New CDC COVID-19 isolation guidance weakens labor protections, discriminates against high-risk people, and does not match the science
On 1 March 2024, the CDC updated its COVID-19 isolation guidelines, removing their 5-Day isolation recommendation for COVID-19 and announcing a new guidance that will weaken labor protections, discriminates against high-risk people, and does not match the science of transmission or public health principles. The new "Respiratory Virus Guidance" rolls COVID-19 guidelines into a larger guidance that includes the flu and RSV, and it lowers isolation for people with COVID-19 to only 24 hours after being fever-free and other symptoms are improving if symptomatic, and no isolation at all if asymptomatic although still infectious. It also does not require or strongly suggest the use of masks when people "go back to [their] normal activities"; it only includes masks third on an either/or list of precautions to consider.
COVID-19 remains far more harmful and deadly than the flu and RSV, and it requires specific guidance and better protections, not worse. The new CDC guidance will contribute to employers forcing people back to work more quickly, schools forcing students back to school more quickly, and it puts an even larger burden on high-risk people to protect themselves. This has already been seen with similar isolation guidance changes in some states. In May 2023, Oregon guidelines were changed mainly so students didn't need to stay home for five days while infectious. In January 2024, California made similar changes to their guidelines which public health officials used to weaken state labor protections. This new guidance does nothing to address the ongoing pandemic and the real problems people face when infected with COVID-19, people will continue to be ill with COVID-19 but now with less ability to rest and isolate when needed.
This new guidance is dangerous, anti-science, anti-public health, discriminatory, and made without public comment. Please sign on to express your alarm for the updated CDC guidance and call upon the CDC to put in place better guidance and advocate for policies and programs that protect workers, students, high-risk people, and others!
We welcome you to sign on as an organization, expert, or concerned individual. Sign on to this letter here via Action Network and we will update this page with signatures.
SIGN-ON LETTER TEXT:
Dr. Mandy Cohen, MD, MPH, Director Centers for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30329
Dr. Cohen:
Pan End It! is a nationwide group of disabled, ill, and immunocompromised individuals and allies working for continued COVID-19 protections. We and the undersigned organizations, experts, and concerned individuals are writing to express our extreme disapproval of the CDC's changes to the COVID-19 isolation guidelines and its new "Respiratory Virus Guidance". This guidance is dangerous, anti-science, anti-public health, discriminatory, and made without public comment.
SARS-CoV-2 is an airborne virus. It does not exist in a separate realm; it requires interaction with people and spaces they inhabit to continue spreading. COVID-19 continues to strongly impact people, and there is no long lasting immunity against infection. Using a symptoms-based approach does not work with a virus like SARS-CoV-2 where it's known to have a large number of people who are asymptomatic yet infectious. Most people remain infectious with COVID-19 for more than five days, whether symptoms are present or not, and a fever is not a good indicator of infectiousness. An isolation period of ten days, not significantly less as the CDC has arbitrarily decided, is scientifically needed.
The CDC's recent guidance change indicates that the CDC either doesn't recognize this, that COVID-19 is spread among people, or they are completely detached from the realities of the lives of people who are impacted by their decisions. The CDC seems to think people who are high-risk - or those who simply don't wish to catch a contagious disease that has killed millions and disabled millions more in the last 4 years - exist in self-contained bubbles separate from "normal" society; that we aren't complete people with families, partners, roommates, friends, neighbors, and strangers we interact with every day. We apparently aren't workers without sick pay constantly exposed to sick co-workers and customers. We aren't teachers and students in overcrowded and unventilated or underventilated classrooms. We aren't people providing care to loved ones. We aren't commuters crammed into buses and trains with no air filtration. We are not people living in congregate settings with caregivers and visitors, incarcerated individuals without access to PPE, or unhoused members of society who are often not able to isolate at all. The lack of consideration of the needs and realities of people living in these situations indicates that, to the CDC, we are not people at all.
