Q: Why are some states changing their COVID-19 policies?
A: Now four years since the start of the pandemic, more than 96.7% of all Americans have antibodies from COVID infection, vaccination or a combination of both (CDC, February 2024). In light of this, authorities are determining if and how public heath guidance should change. In some states like Oregon and California, public health officials have loosened restrictions and no longer recommend isolation for people with asymptomatic COVID-19.
Q: Are people with asymptomatic COVID-19 still contagious?
A: Yes, people with no or few symptoms may still transmit infections, particularly early in the disease; thus all people with COVID-19 should take steps to minimize transmission, regardless of symptoms. People with symptomatic COVID-19 appear more likely to transmit virus and infect others (Buitrago-Garcia, May 2022).
Transmission dynamics have changed over the last few years, affected by factors such as vaccinations and immunity (Mongin, September 2023). While early studies showed that asymptomatic infection played an important role in the spread of COVID-19, more recent work shows symptomatic COVID-19 infections are responsible for higher proportions of viral transmission (Buitrago-Garcia, May 2022).
Q: Do these policy changes apply to people who have symptoms from COVID-19?
A: Both Oregon and California continue to recommend a period of isolation for people who test positive for COVID-19 and have symptoms. CDC recommends both symptomatic and asymptomatic people isolate after a positive test but is considering a change in isolation guidelines as of February 2024.
Q: Do the same rules apply to healthcare workers?
A: In general, no, the same rules do not apply to healthcare workers. In California, updated isolation policies do not apply to healthcare personnel. In Oregon, asymptomatic and symptomatic healthcare workers with a positive COVID-19 test need to follow specific return-to-work criteria. Regardless of state policy, masking and other infection prevention measures protect both patients and staff in a healthcare setting. These measures prevent the spread of COVID-19 and other respiratory infections, which is particularly important with immunocompromised populations.