Last week the Centers for Disease Control and Prevention relaxed recommendations which neither control or prevent a rapidly evolving and disabling disease, COVID-19. However, we must maintain effective efforts to control spread of the virus.
Last week the Centers for Disease Control and Prevention (CDC) relaxed recommendations which I feel neither control or prevent a rapidly evolving and disabling disease, COVID-19. Many of the relaxations appeared to be timed with the opening of schools, ignoring the high rate of COVID-19 related hospitalizations, national deaths hovering just under 500 per day, and the urgent need for a reformulated vaccine, whose delivery is expected in the fall of this year.
The relaxed guidelines no longer recommend those individuals exposed to COVID-19 participate in test-to-stay programs in schools. They no longer restrict the mixing of children in different classrooms, and they eliminated social distancing recommendations. In addition, there is no need to quarantine after exposure to the virus, and there are no longer recommendations for routine screening of individuals without symptoms.
Previously, the CDC has come under fire for recommending that during the BA.4/5 surge an individual only needs to isolate for 5 days and if asymptomatic for 1 day, can intermingle with the public as long as the individual wears a mask. However, several studies still support 10 days of isolation after infection.
The irony is the latest round of CDC relaxations comes at the same time as the Food and Drug Administration (FDA) released guidance that an individual should have 3 negative rapid home tests over 5 days before one can be assured that you are not spreading the virus. A study from Yale University found that routine testing of participants immediately before an event decreased spread by more than 40%, and research from Harvard and the Boston Public Health Commission has reported that schools that abandoned masking requirements had an increase in COVID-19. This increase accounted for 30% of the COVID-19 cases in the school districts.
All these changes are all happening in the backdrop of a flood of studies detailing the dangers of long COVID-19. The Netherlands recently released a controlled study which found 1 in 8 patients developed long COVID-19. The Brookings Institute estimates that 2.4% of the United States’ workforce is not working due to long COVID-19. Similar data has been produced in the United Kingdom where according to the United Kingdom’s “Office for National Statistics cited by Saunders, 1.9% of the adult UK population—1.2 million people—report that their activity is limited ‘to an extent’ or ‘a lot’ by long COVID-19,” and that long COVID-19 is a main driver in the UK’s work forces shrinking by 440,000 workers.
Long COVID-19 also does not spare children, and 80% of children in the United States have had SARS-CoV-2. The CDC recently released a study finding that children can develop long COVID-19, and those afflicted have higher rates of serious illness, including myocarditis and cardiomyopathy (1.99 times more likely), thromboembolism (1.87 to 2.01 times more likely), Type 1 Diabetes (1.23 times more likely) and acute and unspecified kidney failure (1.32 times more likely).
The Idea of letting the virus rip through the community and depend upon vaccination and Paxlovid may not be prudent advice. Current vaccines are not preventing infections nor do they reliably prevent long COVID-19, and not everyone is able to take Paxlovid because it has multiple drug interactions with common medications, including statins, ace inhibitors, beta blockers, warfarin, Plavix, and digitoxin. Unfortunately, those individuals at higher risk for severe COVID-19 are often on 1 or more of these medications.
Relaxation of guidelines may seem prudent in the short term, but it may well have devastating long-term repercussions. It is not possible to control spread of SARS-CoV-2 when individuals are not quarantining nor testing for asymptomatic carriers, and the isolation period for those infected may well be too short. New reports indicate that a pan-coronavirus vaccine is possible. Until one is available, it is best to maintain preventative strategies by using N95 masks in indoor public settings, increasing indoor ventilation, and maximizing the use of testing.