The Omicron Variant and CDC Guidelines Update from Cornerstone
As the Omicron variant of COVID-19 continues to rear its head this January, we know that our community, industry leaders like you, are working hard to make the right decisions for your programming.
After two years of continuous decision making for each and every program, we also hear from community members that finding the right “solution” for your organization can be complex. The responsibility to protect your participants, staff, and the communities you visit can be trying, especially without clear context for transmissibility and the gravity of each variant. With that in mind, we sat down this week with Cornerstone Co-Founder and Medical Director, Joshua Dubansky, MD, FACEP, to discuss the reality of the Omicron variant, the updated definition of “fully vaccinated,” and how to handle some of the most common situations our members and community face.
The Latest
On Monday, December 27, 2021, the CDC updated their quarantine and isolation guidelines for people who have tested positive for COVID-19. The update states that asymptomatic people can now end their isolation after an initial five days “...if they can continue to mask for 5 more days to minimize the risk of infecting others". This update is based on convincing data showing that most COVID-19 transmission occurs beginning one or two days before symptoms begin up until two or three days after symptoms begin. However, most transmission does not mean all transmission. It is our hope and our advice that people always wear well fitted masks in public.
Of note, the CDC did not recommend a negative antigen test or PCR test before ending isolation. This omission generated pushback from many health professionals. Although scarcity of rapid tests may explain their omission from the CDC’s updated recommendations, a negative rapid test makes ending isolation safer, and we recommend them. Importantly, rapid tests are often much easier to come by outside of the US.
On Tuesday, January 4, 2022, the CDC offered guidelines as to how those with access to rapid tests can use them to end isolation. Per these guidelines, if a rapid test on day 5 of isolation is positive, even asymptomatic people should isolate until 10 days after onset of symptoms. If the test is negative, isolation can end, but masks should be worn around other people until day 10.
This update has created confusion by appearing to contradict the CDC’s previous recommendation that asymptomatic people can end isolation without a test. Although the CDC may again be wrestling with the scarcity of tests, it is regretful that this advice has created some confusion and mistrust. Although it must be acknowledged that rapid tests remain expensive and hard to find, we strongly recommend a negative rapid test before ending isolation.
In summary, quarantine and isolation guidelines have been updated as follows:
The Outlook
Considering the evolution of the COVID-19 pandemic since 2020, it is difficult to predict the future. However, there are some early lessons that can help us understand what to expect.
The Omicron variant is more transmissible to others, but symptoms for those that are fully vaccinated and/or boosted are typically less severe than previous variants. Preliminary studies show that the mutations of the spike protein have caused this variant to have less effect in the lower respiratory tract (lungs) and more effect in the upper respiratory tract (nose/sinuses/bronchi). This partially explains why the variant is spread more easily via upper respiratory droplets.
Given Omicron’s rapid transmission rate and the high numbers of infections, this variant may accelerate the transition from pandemic to endemic (present at a constant lower level in a population).
Mutations of the virus will continue to occur, particularly as the majority of the world’s population remains unvaccinated and thus allowing mutations to evolve within unprotected hosts. The severity of new mutations is unpredictable.
What to do now
While each organization has unique contingency plans to align with their own programs, our community will continue to transparently share updates, innovations, and experience as we navigate the evolving environment together. The best way to access these ongoing updates and conversations is to join our bi-weekly community meetings.
To implement the information above into your crisis response plan and training:
Review the CDC guidelines against your current definition of “full vaccination” (and requirements of participants and staff)
Update your plans for potential quarantine and/or isolation if exposure is to occur
Consider plans for a potential situation where an asymptomatic participant or staff member test positive for COVID-19 prior to returning to their home country as per entry requirements (supervision, accommodation, food/water, and communication needs)
Audit your communications and participant-facing policies to reflect these new definitions and plans
Remember that you are not alone and you are not without resources - the Cornerstone community is full of like-minded business leaders who are also using their flexibility, resilience, and grit to ensure their programs continue to make an impact. If you need additional guidance, please reach out so that we can support you.
BONUS: Look for additional, digestible information about the spread of COVID-19 and how the Omicron variant works? We recommend this In the Bubble podcast episode.