Additionally, the CDC categorizing COVID-19 as a respiratory illness in the same category as cold and flu is either a misleading oversight or a deliberate attempt to downplay the actual nature and severity of COVID-19. SARS-CoV-2 is much more dangerous than the flu, and a BSL-3 pathogen cannot be treated the same way. COVID-19 can affect every organ system and may cause Long COVID, with increased risk after reinfections. The chance of developing Long COVID increases with each infection, as does the chance of severe outcomes from COVID-19 with each reinfection. Although the new respiratory guidance's background document says that Long COVID is declining, according to the Household Pulse Survey, it is actually increasing.[1] COVID-19 remains a leading cause of death, disease, disability, and school and workplace absence. Having COVID-19 can weaken your immune system - it does not strengthen it - and can lead to an increase in getting other illnesses more regularly. COVID-19 remains a very serious multi-systemic disease spread primarily though airborne pathways, and none of this has changed. The only thing that has changed is the CDC's complete capitulation to political and business interests to force people into working and going to school while sick and ignoring their own needs.
This new guidance does nothing to address the ongoing pandemic and the real problems people face when infected with COVID-19. The CDC claims this change is to better align with what people need and are currently doing, but it doesn't address the underlying issues for people's behavior. The CDC accurately notes that people are unable to stay home when sick, or that doing so puts livelihoods at risk, because they do not have paid sick leave and can't make money while staying home sick. They also recognize that people are less likely to test for and report COVID-19 infections out of this concern for having to stay home without paid leave. But none of these are reasons that are the results of people's need to rest and isolate while sick; they are the reality of living in a society that does not provide proper support to people - ever - but especially when they need to stay home and cannot work. Many people are not choosing to work while sick; they have no other choice. These new guidelines are incredibly shortsighted.
Although the decision to remove isolation guidelines for COVID-19 is presented as one that benefits workers who are unable to follow the 5-day isolation guideline due to lack of paid sick leave, it does nothing of the sort. Instead of following the science and advocating for better policies, the CDC is putting workers at further risk. The isolation change is not a reflection of COVID-19's impact on workers, which remains substantial, as people are experiencing multiple infections a year. The new guidance was proposed because it serves the interests of corporations that forces workers to work while sick, and to remove any remaining rights they may have to rest and recover. Currently, nothing is stopping workers who want to go to work while COVID-19 positive from doing so if they choose not to test and isolate. This guidance change from the CDC does not affect that reality. What will change is the ability of employees who do need to stay home and rest from doing so. The new guidance gives employers leverage to end COVID-19 sick leave and prevent employees from utilizing and remaining sick leave - even when they want to do so. Ultimately, this goes much farther than isolating or COVID-19; it is an attack on workers' rights to use their sick leave now and opens the opportunity for additional attacks on workers' rights and ability to advocate for paid sick leave in the future.
Another important consideration is the impact of COVID-19 on children and schools. Children are also impacted by COVID-19, and the new respiratory guidance will cause them harm. The CDC has shared that from January 2022 to July 2023, half the children who died from COVID-19 had no underlying health conditions.[2] Children of color are hospitalized and die at higher rates from COVID-19.[3] It is estimated that 16% of children develop Long COVID after an infection.[4] Additionally, conditions resulting from COVID-19 infections such as childhood diabetes are on the rise.[5] Household spread often comes from a child.[6] The inclusion of cleaning the air in the new guidance will be outweighed by the increased exposures in schools, which will lower attendance and cause more infections and harm of children and staff.
This isolation guidance is also discriminatory and against state and federal law. Under the ADA, disabled people have an equal right to access public spaces as nondisabled people; under Section 504, disabled students have the right to a Free Appropriate Public Education (FAPE). Several communities are at increased risk for severe outcomes from COVID-19, including people of color, older people, and other individuals who are at high-risk (a significant portion of the population). The CDC is aware that these communities are at increased risk. This new isolation guidance will cause repeated exposure to students, teachers, workers, and other disabled people accessing public spaces who will get severely ill or die. This means many disabled children can no longer go to their school. It means many disabled workers can no longer work because of the risk of exposure. This also ignores that there are people who may not able to avoid exposure if a person who is COVID-19-positive returns to work, like people who are incarcerated, live in congregate settings, or rely on caretakers.
It is concerning to us that the new guidance is written in vague language that leaves out or de-emphasizes many important points and needed guidance for COVID-19. Masking and testing to protect oneself - two of the most important tools that we have against COVID-19 and other diseases - are listed as "additional prevention strategies" rather than "core prevention strategies," but hygiene such as washing one's hands is included as a core strategy, which is not protective against COVID-19. The photograph on the masking page is also of a surgical mask, thus not modeling an N95 as more protective.
