CDC faces pressure to change isolation guidelines for sick workers

Barbara Sibley’s four New York restaurants had already weathered the city’s initial wave of Covid-19, the wave of pre-vaccination last winter, and the Delta peak this summer when it finally happened over the weekend. last end: fearing an epidemic and having trouble with staff after one of its employees fell ill with Covid, it has temporarily closed one of its sites.

This was only the beginning of Ms. Sibley’s worries. She also had to weigh how long the employee, who was fully immunized, had to self-isolate before returning to work. And the message from public health experts was not clear.

At the start of the pandemic, the Centers for Disease Control and Prevention recommended that most people who test positive for the coronavirus self-isolate for 14 days. He then reduced his recommended isolation period to 10 days. But these policies were based on data from unvaccinated individuals and were implemented before rapid testing became widespread. A growing number of health professionals and politicians now suggest that those vaccinated can end their isolation after five to seven days, as long as they are not symptomatic and negative.

On Thursday, the CDC reduced, under certain circumstances, the number of days it recommends health workers who test positive for the coronavirus to self-isolate, but it did not address other companies.

“All the experts have called for shorter isolation times, so it is a good decision, but it is short-sighted not to apply this more widely: schools, colleges, sports, Broadway, restaurants, airlines,” said Joseph Allen, associate professor at TH. Chan School of Public Health at Harvard University. “They all face the same problem of having to isolate people for long periods of time without the ability to ‘test to come back’.”

The CDC said Thursday it “continues to assess isolation and quarantine recommendations for the general population” as it learns about the Omicron variant of the coronavirus and “will update the public on the case applicable “.

In New York City, Gov. Kathy Hochul said on Friday that fully vaccinated critical workers could return to work five days after testing positive, as long as they have no symptoms or their symptoms go away and they don’t. fever for 72 hours. These workers will also need to wear a mask, she said.

Omicron has escalated staff shortages across industries, and the spike in cases disrupted travel during the holidays, stranding thousands of customers and underscoring the economic toll of employees having to self-isolate. Already, some economists are warning of the potential impact closures can have on consumer spending.

Delta Air Lines on Tuesday asked the CDC to reduce the isolation time to five days for those fully vaccinated, warning that the current 10-day period could “have a significant impact” on operations. It was followed by JetBlue and Airlines for America, a trade group that represents eight airlines.

But the Association of Flight Attendants rejected the request, telling the CDC on Thursday that “we support your agency’s current recommendation to isolate for 10 days” and that decisions to reduce isolation times “should be made by public health professionals, not airlines. “

Sara Nelson, the union’s international president, said flight attendants shouldn’t have to return to work until they are healthy – and have tested negative. “We do not see the justification for reducing the number of days at this time,” she wrote in a letter to the director of the CDC.

The uncertainty surrounding the isolation guidelines has added to the difficulties many face.

“It’s stressful because you have a responsibility to keep your guests, staff and family safe,” Ms. Sibley said. While some companies are asking employees who test positive to self-isolate for 14 days, they are also keen to do what makes sense for their workers.

“You can do 14 days if you don’t try to make sure 150 people survive and pay rent through your business,” she said.

With the scientific understanding of the coronavirus moving faster than public health guidelines, and with a lot of unknowns about the Omicron variant, some business owners feel pressured to play the epidemiologist.

“If I were an employer, I wouldn’t go outside of the CDC’s recommendations,” said Dr. Megan Ranney, emergency physician and associate dean at Brown University’s School of Public Health. “That’s why we need the CDC to update its recommendations, if it thinks the science is backing it.”

According to Dr Ashish Jha, dean of Brown’s School of Public Health, the requirements for longer isolation periods could also discourage people from getting tested. “There will be a lot of people who, if they have mild symptoms, won’t do a test or show up because it’s really important to be away for 10 days,” he said.

Diana Mora, owner of Friends and Lovers, a bar in Brooklyn with just over a dozen employees, said trying to follow public health guidelines while running her business was a constant source of concern. .

