Increasing Long COVID Cases, and Economic Implications. Serious Flaws in the CDC's COVID Isolation Guidance
A staggering 35,230,625 individuals reported Long COVID symptoms persisting for more than 3 months in January 2024, impacting 25 to 54 year olds the most.
Amid the ongoing battle against the COVID-19 pandemic, recent guidance issued by the Centers for Disease Control and Prevention (CDC) has sparked profound concern among health experts and the public alike. The decision to reduce the isolation period for COVID-19 infection from 5 days to just 1 day if the individual is fever-free for 24 hours with improving symptoms lacks a scientific basis and fails to prioritize public health. It poses a grave risks to individuals, communities, and society as a whole.
Despite defending the update, The CDC, in explaining the rationale behind the updated guidance, underscores that the new recommendations "should not replace specific guidance for viruses that transmit through the air and require special control measures."
While the focus is on measles, the question arises about how this justification applies to COVID-19, a highly contagious airborne virus demanding comprehensive mitigation approaches. Similar to measles, COVID-19 can infect a wide range of immune system cells and may endure for extended periods.
Does this imply that the CDC is saying COVID-19 is not recognized as an airborne virus causing lasting harm, despite the overwhelming evidence supporting its airborne transmission and long-term effects?
In the fourth point, the CDC says, "Several factors were considered in updating this recommendation: "The severity of certain symptoms for COVID-19 and flu, most prominently fever, correlates to some extent with duration of viral shedding—an indicator of contagiousness. In other words, as symptoms improve, especially fever, infectiousness tends to go down in most people."
In the link to their source, before leaving the CDC site, it says,
"Links with this icon indicate that you are leaving the CDC website."
"The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website."
"Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website."
They clearly want to distance themselves from their source, but why? The linked article, justifying the CDC using a fever as a marker to end the isolation guidance uses data from the "pre-omicron" era, and includes just 85 nonhospitalized, symptomatic adults, who were enrolled from September 2020 to November 2021.
The CDC's justification for using fever as a determinant relies on a small study from the pre-Omicron era, raising questions about its relevance.
Why didn't they reference a larger, more recent study like that used in TACT's analysis below, which used both Flu Watch and Virus Watch? These comprehensive cohort studies spanned influenza seasons from 2006 to 2011 and monitored over 58,000 individuals from mid-2020 to 2022, providing extensive data on viral transmission and symptoms into the Omicron era.
Contrary to the CDC's assumptions, the Virus Watch study revealed that only 14% of Omicron-infected individuals experienced fevers. This stark contrast underscores the inadequacy of fever as an indicator for ending isolation.
Furthermore, the surge in Long COVID cases highlights the broader implications of the CCDC's flawed guidance.
In January 2024, over 35 million individuals reported Long COVID symptoms persisting for more than three months, signaling a significant public health concern.
In light of these findings, the CDC's decision-making process and the efficacy of its isolation guidance warrant closer scrutiny.
Addressing these flaws is crucial to effectively managing COVID-19 transmission and mitigating the long-term impact on public health and the economy.
Only 14% infected with Omicron BA.1 or BA.2 had a fever.
Rethinking the Reliability of Fever in Assessing Infectiousness
Relying on fever as an indicator of infectiousness contradicts scientific evidence. A study published by Nature, Scientific Report in 2023, showed that cough was the most common symptom amongst influenza, rhinovirus, RSV, and SARS-CoV-2 Omicron BA5 illnesses with 91, 87, 83, 81 percent of illnesses reporting cough respectively. On average, only 17% of all COVID-19 infections reported a fever.
The percentage with a fever reduced with the Omicron BA.1 and BA.2 to just 14% of people. Only around 40% of people with RSV had a fever. Under 60% of people with rhinovirus or seasonal coronaviruses had fevers. This discrepancy challenges the validity of using fever as a determinant of infectiousness.
The notion that individuals should cease isolation based on "improved symptoms" and being fever-free for 24 hours lacks scientific support. This criterion significantly falls below the standard for ending isolation following any respiratory infection, but especially COVID-19.
Typical Infectious Period of COVID-19 is 7 to 8 Days
A recent study conducted by Northwestern Medicine shed light on the dynamics of viral transmission during the early stages of infection. COVID patients were found to exhale high numbers of the virus during the first eight days after symptoms start, with levels reaching as high as 1,000 copies per minute. This underscores the urgent need for effective isolation protocols to curb transmission rates, particularly in light of the significant viral load emitted by infected individuals.
