I'm an Infectious Disease Specialist and Wish You Knew This About COVID

The Centers for Disease Control and Prevention recently updated their COVID-19 guidelines and eased many of the restrictions, including the end of quarantine after someone is exposed to an individual with the virus, but it's still recommended they wear a well-fitting mask for 10 days following their exposure. Eat This, Not That! Health spoke with medical experts who share their thoughts on the new guidelines. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Sunjya Schweig, MD Founder and Director, California Center for Functional Medicine Founder and Executive Director, The Functional Medicine Research and Technology Center says, "On August 11th, the CDC eased many of the COVID-19 guidelines they had in place. The changes include no longer screening testing of asymptomatic people without known exposures and contact tracing only in health care and high risk settings. It additionally states that those who have been exposed but are not feeling sick themselves do not need to quarantine. Instead, they should test on day 5 of exposure. The easing of restrictions comes at the same time as schools begin to open across the country, and will help keep students in school which is likely a key objective. Unfortunately, the CDC missed an opportunity to help protect seniors and highly vulnerable Americans."

Ramzi Asfour, M.D., Board Certified in Infectious Diseases and Internal Medicine Functional Medicine Certified Practitioner with California Center for Functional Medicine tells us, "Estimates of population level immunity, that is people who have some level of immunity based on prior COVID-19 infection, vaccination vary somewhat, but at least as of mid summer, the Institute for Health Metrics and Evaluation at the University of Washington of estimates that 82% of people have had COVID-19 infection at least once as of July 11, 2022 and 69% are fully vaccinated (but not necessarily boosted). COVID-19 Results Briefing United States of America July 18, 2022 Current situation .This implies that a large majority of the US population has some level of immunity to COVID-19. The CDC's press release states: "With so many tools available to us for reducing COVID-19 severity, there is significantly less risk of severe illness, hospitalization and death compared to earlier in the pandemic." CDC streamlines COVID-19 guidance to help the public better protect themselves and understand their risk. In other words, because we have treatments such as Paxlovid, Remdesivir and others, we have vaccines and booster doses, and we have therapies to mitigate the severity of COVID-19 for those who have been hospitalized such as dexamethasone, there is a significantly decreased risk of death from COVID-19 infection."

Dr. Asfour shares, "Having worked in public health myself (at the World Health Organization), we also need to recognize that the public's fatigue with stricter guidance is real, and public health authorities are trying to adopt an approach that minimizes restrictions while also protecting the health of the general public. There may as yet be another wave of a more serious variant where stricter public health guidance will be necessary; the public needs to see that current guidance makes sense, is logical and is not unnecessarily strict." 

According to Dr. Asfour, "The pandemic has not ended, and we must remain vigilant and responsible. There are always going to be new variants and we need to watch out for those as they may have potential to cause more severe disease especially in more vulnerable populations."

Dr. Schweig adds, "The pandemic is not over, and in fact the CDC community transmission data shows high transmission across 94% of the country. According to Eric Topol, founder and director of the Scripps Research Translational Institute, focusing on the "community level" metric "is a deceptive way for CDC to present a rose-colored-glasses semblance of lower risk. That, too, is unnecessarily promoting the spread of Covid to others, especially the vulnerable, that it purports to want to protect. No less, this is further exacerbating the toll of long Covid, a condition that millions of Americans are suffering from, due to the virus's massive, unbridled spread throughout the pandemic." (The default setting on the link below is a problematic metric called "community level" and one needs to choose "community transmission" from the dropdown to see this data). As Topol points out, "we are in the midst of the BA.5 wave, the variant with the most immune escape and transmissibility we have yet seen, now with well over 100,000 new confirmed cases per day (the actual number is unknown, but far higher), over 40,000 people hospitalized, and more than 500 deaths per day." 

Dr. Asfour states, "We, at CCFM, remain concerned about the ongoing risk of long Covid which can be incredibly debilitating for some. Prior infection and vaccination provide only limited protection against Long Covid. Long COVID risk falls only slightly after vaccination, huge study shows. While this is a major concern of ours, the new CDC guidance does require masking when in public for 10 days after a new infection."

Dr. Schweig says, "We are in the midst of the BA5 variant wave and cases are at all time highs. The CDC's new guidelines are problematic for several reasons. For one, ongoing vigilance with rapid antigen testing is important to prevent spread. As Eric Topol wrote in a recent article, 'Back in late December 2021, with the onslaught of the Omicron BA 1 wave, the CDC came up with a five-day isolation policy without any evidence that it would prevent the spread of infections to others, and without advocating the need for rapid antigen testing. Indeed, multiple studies have shown that most people are still infectious after five days, with even rigorous assessment that shows the virus can be cultured from some people with Omicron infections at two weeks.'

In addition, the CDC's guidelines do not take into account the most vulnerable populations such as the elderly and the immunocompromised.  Finally, with the CDC's shift in guidelines is that it does not consider ongoing risk for long Covid. COVID cases and transmission are at an all-time high in the US and abroad as the current BA.5 variant is the most contagious variant we have experienced yet in the pandemic. I will continue to recommend people to stay up to date on vaccinations and booster shots and to mask when indoors, especially when at high crowd density events such as concerts, sporting events, or similar. We are also optimistic and hopeful that we can work to build mucosal immunity, which is why Topol and Professor Iwasaki have called for Operation Nasal Vaccine. As Topol says, "We also need to press on with a universal, variant-proof coronavirus vaccine which would get ahead of potential pathogenic mutations of the virus rather than chasing specific variants, the untenable strategy as the virus continues to adapt faster than our response." And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.