How long to isolate? Vashon’s experts weigh in
Published 1:30 am Thursday, August 25, 2022
The news media have been filled with stories about new COVID guidance from the Centers for Disease Control and Prevention (CDC), some of them accompanied by conflicting or confusing interpretations.
The CDC’s new guidance includes leaving isolation five days after testing positive.
However, a number of experts – including the Vashon Medical Reserve Corps (MRC) – continue to recommend that anyone who tests positive for COVID should isolate for ten days, or until they have a negative home antigen test. This approach will significantly reduce the community spread of highly contagious variants such as BA.5.
You can read the CDC guidance at bit.ly/CDCstreamlineNewRelease, and make your own evaluation.
The Vashon Medical Reserve Corps and the Emergency Operations Center closely follow scientific and lay publications on COVID. One highly regarded source is the Your Local Epidemiologist (YLE) blog by Dr. Katelyn Jetelina. Vashon MRC agrees with her plain-spoken take on the new CDC guidance, found at bit.ly/YLE-CDCguidance.
“There’s really no substitute for preventing the spread of a potentially deadly disease, especially when more than 400 people are dying each day from COVID in the United States,” said Dr. Jim Bristow, one of the coordinators of the Vashon MRC efforts. “It’s not logical to tell people they can leave isolation after five days when studies tell us someone with Omicron is at peak infectiousness at four or five days, and an Omicron infection lasts an average of eight to ten days. Even if people wear a quality mask, and many people won’t do that, they can still give COVID to someone else, especially if they have the currently dominant and highly contagious BA.5 variant.”
Vashon MRC strongly recommends anyone who tests positive for COVID should isolate for a full ten days or until they have a negative home antigen test.
The Vashon MRC views have been forged by the specific circumstances of Vashon.
The island’s median age is 55, compared to 35 on the mainland. In the last 30 days, 90 people have died of COVID in King County. All but six of them were 50 or older. Even though young people are less likely to be hospitalized or die from COVID, young people get infected and do spread the disease to vulnerable people around them, including the elderly and those who are immunocompromised. That is even more likely to happen if the isolation and quarantine guidelines are relaxed.
FDA: Test Two or Three Times to Be Sure
As described above, the CDC relaxed its guidelines for quarantining if someone has been exposed to COVID. However, a day after the CDC guideline revision, the FDA came out with more conservative advice.
The FDA recommends that you quarantine if you have been exposed to someone with COVID and suggests you should have a negative home antigen test before leaving quarantine.
In order to be sure you don’t have COVID, the FDA suggests people without symptoms test three times, once every 48 hours.
The FDA advice takes into account that home antigen tests can ultimately provide results similar to a single PCR test if multiple tests are run over time.
The reason antigen tests may require more time for detection of the virus is that they are less sensitive than PCR tests and it can take several days for the virus to reach levels high enough to be detected by an antigen test.
Anyone who tests positive or has symptoms should, of course, isolate to avoid spreading the disease. The FDA recommends that anyone in isolation test negative twice, 48 hours apart, before leaving isolation.
CDC: Stay “Up to Date” on COVID Vaccinations
The new CDC guidance places a much stronger emphasis on getting vaccinated to prevent hospitalization and death.
The old CDC advice to be “fully vaccinated” has been replaced by guidance to “stay up to date” on vaccinations. The CDC website elaborates by saying: “You are up to date with your COVID-19 vaccines when you have received all doses in the primary series and all boosters recommended for you, when eligible.”
For most people that means at least one booster, and for many, it means two boosters in addition to the initial two-dose vaccination series.
As reported in the last edition, a task force has been working on plans for mass public vaccination clinics on Vashon for the new Omicron-targeted bivalent booster vaccines when they are available. The clinics are likely to be taking place on weekends in October.
The task force consists of representatives from Vashon Pharmacy, VashonBePrepared, the Emergency Operations Center (EOC), Medical Reserve Corps (MRC), Community Emergency response team (CERT), and Vashon Island Fire & Rescue (VIFR).
Latest Vashon COVID Statistics
Source: Public Health — Seattle & King County (PHSKC) and Vashon Emergency Operations Center. New and historic case counts shown here reflect test results from the public health reporting system, which does not regularly capture results from home tests.
6 = New cases reported since the last weekly report (16 new cases in 14 days).
1,108 = Total reported COVID cases for Vashon residents since the pandemic began.
21 = Patients hospitalized since the pandemic began.
5 = Deaths since the pandemic began.
93% = Percentage of Vashon residents age 5+ who have completed the primary vaccine series, compared to 86.7% of the King County 5+ population.
68.3% = Percentage of Vashon residents age 5+ who have added a booster shot to their completed primary series.
For King County, the PHSKC dashboard for the last 30 days says people who are not fully vaccinated are 1.9 times more likely to get COVID, nine times more likely to be hospitalized for COVID, and 10 times more likely to die of COVID.
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