Missouri DHSS Statement on Updated CDC Guidance for Shortened Isolation and Quarantine Period for General Population

On December 27, 2021, the CDC released a media statement regarding the decision to reduce the duration of isolation for known COVID-19 cases and shorten the quarantine period for close contacts. DHSS will adopt and implement the new guidance statewide. To date, the CDC has not updated their webpage for the public to reflect this new guidance. Updated healthcare worker guidance on strategies to mitigate staffing shortages was released by the CDC on Dec. 23, 2021, but may be further modified as a result of these new quarantine and isolation changes. Additional clarification will follow as we receive more information from the CDC. Guidance documents for specific groups such as K-12 will also be updated as soon as possible.

The media statement on the new CDC guidance may be viewed here:
https://www.cdc.gov/media/releases/2021/s1227-isolation-quarantine-guidance.html

For known COVID-19 cases requiring isolation:

CDC is shortening their recommended isolation period from 10 days to 5 days, provided the case is either asymptomatic or has symptoms that are resolving. Individuals with a fever should remain in isolation until the fever resolves. After the 5-day isolation period, CDC recommends that cases wear a mask around others for an additional 5 days.

Per the CDC press release, the rationale behind this change is a growing understanding that the majority of SARS-CoV-2 transmission occurs in the 1-2 days prior to symptom onset and the 2-3 days afterwards. Some individuals will still be capable of transmitting the virus following the 5-day isolation period, and the additional 5-day masking period recommendation is an attempt to further reduce the risk of those individuals infecting others.

For close contacts to COVID-19 cases requiring quarantine:

CDC has effectively created a two-tier grouping for close contacts. The first group includes those who have recently completed the primary series of an approved vaccine (within the past 6 months for Pfizer or Moderna, or within the past 2 months for J&J), as well as those who have received a booster dose of vaccine. Individuals in this group are not required to quarantine if they remain asymptomatic. CDC does recommend that these individuals wear a mask around others for 10 days and test on the 5th day after their exposure, if possible. If an individual in this tier does develop symptoms, they should be tested and stay at home while awaiting results.

The second group includes anyone who is unvaccinated, partially vaccinated (only completed one dose of a 2-dose series), or who has completed their series (over 6 months prior for Pfizer and Moderna, or 2 months prior for J&J) and who hasn’t yet received a booster dose. CDC does recommend a shortened 5-day quarantine for anyone in this group, followed by mask usage around other individuals for an additional 5 days. A significant change is that CDC allows a modification of mask usage for a 10-day period for anyone in this group who “can’t quarantine.” Individuals in this group are also recommended to test on the 5th day following an exposure and to test and stay at home if symptoms develop at any point.

DHSS is providing the following clarifications to the CDC guidance:

·         Where active monitoring by a local public health authority is not possible due to resource constraints, individuals should be advised to self-monitor using CDC’s checklist of signs and symptoms, and report the development of any COVID-related symptoms to a healthcare provider or local public health authority;

·         DHSS advises that the determination of the starting point of the time period for a household contact should still be calculated from the final isolation day of the index person as the last possible exposure for the household contact;

·         For all Missourians, DHSS continues to advise citizens to engage in social distancing, wear a mask in accordance with recommended guidance, use proper self-hygiene and handwashing techniques, and avoid contact with symptomatic individuals;

·         Both, DHSS and CDC, strongly encourage COVID-19 vaccination for anyone aged 5 and older, as well as a booster dose for anyone eligible.

DHSS will continue to assist local public health authorities, where possible, to provide additional clarity and consistency to this statement.