In the new guidance, the CDC does not tell people to mask if they are COVID-positive or feeling sick - or even strongly recommend it - but instead lists masking as the third item presented in an either/or list, thus downplaying it as an essential tool to make public spaces accessible. In addition, the high-risk groups list appears narrowed and doesn't include other groups at heightened risk, including people of color; the CDC's main People with Certain Medical Conditions page has also not been migrated over, which is an important page many people access to learn about their own risk and use for documentation of being high-risk. There is also concern about other COVID-19-specific pages being marked as no longer up-to-date, when COVID-19-specific information is still needed for people to stay safe.
The continued chipping away of guidelines continues to reduce people's abilities to keep themselves safe now and in the future. What will we do when COVID levels reach or exceed previous surge wastewater levels again? What will be do when we need paid sick leave? What will we do when the next pandemic hits? The CDC must provide leadership with public health guidelines that reflect the path that we should be taking, not the path that has been forced upon us for the sake of convenience. The CDC should not make recommendations that make people sicker.
The consequences of health outcomes from COVID-19 will affect citizens, health policies, and resources for years to come. The CDC is shirking their responsibility to public health and equal rights under the law. The CDC must rescind these new guidelines and address that the lack of paid sick leave in the United States is a public health emergency by working with other agencies in support of universal paid sick leave. The CDC should emphasize in updated guidance that masking and testing are core prevention strategies. More specific information on groups and individuals who are high-risk needs to be added to future guidelines, and the CDC high-risk conditions page retained. The CDC must cease capitulating to business interests and political pressure and recommend scientifically-based isolation guidance in order to protect people and reduce the burden of COVID-19.
Citations
1. Centers for Disease Control and Prevention. (2024, February 23). Long COVID - Household Pulse Survey. https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm
2. Evidence to recommendations framework. (n.d.). https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/11-COVID-Wallace-508.pdf
3. Two-year study finds black children with Covid-19 had twice as many deaths as white children with the virus. Morehouse School of Medicine. (n.d.). https://www.msm.edu/RSSFeedArticles/2023/March/2022BCAC_Report.php
4. A Systematic Review of Persistent Clinical Features After SARS-CoV-2 in the Pediatric Population . American Academy of Pediatrics. (n.d.). https://publications.aap.org/pediatrics/article/152/2/e2022060351/192816/A-Systematic-Review-of-Persistent-Clinical
5. Children's Health. (n.d.). COVID-19 and diabetes in children. https://www.childrens.com/health-wellness/can-covid-19-cause-diabetes-in-children
6. More than 70% of us household COVID spread started with a child, study suggests. CIDRAP. (n.d.). https://www.cidrap.umn.edu/covid-19/more-70-us-household-covid-spread-started-child-study-suggests
Letter Signatories
stacie hipp
Ardis Smith
Paul Hennessy
Jennifer Ritz Sullivan
Samantha Crausman
Karen Dailey
Sarah Lowenstein
Reema Sweidan
Kari Wilder-Romans
Erica Harrison
Lauren Stark, Ph.D.
Whitney Fisher
Cassidy Loyd
Sophia Borgesi
Greg Schacht
Temple Loveli
Jessica Tardieu Haines
Jenifer Steinmeyer
Monica Allen, Pan End It!
Stephanie Wilson-Krause
Don Nowland
Claire Anderson
Zoya Melkova
Lori Ross
Marisma Espana
Edie Schaffer
Del Hanson
Corina Weidinger
Michelle Masini
Pamela Kedderis
Catie Faltisco, Licensed Clinical Social Worker Catie Faltisco LCSW
Bonnie Smith
Karen Walker, RN and CCM
Erica Victoria, University of Vermont Mental Health Worker
Peggy Lavelle
Hillary Okun
Alyssa Guild
Tony Barone
Gloria Whipple
Nikul Sheth
scout Phillips
otto Norton, Covid Safer PDX
Syd Bauer, Mask Up Morris
Rachel Steuer
Matthew Krumrie
Bridgette Jones
Hannah Nowland
Hannah Nowland
Katherine McGinn
Hannah Nowland
Jamie Leonardi
Sarah Liebman
Kaitlyn Tykhonovska
Patrick Forsythe
Cameron McCuen
Shelby Pumphrey
Cristie Burghardt
Claryn Spies
Lora Smith
Oren Pilinger, L.Ac.
