Concerns While the Centers for Disease Control and Prevention is preparing for a fall, it is growing among medically vulnerable people. Long-term advice is for five days of self-isolation for people infected with Covid-19.

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People with weakened immune systems worry that co-workers will return to the office still contagious. At the same time, the remaining policies that allow payments to workers with Covid are mostly coming to an end. New York, the only state that still requires paid leave for Covid-19 isolation, is considering ending the benefit this summer.

Although many resolve the exclusionary rule, others. They are troubled by a recent move by federal health officials to stop treating Covid as a special respiratory virus threat.

The coming change It was first reported by the Washington Post People can return to school and work if they have been fever-free for at least 24 hours without medication. They have simple and improving symptoms.

This is similar to the guidelines for people with influenza and respiratory syncytial virus (RSV). Supporters, including prominent doctors and public health experts, say it’s the right move Shining The fact that there are many people infected with covid Isolation and threat are not Severe illness has been blunted by vaccinations, pre-infectious diseases and antiviral therapy. But critics say Covid shouldn’t be treated like other respiratory viruses because it currently hospitalises and kills. More people than the flu And can They cause long-term problems that scientists are still trying to understand.

“I feel like I’m on my own island,” said Lisa Savage, 60, a retired nonprofit fundraiser. In Charleston, S.C., she has multiple immune disorders that protect her body In case of constant inflammation.

Savage said the CCC’s proposed changes scare her. When you hear people say it’s time for the country to move on, you say, “You’re lucky. Those of us with weakened immune systems don’t have that luxury.”

The CDC is expected to release the proposed revisions in independent guidance and seek public comment in April.

The science surrounding infection and transmission has not changed. A person who tests positive for Covid may still be contagious for more than five days. People who do not have symptoms or fever can spread the virus early in their illness. What’s unknown, experts say, is how closely people follow the five-day self-isolation advice and whether loosening the guidelines will affect the rate of community transmission.

Oregon eliminated the five-day isolation requirement for Covid in May 2023 and told people to remain isolated for 10 days and wear masks around others until they recover — similar to other respiratory illnesses. According to data shared last month with the National Association of State Health Officials, the state has not experienced any disproportionate increase in community transmission or severity compared to California, which has maintained a five-day isolation advisory until January 2024.

Walid Gelad, M.D. and professor of medicine at the University of Pittsburgh, said that ignoring neutral recommendations increases the risk of disease in people with compromised immune systems. But those risks must be weighed against the long-term effects of isolation, including people missing work and school, he said. “It’s definitely a different world now,” he said.

Caitlin Zetelina, an epidemiologist who closely follows Covid-19 policy, says health policy is complex and important. Consider trade-offs that change over time US population 330 million people have different priorities, risk factors, Behaviors and beliefs. “Ultimately, we need a policy that is defensible and practical and feasible,” she wrote in her latest weekly newsletter.

Public health experts say it’s more feasible to drop the revised guidelines at the expense of the immunocompromised and elderly to reduce economic disruption. They say there is a middle ground between living in fear and ignoring the virus.

Paul Offitt, MD, a pediatric infectious-disease specialist at the Children’s Hospital of Philadelphia, said high-risk people would benefit if Americans focused more on isolating when they got sick, not on which virus they have.

“I think people have the mindset that if they don’t have Covid, they’re fine,” Offit said. But all of these viruses can cause people to be hospitalized or go to the intensive care unit or die… So stay home when you’re sick, even if you’re not in a high-risk group.

Public health officials have confirmed measures to limit the spread of Covid-19, citing sharp declines in hospitalizations and deaths since the outbreak began. But longtime Covid activists have overlooked how the virus can cause symptoms for which there is no clear cure.

“The CDC is part of misleading the public at all times to view this crisis as a serious crisis, but not as a major chronic impact,” said JD Davids, executive director of Long Covid Justice. “It fosters this dangerous idea that we are always sick and working by transmitting diseases to others.”

The latest major revision to the CDC’s isolation guidelines, from 10 to five days in December 2021, has prompted companies including Walmart, Amazon, CVS and Walgreens to pay employees to stay home when sick with Covid-19. Fewer employers now offer any kind of paid leave for Covid and instead require workers to use traditional sick time benefits; Even if they offer them. Others say workers should return to work when they are asymptomatic or have no fever or are still sick.

