疾病控制和预防中心周二澄清了其指导方针当你得到新冠肺炎后该怎么办,这一举动是在上周批评他们的最新指导缩短隔离至五天而不要求阴性测试之后发生的,这是令人困惑和松懈的。
最新的更新仍然没有包括建议人们在离开隔离区之前进行阴性COVID测试,但为“有机会”和“想测试”的人提供了指导——这种语言反映了许多美国人最近几周在试图接触他们时面临的挑战——同时仍然坚持认为阴性快速测试不是一个完全清楚的答案。
疾控中心表示,五天后检测呈阳性的人应该再隔离五天,而检测呈阴性的人仍然应该遵循那些没有检测的人的指导:直到第10天,戴上口罩,避开高风险人群,不要旅行,也不要在别人身边吃喝。
疾控中心表示,这一决定是基于这样的数据,即快速检测阴性并不一定意味着有人已经停止传播病毒,聚合酶链反应检测——最准确的类型——也不可靠,因为即使有人没有传染性,它们也会在几周后继续显示阳性结果。
“因此,无论测试结果如何,仍然建议佩戴合身的口罩,”指导意见说。
虽然更详细,但更新后的指南与上周的指南没有明显不同,上周的指南将COVID患者的建议隔离期从10天改为5天,然后在其他人周围进行5天的掩蔽。它适用于每个人,无论是否接种疫苗,只要人们在第5天之前基本上没有症状,谁就会获得COVID。
但这一决定激怒了公共卫生专家,他们认为在没有阴性检测的情况下缩短隔离时间会导致更多的传播。
“疾控中心将阳性患者隔离时间降至5天而不进行阴性检测的新指导是鲁莽的,”eMed的流行病学家兼首席科学官迈克尔·米娜博士在最初宣布后于上周在推特上写道。“我绝对不想坐在一个五天前变成(阳性)但还没有检测出(阴性)的人旁边。”
联邦官员反驳了这些批评,坚称新的建议是基于科学,而不是社会压力。
“只要人们没有症状,戴上口罩,你就可以在五天内让他们安全返回。这就是科学,”白宫首席医学顾问安东尼·福奇博士上周告诉美国广播公司新闻。“这样做的影响是,尽量不要陷入我们必须关闭整个国家的局面。”
美国广播公司新闻
疾病控制和预防中心主任罗谢尔·瓦伦斯基博士出现了.
疾控中心主任罗谢尔·瓦伦斯基(Rochelle Walensky)也为该指南进行了辩护,他说,该指南基于行为研究,表明只有三分之一的人遵循了之前的指南,数据显示,高达90%的COVID传播发生在有人感染的前五天。
“这确实与我们认为人们能够容忍的事情有很大关系,”她上周在接受美国有线电视新闻网采访时表示。
周二,指南基本上坚持了这一立场,尽管它进一步澄清了人们在所有情况下应该做什么,包括他们是否决定测试。
以下是最新消息:
疾控中心说,如果你获得了COVID,你应该隔离五天。
第0天是出现症状的第一天,第1天被认为是“症状出现后的第一整天。”例如,如果你在星期一有症状,星期二是第一天,星期六是第五天。
如果你的病例没有症状,第0天就是你检测呈阳性的那一天。但美国疾控中心(CDC)周二的指导说明,如果人们在没有任何症状的情况下检测呈阳性,然后在随后几天出现症状,他们应该在出现症状的当天将隔离时钟重置为零,并再隔离五天。
五天之后,如果你大部分都好了,你可以离开隔离区。这是什么意思?没有发烧,正在好转。
根据疾控中心的指导,“如果你24小时不发烧,没有使用退烧药物,并且你的其他症状有所改善,你可以在5整天后结束隔离。
味觉和嗅觉丧失是两种常见的COVID症状,可能会持续“康复后数周或数月”,不符合应该让你隔离的症状。
然后,在五天之后,你应该在你的5天隔离期结束后,在家里和公共场所的其他人周围再戴上一个“合适的口罩”5天(第6天到第10天)。
疾控中心说,如果你不能戴口罩,或者如果你可以戴口罩但会和高危人群在一起,选择隔离。
“如果你在别人身边时无法戴口罩,你应该继续隔离整整10天。根据美国疾病控制和预防中心的说法,“至少在10天后,避免免疫功能低下或有严重疾病高风险的人,以及养老院和其他高风险场所。
如果你还想测试,可以找一个
至于检测部分,美国疾病控制和预防中心建议能够并且想要检测的人应该在第五天左右进行,如果他们已经24小时没有发烧的话。
“如果你的检测结果是阳性,你应该继续隔离,直到第10天,”指南说。
而且,重要的是,根据疾控中心的说法,阴性检测并不是完全明确的。
“如果你的检测结果是阴性,你可以结束隔离,但在家里和公共场合继续戴着一个非常合适的口罩,直到第10天,”指导说。
疾控中心建议不要旅行,不要去任何你不能戴口罩的地方,比如餐馆和健身房,也不要在人们身边吃饭——无论是在家里还是在公共场合——“直到你出现症状的第一天后整整10天”,即使测试结果是阴性。
周一晚上,瓦伦斯基在接受《深夜秀》主持人史蒂芬·科拜尔的采访时被问及指导意见时表示,她会把即使是阴性测试也解释为可能“有一些遗传性。”
瓦伦斯基说:“如果你有机会做测试,如果你想在第五天做测试,如果你的症状消失了,你感觉很好,那就去做那个测试。
“但我会这样解释这个测试。如果是阳性,再在家呆五天。如果是否定的,我会说你还是真的需要戴口罩。你可能还会有一些遗传性,”她说。
“你大概还是不应该去看望奶奶。你不应该上飞机。当你和其他人在一起时,你还是应该非常小心,要一直戴着口罩。”
虽然该指南的推出遭到了很多批评,但专家们指出,这最终是一个快节奏的环境,没有简单的一刀切的解决方案。
约翰·霍普金斯彭博公共卫生学院的流行病学家大卫·道迪博士告诉美国广播公司新闻,“疾控中心发出了一个复杂的信息,但我认为没有任何方法可以解决这个问题。
“我认为,在形势迅速变化的背景下,我们不应该太快判断混杂的信息。我们希望我们的指导方针反映我们所掌握的最新知识,这意味着这些指导方针将会改变,有时会很快,”他说。
CDC clarifies isolation guidance after criticism but still no call for testing
The Centers for Disease Control and Prevention on Tuesdayclarified its guidelinesaround 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.