Confused by COVID guidance? Here’s what Thurston’s Health Officer recommends
COVID-19 guidance has changed as new variants have emerged and understanding has improved. In a letter to the community issued last week, Thurston County Health Officer Dimyana Abdelmalek offered updated recommendations for residents.
While case counts have started to decline, disease activity remains higher than any previous wave because of the more transmissible Omicron variant.
“As Thurston County and Washington state recover from the Omicron surge and as our hospital capacity becomes more manageable, we anticipate additional changes to mitigation measures relaxing,” Abdelmalek’s letter says. “In the meantime, please continue to mask up to reduce disease transmission in Thurston County.
Such changes have already started. In late December, the Centers for Disease Control and Prevention updated its isolation and quarantine guidance for some people.
And on Wednesday, Gov. Jay Inslee announced the state’s outdoor mask mandate will be lifted starting Feb. 18. Meanwhile, state officials are actively considering when to lift indoor mask mandates.
Isolation guidance
In December, the CDC shortened their recommended isolation period from 10 to five days, regardless of vaccination status, for members of the public who meet certain criteria.
They must not be immunosuppressed, have not had severe disease, have shown great symptomatic improvement and have experienced subsiding fever for at least 24 hours without the use of fever-reducing medication.
“Individuals who have had severe disease and people who are moderate to severe immunocompromised have a greater risk of being infectious beyond 10 days and are required to isolate for at least 20 days,” Abdelmalek’s letter says.
A person who fits those criteria should isolate at home for five days if they experience symptoms or if they test positive for COVID-19. After that period ends, they should strictly mask around others.
“Because a minority of people may still be infectious after day five even though they had symptomatic improvement, it is essential to continue to wear a well-fitted mask for an additional five days when around other people to prevent further spread,” the letter says.
The CDC changed this guidance, citing data showing most people with mild disease are not infectious after five days.
However, some experts have since pushed back against this change because of its complexity and because the CDC did not recommend testing at the end of the isolation period.
Quarantine guidance
In December, the CDC also shortened the quarantine period to just five days for people who are unvaccinated or not up to date on their vaccinations.
Such people should quarantine at home if they have been exposed to COVID-19 and may become infectious. Quarantine can turn into isolation if the person develops symptoms or tests positive for the virus.
In her letter, Abdelmalek attributed this change to studies showing the incubation period, or the time it takes for an exposed person to become infectious, with the Omicron variant may be as short as 2-4 days.
Similarly to isolation, the five-day quarantine period should be followed by five days of strict masking because there’s a chance the incubation period may be longer for some people.
Quarantine is not required for people who are up to date on their vaccinations, including booster doses, and remain asymptomatic, according to Abdelmalek. However, they should still wear a well-fitted mask around others for five days.
“Testing for COVID-19 whether with antigen or PCR testing is recommended on or after day five from exposure,” the letter says. “Everyone with symptoms of COVID-19 should stay home and get tested for COVID-19.”
While this guidance applies to most of the public, guidance can vary depending on a person’s setting and other risk factors. For example, a 10-day isolation and quarantine period is still recommended for people who live or work in congregate settings.
Sector specific guidance for healthcare workers, schools, daycares and other settings can be found on the Thurston County Public Health and Social Services website.
Masking guidance
Washington state’s current mask mandate calls for individuals 5 and older to wear masks at indoor public settings and large outdoor events with 500 or more people, such as sporting events, fairs and concerts, regardless of vaccination status.
Though some other states have already lifted their mask mandates, Washington state mandates are still in effect. Yet, change appears to be on the horizon.
The state plans to lift its outdoor mask mandate on Feb. 18 but plans for lifting the indoor mask mandate are still being discussed, the Olympian previously reported.
The CDC recommends wearing the most protective mask that also fits well and can be worn consistently.
Loosely woven cloth masks offer less protection than layered, finely woven masks, according to the CDC. Well-fitting disposable surgical masks provide better protection than cloth masks.
For even better protection, the CDC recommends KN95 and N95 masks.