“We’re so small that we don’t really have enough staff to tell everyone to stay home,” she said, although the bar followed the CDC’s 10-day guideline. “If there are more than two people who are exposed and need to self-isolate, we are caught in a swerve. “

Budget management is also a concern. “Lucky for us, we are able to keep paying people, but as this continues it becomes difficult,” Ms. Mora said.

In areas where employees can work remotely, such as technology, companies seem little to feel the need to go faster than the CDC. Even employers who need large numbers of on-site workers, like Target, Kroger and DoorDash, say they continue to follow the agency’s recommendations.

The National Football League now allows vaccinated players who test positive to return the next day provided they test negative twice. It has also eliminated weekly testing for vaccinated players who are asymptomatic, with its chief medical officer saying the pandemic has reached a stage where it is not necessary for vaccinated players to sit down if they are feeling healthy. .

Calls to reduce the isolation period could increase if infections increase as expected during the holidays. Already, Broadway shows have canceled performances until Christmas. CityMD, the private emergency care clinic, has temporarily closed 19 sites in New York and New Jersey due to understaffing. At least a dozen New York restaurants have temporarily closed their doors in response to positive tests.

“I think a lot of companies are looking at a lot of disruption over the next month and trying to put policies in place now because they know their employees are going to be infected in massive numbers,” Dr Jha said.

The United States could learn from foreign policy changes. Britain said on Wednesday it was cutting to seven to ten the days people must isolate after showing symptoms of Covid-19.

After the UK government lifted nearly all of its pandemic restrictions in July, hundreds of thousands of workers were interviewed by the National Health Service’s track and trace app and ordered to self-isolate because of they had been exposed to the coronavirus. Companies have complained of understaffing, and economists have said the “pingemia” may have slowed economic growth in July.

In the United States, new tools to help manage the pandemic are on the way.

The Food and Drug Administration this week authorized two pills to treat Covid, from Pfizer and Merck. These treatments have been shown to prevent serious illness and have the potential to reduce transmission of the virus, although the supply of both pills, especially Pfizer’s, will be limited over the next few months.

President Biden said on Tuesday he plans to invoke the Defense Production Act to purchase and donate 500 million rapid antigen tests, a crucial tool for detecting transmissibility, although those tests will not be available for weeks or more.

If a combination of antiviral pills and rapid tests can get people back to work faster, “that’s a big economic point,” said Dr Eric Topol, professor of molecular medicine at Scripps Research.

Yet some employers are proceeding with caution. Molly Moon Neitzel, who owns an ice cream business in Seattle with just over 100 employees, said she has kept conservative isolation guidelines.

“I’m on the side of protecting people rather than putting them back to work right now,” she said, adding that if it was summer and her business was busier, she might consider a period. shorter isolation. “It’s the slowest time of year for an ice cream company, so it’s in my favor.”

Some public health experts fear that if the CDC shortens its isolation guidelines, employers could pressure workers to return before they are fully recovered.

“What I don’t want to happen is that this is used as an excuse to force people to come back when they are not feeling well,” said Dr Ranney of Brown.

And even with clearer guidelines, putting in place policies can be tricky. While some experts suggest different isolation rules for vaccinated and unvaccinated employees, some companies do not yet have a system to track which of their employees has received a vaccine. Whether the CDC will change its definition of fully immunized to include booster shots adds another layer of complexity.

It’s not just sick employees who may have to stay home: Companies are also wondering if vaccinated workers should self-quarantine after being exposed to someone with Covid-19, which the CDC guidelines do not. ‘do not require.

“It becomes a challenge for employers to choose between providing a safer environment and keeping staff intact, or following CDC guidelines,” said Karen Burke, advisor at the Society for Human Resource Management.

But nearly two years after the start of the pandemic, this is the position employers continue to find themselves in, amid an ever-changing cascade of new data, guidance and considerations.

“At every moment you are making life and death decisions,” Ms. Sibley said. “This is not what we signed up for.”

Rebecca robbins contributed reports.

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