impacts from COVID-19 compared to prior years,” the California Department of Public Health said.
The Jan. 9 guidance shift “did represent some significant changes,” said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s School of Public Health.
But while he said the new guidance “does make sense,” given the reduced threat of the virus today, it’s also made some disease experts uncomfortable, given the timing.
“COVID is a more serious illness than influenza — that observation makes me pause about these recommendations,” Swartzberg said. “Another thing that makes me pause is that they came out at a time after students were back in school and at a time when COVID cases are increasing, and hospitalizations up until last week had been increasing.”
The CDPH reported that there were 563 new COVID-19 hospital admissions in California as of Jan. 5, numbers not seen since last January. Wastewater samples in Santa Clara County indicate high concentrations of the virus countywide.
The Centers for Disease Control and Prevention indicated that Alameda, Contra Costa, Napa and Solano counties have moderate levels of new hospitalizations while other Bay Area counties are low. The CDC reports that 62% of cases nationally are likely the JN.1 subvariant, a newer member of the virus’ omicron family that’s been dominant since late 2022. The current vaccines are based on earlier omicron subvariants and continue to offer protection.
Health officials say protection from vaccines and past infections fades over time and urge people to get the shots. But the CDC reports only about 21% of U.S. adults and 24% in California have had the updated shots that were rolled out last fall. The CDC said among children under 18, just 8% nationally and 7% in California have had the updated shots.
The new CDPH guidance advises those with COVID-19 symptoms to stay home until they are fever-free for 24 hours without using fever-reducing medication and other COVID-19 symptoms are mild and improving, a move away from the previous recommendation for five days of isolation even if someone has no symptoms.
CDPH still advises those with COVID to wear face masks when around other people indoors for 10 days after becoming sick or testing positive, though they don’t need a mask if they have two negative tests at least one day apart.
The CDPH also urges those with COVID to avoid contact with people at higher-risk for severe disease, such as the elderly, people with weakened immunity or those living in congregate care facilities, for 10 days.
Bay Area school districts have begun notifying parents about the new guidance. Oakland Unified School District sent notices Monday advising that the district will no longer issue COVID-19 isolation notifications that provide the first possible date staff or students can return to school after testing positive. Staff or students who test positive for COVID-19 but do not have symptoms can continue to come to school as long as they wear masks indoors for 10 days after their last positive test and avoid contact with higher-risk people, the district said.
San Jose Unified School District said in a statement Wednesday that it is “actively reviewing the updated guidelines” and will soon update parents of any change.
Fremont Unified School District Superintendent CJ Cammack said the new state guidelines “will go into effect on January 22.”
Santa Clara Unified School District spokeswoman Jennifer Dericco said the district has already switched to the new guidance, calling it “a welcome change” for the district’s staff. She added that absence rates have been about the same as this time last year.
San Ramon Valley Unified School District spokeswoman Ilana Israel Samuels said the district has updated its advice to families, and that since winter break there have been 37 reported COVID cases districtwide.
For those who have had rough experiences with the virus, the change was unsettling. Grace Stetson, a freelance writer in Santa Cruz, still hasn’t regained her sense of smell and says she has more trouble fighting off colds since a COVID infection last May. She does her best to avoid the virus and said the revised rules, at a time when virus levels are high, was “very discouraging.”
“It really doesn’t make sense and leaves me at loss for words,” said Stetson, 30. “I’m still dealing with the ramifications of having COVID.”
Swartzberg said that he’s seen both praise and condemnation for the new guidance among health professionals.
“I’ve talked to people in public health who support it, and I’ve talked to people in public health who think it’s terrible,” Swartzberg said. “I don’t think it’s great or terrible. CDPH is trying to find that sweet spot.”