Christopher McCormick
Eleanor Bravo, NM COVID-19 Memorial
Marie Biondolillo
Connie Woods
Amanda M
Emma Gutierrez
Cynthia Bukowski
Mackenzie Knapp
Carly Cais
Chelsea Trull
Debbie Holloway
Kendra Peterson
Todd Czerner
DeAnna Baumle, JD, MSW
Felicia Alfieri
Lisa Jordan
Caitlin Olson
Emma Smith
Jen Smith
Olivia Hunt
Ryan Costello
MC Burkhardt
Tabitha Kush
Bianca Giosa, Certified Court Interpreter
Berthe Palmrose
Seven Blond
Julian Pecina
Crystal Miller
Olivia Powell
Kaitlyn Amaral, Kaitlyn Amaral Photography
Mackenzi Oswald
Rey Stevens
Martha Burwell
Jacinda Swanson
Cara Rosenburg
Yehudah Alan Winter, Retired RN Compassionate Listening Oregon
Lilla Fortunoff
Mira Lee, PSS, THW Quest Center
Devan McGirr
Linda Green, ACP, MD, PanEndIt
Adrian Brown
Robin Burgess
Christina Spangler
Madison Kersting
Mary stempien, Youth educator and advocate
Natasha Forrester
Quinn Francix
Kym Julia Lambert
Caroline Blanchard
Henry Venneman
Daphnée Venneman
Maria Monks Gillespie, Ph.D., Mathematics Colorado State University
Mary Vest
Matteson Knox
Maya Rose
Kate Nash
Teri Jo Rask
Sindri Woodard
Hila Keller
Shea Oneil, World Health Network, BA Psychology, World Health Network Volunteer
rachel mulder
Rebecca Hayes
Melissa Mackey
Erin Dahl, Covid Times, Health Inclusion
Erin Bell
Kim Fortin
Siobhan O’Reilly
Amelia Diehl
Ann Miller-Larson
Angela Jarman
Janice Cavanaugh,IC
Jessi Presley-Grusin
Brezlyn Stork
Chiron BARRON, Peer support worker
Alexandra Campbell
Doreen Gordon
Lindsay Gutierrez
Rollin Kunz
Lauren Moss
Victoria Wu
Heather Lobitz
Vanessa McKinney
Tatiana Henry,DVM
Rachel Shaw
Carlos Hoyer
Savannah Brooks, COVID Longhauler
Kenneth Clark
Shelby Wayment. Lawyer
Kelly Forrester
M. Flores Farley
Hannah Carls
Liesl McCormick, PhD
Lauren Eggert Crowe
Jamie Lawson
Leora Matison
Leigh Fullmer
Ana Zink, PhD
R Catania
karyn pomerantz, MLS, mph Apha
Claire O'Brocta
Daphnee Venneman
Hannah Song
Jill Vosberg
Ellen Pimentel
Helena Gindi
Kristin Gross
Eliana Martel
Mae Melaku
Angel Gomez
Keeley Carnes
zed behlen
Susan Garner
Keeley Carnes
kaila trawitzki, World Health Network/COVID Survivors for Change
Jodie Eason
Evan Berry, Mask Up! Rochester NY
Lisa Boscov-Ellen
Reed Fowler, Rev.
