New Phase, New Rules

On August 11, 2022, the CDC came out with a new set of guidelines relating to COVID-19. A few of the rules have changed a lot.

Donna Matson and Liz Ruark
Friends at a dinner party

December 2022: Whenever you test yourself for COVID at home — whether you’re positive or negative — you should report your result. The results are kept private and anonymous. Every test that gets reported helps public health teams better understand where outbreaks are happening, so they can get help to people who need it.

September 2022: This post has been updated to reflect changes to CDC guidelines.

A new flurry of questions came our way after the CDC announced major revisions to their guidelines.

Did I hear that the rules just changed? Again? 

Yes. That’s how things are supposed to work.

For some reason, we as a nation seem to have this idea that rules, once put into place, should never change. Ever. That doesn’t make sense when you’re dealing with a brand-new disease. When the pandemic started, we didn’t have any tools to fight the virus. Now we do: vaccines, boosters, and treatments. All of these do a great deal to prevent severe illness. The situation on the ground has changed, so the rules should, too.

Back in 2020 we also didn’t know much about how the virus spread, so the guidelines the CDC put together at that time were based on experience with similar diseases. Now that we know more, it’s clear that some rules weren’t that helpful, so it makes no sense to keep them around.

The best example of that is the six-foot rule, which the CDC has dropped. It was based on the idea that COVID-19 spread mostly through large droplets of moisture that people cough or sneeze out. Those droplets were thought to travel no more than six feet.

Over time, researchers learned that while the virus can travel on large droplets, the main way it spreads is on much smaller bits of moisture called aerosols. Those can travel a lot further than six feet, and they can hang out in the air for a long time. That’s how superspreader events like the infamous 2020 choir rehearsal in Washington State happened — people much farther than six feet away from the infected person breathed in aerosols carrying the virus.

So the six-foot rule didn’t help that much, and it’s now gone. In its place is emphasis on what does help: Wearing masks and keeping indoor air as clean, fresh, and virus-free as possible.

What do I do if I’m exposed to COVID-19 now?

This is probably the most significant update the CDC made: You don’t have to quarantine after you’ve been exposed to the virus. Instead, the new guidelines recommend that you wear a high-quality mask around others for 10 days and get tested on day five. If you’re using a rapid test and you test negative, the safest thing to do is to test yourself at least one more time (ideally two more times) with 48 hours between each test. If you are infected, you may not have enough virus in your system yet to test positive the first time.

If you get symptoms, you need to isolate and get tested. Stay home and masked until you know the results. If you're using a rapid test and you test negative, the safest thing to do is to continue to isolate and test yourself again in 48 hours. If you test negative a second time, you can end isolation but should continue to mask until the full 10 days are up.

I tested positive. What do I do now?

The general rules here aren’t new, but there are some new details.

  • You should isolate for at least 5 days. If you must be around others during this time, wear a high-quality mask (i.e., N95, KN95 or KF94).

  • If you never had symptoms, you can stop isolating after Day 5. If you had mild symptoms, you can stop isolating after Day 5 if you are fever-free for 24 hours without taking any medication and your symptoms are improving.

It’s a really good idea to take a rapid test at this point. Why? Two reasons:

  • Some people are still contagious past Day 5. If you test positive, you’re one of them. If you want to be as safe as you can possibly be in that situation, you should keep isolating, though that’s not required.

  • The guidelines specify that on Days 6-10, you should wear a high-quality mask whenever you’re around other people. But you can take your mask off a little early if you test negative two times, with a 48-hour break between tests. Once that happens, you can be fairly sure you’re not contagious any longer.

Finally, three more important details:

  • During Days 6 - 10, avoid being around anyone who’s at high risk of getting very sick from COVID-19. It’s okay to travel during this time as long as you can wear a good mask the entire time you’re around other people.

  • If you had any difficulty breathing while you were sick, you should isolate for the full 10 days. People whose immune systems don’t work properly should isolate for the full 10 days, as well.

  • If you get symptoms during the 10 days after you’ve come out of isolation, I’ve got bad news: You have to start the whole process over at Day 0.

Do workplaces and schools still have to test everyone once a week?

The CDC no longer recommends screening testing except in certain situations.

If the COVID-19 Community Level is high in your area (you can check the level here), they still recommend that schools screen students, teachers, and staff who are involved in high-risk activities like close-contact sports, band, singing, and theater. People who do those things breathe out a lot of virus.

If your workplace is a location where a lot of people live together, it should consider screening everyone when COVID levels are high, too — especially if those folks are at high risk of getting very sick from COVID.

And whenever screening happens, it should include everyone, no matter what their vaccination status is.

What does this mean for me?

Here’s how one of us has processed the changes, in a real-life example:

A group of friends and I recently decided to have dinner together. We ate in a very large room with open windows and lots of fresh air, and a good time was had by all. But the next morning, the email came — one of the couples just tested positive for COVID-19.

I read this article to help me decide whether we had been exposed — and the answer was “yes.” We checked the new CDC guidelines before making our plan, but we also understood the guidelines to be minimum standards for everyone’s safety.

  • While the new guidelines said we didn’t need to isolate, my husband and I decided we would not be indoors with anyone but each other for at least the next five days.

  • After five days, we would take an at-home test. If we tested negative, we’d take another one 48 hours later. If all was well, we’d get back out in the world but would wear masks when indoors in public for the remainder of the 10 days. Of course, if we got symptoms at any time, we would have tested and taken further precautions.

I’m happy to report there was no COVID-19 in our household — this time!!

CDC guidelines are a great baseline. But if your risk of getting sick is higher than average, or you just want to be as careful as possible, don’t hesitate to do what makes you feel safer. Take into account whether you’re up to date on your vaccines and the number of high-risk people around you. And don’t forget all the information you have at your fingertips to help you know how best to protect yourself, including WhenToTest’s COVID Risk Quiz. Stay safe out there!