I think it’s employers who want to go back. [paid leave] It uses the CDC guidelines as a rationale for doing so,” said left-leaning Vicki Shabo, a senior fellow who focuses on New America’s paid leave policy. But what I hope employers understand is that making sure their employees stay home when they’re highly contagious…better for business, better for morale and better for productivity.

Nearly 1 in 4 workers do not have a single paid sick day, according to the Bureau of Labor Statistics.

In the year In 2020, when the coronavirus hit the world, the United States asked businesses with 50 to 499 employees to pay workers with Covid. The rule was lifted later that year, prompting some states and cities to enact similar protections that have now expired.

New York Gov. Cathy Hochul (D) has proposed ending the nation’s monopoly. State law requiring paid leave for covid isolation. Business groups in the state say ending paid Covid leave is long overdue, especially when New York has a broader law mandating paid sick leave.

“It’s time to end these special Covid benefits, and this is the last one left,” said Frank Kerbein, director of the Business Council’s Human Resources Center in New York. “We don’t have a paid leave program for tuberculosis.”

Covid isolation policies have been a challenge for health care systems that already face staff shortages but also need to protect patients from the contagious disease.

Northwell Health, New York’s largest health care system, is offering five days of Covid leave in line with state guidelines and requiring employees to wear masks for another five days when they return. In the first week of February, 123 of the more than 80,000 workers were quarantined., According to the hospital system. But Northwell leaders believe a 24-hour fever-free period as recommended by the CDC makes sense as a starting point for workers to determine contagiousness.

“When healthcare workers don’t want to stay in isolation because they’re not in a contagious situation, we need it,” said Peter Silver, Northwell’s senior vice president.

CDC officials told the Post that the new isolation recommendations do not apply to hospitals and other health care settings that are more vulnerable.

Activists organize to defend New York’s repeal of Covid-19 leave policy would hurt low-wage earners and people at risk of chronic illness.

State Sen. Jessica Ramos (D), who chairs the Labor Committee and opposed the measure, said: “We know that Covid is not completely done, and while we’re still seeing some tailwinds, it’s too soon to make this big of a change. The governor’s attempt to sunset the paid vacation law. “Making sure that they are employees as a It should be one of our most reliable missions.

For some, the advice from supporters to ease the isolation guidelines is more of a dilemma than a serious one. – and it can be very expensive. For mild pain, people isolate Instead, accepting ignorance as bliss will not make a covid diagnosis.

Reshma Chugani, a pediatrician in Atlanta, said parents often cut back on coronavirus testing because they don’t want their children to miss five days of school, which could force parents to miss work if they test positive. She also said that the antiviral paxlovide, which is approved for use, is no treatment for most children. People 12 and over.

Many schools, dependent on the availability of funding, have sent home letters indicating the number of children who have been sick with Covid, adding to the pressure on parents who keep them out of school for longer periods of time.

That puts pediatricians “at a disadvantage from a public health perspective,” Chugani said.

“By sending sick children to school, we risk exposing vulnerable people,” she wrote in an email. “On the other hand, it’s a real problem for kids to be out of school, as we’ve seen with learning loss, isolation, mental health issues during the height of the epidemic.”

Her college-age son contracted Covid for the first time last week and had to self-isolate in his dorm for five days per school policy. He had no fever, and with no remote options, he had to skip four days of class, emerging in time to attend the Super Bowl party.

Andrew Frank, a Boston-area consultant who has a 2-year-old daughter, said he sees the virus as a major cause of death, but said employers don’t offer additional incentives to isolate. When he is sick. His wife only has seven sick days a year. If the daughter has a positive test, she must wait at least five days to return to the nursery and a negative test result, and must leave work to take care of her.

Frank, 37, said: “One case of the coronavirus spreading through our entire family could easily wipe out all of our sick days.”

He said he understands why many parents do not get tested for Covid when their children are sick.

“If I test her and she tests positive, she will have to stay at home for two weeks.” Franks said. But if I don’t test her and she never gets a fever, she can go on living. They are actually perverse incentives.

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Video: The new guidance, expected in the spring, will bring Covid-19 in line with advice for other respiratory viruses such as the flu. Health reporter Lina Sun explains. (c) 2024, The Washington Post

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