a kindling
Katie Turner
J Havel
Hannah Davidson
Rose Redwood
Tara Eng
Rhea Sellitto
Esther Cho
Alli Bratt
Nia Nottage, member of ACT UP NY and Peoples CDC, patient / concerned citizen
Sunny Davey
Martha Moore
Rebecca Stuebe
Sabrina Sayegh
maeve sherry
Elizabeth Allen, OTR/L
siobhan shea
Orville Mansfield
Caitlin McKenna
Keagan Autry
Amie Stager
k dublap
Jessica Sobel, Rn
Mary Calhoun
Caitlin Chow-Ise
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Hannah Byers-Straus
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Jessica Broberg
Ligia Fragoso, MD, MA
C Filson
Pamela Mackay, RN
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Kaleigh Fleming
Beck Wehrle, PhD
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Nicole Petrin
Ari Libove-Goldfarb
Elizabeth McLister, Registered Nurse
R. E.
Lisa Milbrand
Elizabeth Kebbekus
Ann Egyhazi, MA Early Childhood Education
Emi Glaeser
Dana Ludwig, UCSF MD Dana Ludwig
Howard Robinson
Olive Au
Sarah Smith
Sarah Harper,COVID Safe Maryland
Victoria Cagande
Cecelia Huang
DeForest Wihtol
Laurice Fattal
Janna Moreau, RN
Riley Collins
Kris Owens
AJ Heemstra
Liana Fixell
Ian Leinbaugh
Teresa Aquino, Long Covid expert (of necessity)
Lisa France
Theo Dautovich
Aliyah Uhlig
Stephanie Cox
Aliyah Uhlig
Teri Hall
Chip Cox
Grace Kufeldt
Kori Lay
Martha Young JD, MBA
Michael Askren
Matt Hill, Helios Research
Lindsay Heinonen, BSN, RN, PHN
Molly Officer
Seleste B
Jessica Class
Alison Wortz
Henry Newman
Susan Heath
Ellen Green
Oni Blackstock, MD MHS Health Justice, LLC
AJ Di Nicola
Caleb Wetzel,Mechanical Engineering
Joseph Gonzalez
Rob Zeno
Alex Einweck
Irene Papaefthemiou
Joseph Nield
Pooja Sen
Samantha Figuly
Danielle Autino
Ryan Gallo
Shiloh Ferguson
Kimberly Barosh, BA & CVT
Reid Gilsdorf
Nicholas Pahl Skinner
Sam Mendoza, RMA
Cassidy Romaire, Torello
Roselie Bright, ScD (Doctor of Science in Epidemiology)
Jessica Peterson
Anita Briggs
Margaret Hollick
Marianna De Leon
Emily Dunham
Jack Degrave, Personal Care Attendant
Walter McGhee, US Navy Retired, Past President Toledo Rotary
RUTH FEIERTAG, Person with high-risk health conditions
Wiley W
Melody Caspari
ned moran
Kim Phillips
Cheryl Elmer, LMFT
Maxwell Delzer
Diana Striplin, Concerned citizen, Masters of Science Clinical Psychology
Amy Wang
James Cameron
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Tyler Chisenhall, WHD
Melina McCrain
Captain Brisker
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Emily Kerr
Artesia Wagersreiter
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Courtney Haworth, LMSW
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Benny Winer, Community Healthcare Network
Malone
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tilley jean
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Jordan Rhea
Holly Brestel
Evelyn Dial
Morgan Elliott
Eric Jenson
Abby Taylor
Connie Rab
Lorena Galvan, DO
Ellen McGregor
tuesday harwood
Sarah Haynes
Nathanael Nerode, World Health Network Expert on Covid-19 prevention, published paper on the topic
Aubree Bernier-Clarke
Elliot Seiler
Track Trachtenberg
Ursula Tooley
Jason Kron
Alex Fay, BSN, RN
Flora Wright
Nicholas Winningkoff
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Nora Pearson
Leah Pruente
Kelsey Fong
KC Caudron
Leona Lee, Disabled Debtors Cohort, Access Living, Ms
Winifred Weaver, Community Projects Rehabilitation Counselor, Retired
Claire Wang
Raul Odo
Grayson Breen, MSW, LSW, PEL:SSW
Mary Sorensen
Cheryl Colan
Jessica Tang
Gideon TG
Shae McCarty
Michelle Rochniak
Marc Meadows, AFSCME, PhD
Z Dong
Anna Conklin
Juniper Sedlock, Social worker, Do Good Multnomah
Allison Taylor, RN
Debby Schwartz, Multnomah County Case Manager, Do Good Multnomah
Jamie Partridge, American Society for Clinical Pathology, Medical Lab Tech Portland Jobs with Justice
