CDC issues new COVID guidelines for return to work

Testing positive for COVID-19 will no longer mean prolonged isolation for most people under new U.S. guidelines released Friday.

People with COVID whose symptoms are improving and have been fever-free for 24 hours without medication can return to work, school or other public places, U.S. health officials said. The updated Centers for Disease Control and Prevention recommendations acknowledge the waning severity of infections along with the effectiveness of treatments and vaccines. 

Read more: Does your disability insurance cover long COVID? What's at risk for employers and employees

After sweeping across the world and leaving more than 1.1 million Americans dead in its wake, COVID has been significantly tamed by vaccines, drugs such as Pfizer's Paxlovid and widespread immunity resulting from infections. The new U.S. guidance extends beyond the coronavirus to familiar contagions like flu and RSV that can be fatal for the most vulnerable, but aren't considered national emergencies. 

"We are in a new place," CDC Director Mandy Cohen said in an interview with Bloomberg Television. Even as COVID cases remained high this winter, there were fewer hospitalizations and deaths. "With that continued trend over yet another season, we felt we could move forward." 

Respiratory viruses still remain a threat, particularly for people 65 and older and those with compromised immune systems. Elderly people and those with chronic diseases who are vulnerable to COVID have opposed changes in guidelines that would put them at higher risk of contact with infected people.

Read more: After COVID, this healthcare worker quit her full-time job to escape burnout

There were 76,000 COVID deaths in the U.S. last year, the CDC said, down from 245,000 in 2022. Flu causes as many as 51,000 U.S. deaths annually. 

Cohen said she hopes that the revised guidance will be easier for Americans to observe. "And if more people are following that guidance, that means less viral spread," she said, noting that high-risk individuals were "top of mind" while developing the recommendations. 

People infected by COVID, flu or RSV should still stay at home as much as possible and seek treatment, the CDC said. Some remain contagious even after their symptoms abate or their fever resolves without medications like Tylenol. Those who do return to work or school should mask, keep their distance from others, wash their hands and take other measures for five days. 

The CDC has additional recommendations for people who are pregnant, immunocompromised, have disabilities or are over the age of 65. 

Read more: What to know about the state of COVID today

Today, 98% of the U.S. population has some COVID immunity from vaccination, infection or both, Brendan Jackson of CDC's National Center for Immunization and Respiratory Diseases told reporters on Friday. Still, that immunity can subside, so it's important to stay up to date with shots, he said. 

"We saw far too few folks get the updated COVID vaccine this past season," said Cohen, who took over as CDC director last summer. "Get ready now for your updated COVID-19 and flu shot this fall." 

The guidance removes yet another obstacle to employers' efforts to coax workers back to the office. Payroll company Gusto found that at professional service firms, almost a third of employees took at least one sick day in 2023, a 42% increase from 2019, and average absences were about 15% longer.

Companies should provide flexible paid leave and remote options to employees to help them stay home when they're sick, Cohen said. 

While the CDC has repeatedly evaluated its COVID isolation guidance in recent years, new waves of illness brought about by viral mutations have discouraged the agency from making major changes. CDC last changed its COVID-19 isolation recommendation in 2021. 

"We know that this virus can change and we may need to change with it," Cohen said. "This is the best information we have today."