Thread by @michaelmina_lab

CDC’s new guidance to drop isolation of positives to 5 days without a negative test is reckless

Some ppl stay infectious 3 days,Some 12

I absolutely don’t want to sit next to someone who turned Pos 5 days ago and hasnt tested Neg

Test Neg to leave isolation early is just smart

I am 100% for getting people to drop isolation early.

Heck, I formally recommended it to CDC in May 2020 and Published the recommendation in J of Clin Infectious Diseases in April 2020.

But it was always with a negative test.

What the heck are we doing here?

2/

This is the part that hurts the most. The reason they are doing this:

"The change is motivated by science demonstrating... SARS-CoV-2 transmission occurs... generally in the 1-2 days prior to onset of symptoms and the 2-3 days after"

That was BEFORE OMICRON.

3/

Today, it is OBVIOUS the situation has changed.

Ppl are testing earlier b/c symptom onset is early - no longer two days after people are infectious.

So now people are staying positive even longer after testing positive, because they find out earlier they are positive.

4/

And by positive I don't mean PCR positive. I mean rapid antigen test positive for days longer. Often more than 10 days.

So to say, leave isolation regardless of if you have a positive antigen test is remarkable.

5/

Someone KNOWN to be Pos for 5 days is, in my view, still one of the highest risk individuals in society for onward spread. We do SO much just to find ppl who are positive in first place. When we do identify them, we should do everything possible to keep them from spreading

6/

At least, If leaving isolation at 5 days w/out Neg test - WEAR N95 or similar performing mask

Govn't should provide them to everyone who enters isolation (along with a rapid test!)

If entering isolation - click a button & get N95 & rapid test SIMPLE

@linseymarr @kprather88
7/

This is but one of a nearly limitless set of examples of how reckless this decision is.

https://twitter.com/ErinBromage/status/1475598716681793541?s=20

8/

The thing that really hurts me the most - is that not requiring a positive rapid test to leave isolation is probably linked to a perception of not having enough rapid tests in the US...

Which is obviously a massive problem in its own right but one that is EASILY changed.

9/

We CAN get the tests

We CAN. Many countries are getting these and more.

This doesn't have to be a hard decision:

In Isolation? Yes --> Click a button --> Get 2 rapid tests delivered to you for free for use on day 5 and if still neg on day 6, exit.

https://twitter.com/michaelmina_lab/status/1475607146461114383?s=20

A good example - among so so many of why rote removal from isolate without a negative test is just not a smart public health move.

We put all this effort into discovering infectious people... why not at LEAST ensure those we do discover don't spread on.

https://twitter.com/michaelmina_lab/status/1475732285307695108?s=20

/12

https://twitter.com/michaelmina_lab/status/1475692379441086466