Courtney Childs
Erika
Rachel R
Shoshanna Press, MD
Ray Soller
Kelly Renee
John Spillane
Sarah Ribero
Jess Jones
Janelle Maroney
Laura Long
L Marks, Mask Together Capital Region
valentin macias
Ras Goodwyn
Jessica Cece
Kaia Dresselhaus, Senior and Disability Action
Sara Johnson
Elizabeth Mandelbaum
Megan Ausen
Jessi Presley-Grusin
Peter Bishop
Crash Margulies, Mask Bloc MSP
Allison Alvarez
Voula O'Grady, Long COVID Justice / Strategies for High Impact
Sydney Muraca
Stephanie Muraca
Aidan Muraca
Morgan Gallardo
Isabelle Leppala
Caleb Dobbs
Briana Gregory-Howe
D. T.
Alana Spence
Emily Yurina
Claire O
Sarah Bapty
Grace Heneghan
Kaitlyn Bingham
Milo Quinn
Giuseppe Borrelli
Gabriela Garcia
George Guerios
Allison Goins
Scott Raboy
Whitney West
Greg Jacobs
Sam Emo
Angie Johnson
Ness Mata
Claire Ardis, MS, MD/MPH candidate
Miranda Oehler
Taryn Tranby, A Citizen and Employee in the US
Chris MacKenzie
Kelly Scott
Abigail Trapp
Kathryn Willey
Everett Anderson
Seth Kane
A L
Miles Dievend
Jannell Nickols
Mollie Gaffino
Emily Wright
Rebecca Daly
Natalie Kelsey
Jay Nadolski
Christian
Salome Whittamore
Katie Curry, mask bloc nova
Sarah Weir
Mary Friedle,Registered Nurse
Jennifer Haber
Cass Torrez
Sonya Montour
Maria Ziegelbauer
Logan Comeau
Teresa Aquino, Long Covid expert (of necessity)
alexa r, Fight COVID NOLA
Kristin Faulkner
L Marks,Mask Together Capital Region
Janna Moreau, RN
Nancy Iannuzzi
Sadaf Ajani
E S
Lindsey Esplin
August Metzger
Holley Madden, Volunteer, WHN
Erica Olson
Jacinda Swanson
Erin Hinton
Martha Burwell
Roselie Bright ScD (Doctor of Science in Epidemiology)
Emily Parker
M Clark
Rachael Babiracki
Flavia Martinez
Kaila Trawitzki
Ken Kenegos RN AZ Medicare for All Coalition
Mae M
marlene bluestein MD
Janelle Goodman
Lisa Wilson
M Oxley
Erin Dodge
Chelsea Trull
Jennika Stamm MS
Nicole Malinoff
Shinae Galli
Gina Bonilla
Fern Viridian
Jenny O'Connell
mik varunok
Spearance Early childhood educator
Clarice Bales
Caleb LoSchiavo Rutgers School of Public Health MPH
Tyler Jones
Emily Ball
Kaleigh Fleming
Amanda Hennessy
Clarissa Mitchell
marlene bluestein MD
Dan O'Neal Az State Coordinator Progressive Democrats of America
Jessica Peterson
Connie Woods
Victoria Wu
otto norton
Paula Marks
Evan Berry Mask Up! Rochester NY
Caroline Blanchard
Henry Venneman
Daphnnee Venneman
Jen Lamoureux
Austin Wilkes
Jolie Misek
Kristen Otenti
Kimberly Barosh BA & CVT
Justin Philipps
Cooper Campbell
Sarah Zarzynski CCRA
Gabriela Santiago
Joanne Mallett MD, FACOG
Julie Vanderschaegen
Jill Lock R.N. Fulton Neighborhood Association
Anne Greene
Anne Riley
Dennis Young
Marjorie Laboy-Vagell
Betty Nash
Justin Philipps
JL Angell
Rory May
Anne Greene
Zara Petkovic
kaila trawitzki BS Electrical and Computer Engineering Tech
Taylor Stover
Laura Finch MIT Assistant Professor Individual
Kevin Churchill
Justin Philipps
Mary Chase
JL Angell
Bonnie Gorman RN
Esther Kim
Oregon Health Equity Alliance
Michael Neil
Erika Jahneke
Joy Bunton
Perry Kendall
Michael Fox Deputy Executive Director Progressive Democrats of America
Progressive Democrats of America
Mary Higgins M.Ed
PDA Disability Team
Roger Batchelder
Justin Philipps
JL Angell
Justin Philipps
Lori Stefano