Similarly, research from the Imperial College London, published in The Lancet Respiratory Medicine journal, contradicted the CDC's new guidance. Their real-world study revealed that the majority of infectious cases remain so for at least five days after symptom onset. These findings, along with numerous other studies, consistently indicate that individuals typically remain infectious for a minimum of 7 to 8 days, with some remaining infectious for up to 10 to 20 days.Only 14% infected with Omicron BA.1 or BA.2 had a fever.
A Scientific Approach to Ending COVID-19 Isolation
A significantly more effective approach, rooted in scientific evidence, is outlined in the above study by the Imperial College of London. It suggests a protocol of isolating for 5 days followed by testing on day 6 to assess continued infectiousness. Repeat testing on day 7 helps confirm the results. If still negative on the 7th day, it's likely that the individual is no longer infectious and can safely end isolation. However, if the test is positive, continued isolation is necessary.
Increased Hospitalizations in Adults Linked to COVID Transmission from Children
The updated CDC guidance ignores that the transmission from children to adults can send adults to the hospital. The New England Journal of Medicine published a study on July 21, 2021, in which over a dozen Ph.D.'s, MDs, and other officials from the CDC in Atlanta, the Georgia Department of Public Health investigated an outbreak. They wrote, " This retrospective study showed that the efficient transmission of SARS-CoV-2 from school-age children and adolescents to household members led to the hospitalization of adults with secondary cases of COVID-19."
CDC Guidance Ignores Long COVID
The long-term health effects of COVID-19, including Long COVID and organ damage are being overlooked. Studies have shown that COVID-19 can persist for weeks to months in children, leading to prolonged symptoms and potential complications, even in those with no or mild symptoms. For some families, the cost of an asymptomatic or mild COVID-19 infection can last for months or years.
"Our analysis suggests that in children, independent from disease severity, SARS-CoV-2 can spread systemically and persist for weeks to months. Viral RNA has been documented in children who have died from critical acute disease, but also in pediatric patients diagnosed with multisystem inflammatory syndrome weeks to months after previous asymptomatic or mild infection with SARS-CoV-2." (published in the Lancet, June 26, 2023)
"Today, Long COVID in the pediatric population is a significant and real problem. Without a doubt, all children with suspected or documented COVID-19 infection and their parents, even in the absence of symptoms at the time of diagnosis, should be informed about the possible persistence of symptoms for more than 4 weeks and their possible reappearance after the acute phase. It should be remembered that girls and adolescents with comorbidities, including psychiatric conditions, are associated with a higher risk of prolonged COVID-19."(published January 6, 2023)
Rising Long COVID Cases and Economic Implications
According to recent data reported by the CDC, the prevalence of Long COVID symptoms in the United States has seen an increase from 14.3% in October 2023 to 17.6% in January 2024. Notably, working-age adults, particularly those between 30 to 49 years old, reported the highest percentage, with over 20% experiencing Long COVID symptoms. The latest survey indicates that a staggering 35,230,625 individuals reported Long COVID symptoms persisting for more than 3 months.
Among them, 940,081 individuals aged 25 to 39 and 910,655 individuals aged 40 to 54 reported that Long COVID significantly impacted their ability to perform daily functions. Additionally, 2,616,472 individuals aged 25 to 39 and 2,423,290 individuals aged 40 to 54 reported a moderate impact on their daily functioning due to Long COVID symptoms.
"There is money in prevention."
The CDC's guidance fails to adequately consider these factors, seemingly prioritizing economic interests over public health. However, even from an economic perspective, this guidance is deeply flawed. A recent article published in the Harvard Business Manager underscores the economic risks associated with Long COVID. The effects of Long COVID, which include cognitive impairment and increased absenteeism, have the potential to have a more lasting impact on the economy than the lockdowns did. A virus that impairs cognitive processes and leads to persistent absenteeism and occupational disability poses a serious threat to businesses and the economy as a whole. “Companies who invest a medium amount in protective solutions today can save large sums in the long term.”
There is a growing call for the reevaluation of the CDC's guidance and the adoption of evidence-based recommendations that prioritize the long-term health and safety of individuals. Public health that follows the science should always be the top priority in managing infectious diseases, and it is crucial that guidelines reflect this principle.
We need health authorities to uphold their responsibility to protect the health and well-being of all individuals and communities. We need schools, hospitals, medical professionals, and the general public to follow science-based health protocols to mitigate the spread of COVID-19.
Make sure to explore this comprehensive resource detailing the impact of COVID-19 on children's short and long-term health and the extent of transmission in schools. It's backed by numerous credible sources and provides valuable insights into this important topic.
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