Have COVID-19? Here’s How Long You Need to Isolate

Vaccines, treatments remain highly important for older adults

Rachel Nania,

AARP

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En español

Published February 16, 2024

/ Updated July 18, 2024

a clock face in the shape of a covid nineteen germ with the clack hands spinning around

Paul Spella (Getty Images, 2)

This summer, an increasing number of people are finding that their sniffles, sore throat and cough aren’t allergies but actually COVID-19.

Cases of COVID are increasing in many areas of the U.S., the latest data from the Centers for Disease Control and Prevention shows, as are emergency room visits and hospitalizations from the virus, particularly among people age 65-plus. Even deaths, which remain low compared to previous pandemic peaks, are once again creeping up.

Wondering what steps you need to take if you test positive for COVID-19?

The CDC recently updated its guidance to say that people with COVID-19 can return to work, school and other activities if their symptoms are mild and improving and they’ve been fever-free for at least 24 hours without the use of fever-reducing medicine.

Once normal activities resume, additional prevention steps are recommended for at least five days to help curb the spread of the disease.

All about coronavirus

These steps — wearing a mask, improving air quality in your home, handwashing and keeping a distance from others — are especially important for older adults and people who spend time around older adults, the CDC says. Seeking treatment for COVID-19 and staying up-to-date on vaccines is also key for older adults and others who are at higher risk for a severe case of COVID-19.

Previous guidelines called for people with COVID-19 to isolate for at least five days from the start of symptoms or a positive test, and to wear a mask though day 10 to avoid spreading the illness to others.

The CDC says the updated guidance “brings a unified approach to addressing risks from a range of common respiratory viral illnesses, such as COVID-19, flu and RSV, which can cause significant health impacts and strain on hospitals and health care workers.” This approach makes recommendations easier to follow, the public health agency says, and it makes it more likely that people will adopt them.

The change also “reflects how the circumstances around COVID-19 in particular have changed,” the CDC said in a statement. “While it remains a threat, today it is far less likely to cause severe illness because of widespread immunity and improved tools to prevent and treat the disease.” At this point, the majority of people in the population have built up some sort of immunity to COVID-19, either through vaccination, infection or both, health researchers say.

The updated guidelines are just for community settings; the CDC says there are no changes to respiratory virus guidance for health care settings.

Don’t ignore treatment, vaccines

Jodie Guest, a professor and senior vice chair in the department of epidemiology at Emory University’s Rollins School of Public Health in Atlanta, says it’s important to not dismiss the virus and to remember that “COVID is still a very significant burden of long-term illness and death.”

More than 350 Americans died from COVID-19 the week of June 22, CDC data shows. And the death rate for older Americans continues to tower over younger populations.

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“We still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses — this includes vaccination, treatment and staying home when we get sick,” CDC Director Mandy Cohen, M.D., said in a statement.

Paul Offit, M.D., an infectious disease physician at Children’s Hospital of Philadelphia and the author of the book Tell Me When It’s Over: An Insider’s Guide to Deciphering COVID Myths and Navigating Our Post-Pandemic World, tells AARP that when it comes to COVID-19, “at least half of the hospitalizations and deaths in people who are at high risk are in people who never [got treated].”

A study published in January found that only 12.2 percent of 309,755 patients eligible for Paxlovid received a prescription. Another study, yet to be peer reviewed, found that only 9.7 percent of more than 1 million high-risk patients received the treatment.

Paxlovid and other antiviral medications, such as Lagevrio and Veklury, are recommended for older adults — who make up the majority of COVID-19 hospitalizations and deaths — and people with underlying health conditions, like heart disease or lung disease.

These medications “work extremely well at mitigating symptoms and shortening the amount of time that people are sick and how sick they feel while they have it,” Guest says.

The key is starting these antiviral medications right away — within the first five days of symptom onset, says William Schaffner, M.D., a professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.

“We tend to say, ‘Oh, I’ll see if it gets better tomorrow. I don’t want to bother the doctor with this,’ ” Schaffner says. “Do this as quickly as possible, because if you have either flu or COVID, instituting the treatments early gives you the best benefit. The longer you wait, the less effective the treatments are.”

Another tool available to older adults: a second dose of the 2023–2024 COVID-19 vaccine. Health officials said in February that adults 65 and older should get another shot, as long as it’s been four months since their last, “to provide added protection that may have decreased over time for those at highest risk.”

Three versions of this vaccine are available in doctors’ offices and pharmacies: an mRNA vaccine from Moderna, an mRNA vaccine from Pfizer-BioNTech and a protein-based vaccine from Novavax. A new vaccine for the 2024–2025 season is expected in the fall.

Another important point, Offit says, is to remember that it’s not just COVID-19 that can cause people to get seriously ill. Flu and RSV send hundreds of thousands of people to the hospital each year too. Like for COVID, vaccines also help prevent severe illness from these infections.

Offit says the key message is to stay home if you’re sick. “Or if you can’t stay home because your work doesn’t allow you to stay home, then wear a mask,” he says.

“The bottom line is that when people follow these actionable recommendations to avoid getting sick, and to protect themselves and others if they do get sick, it will help limit the spread of respiratory viruses, and that will mean fewer people who experience severe illness,” National Center for Immunization and Respiratory Diseases Director Demetre Daskalakis, M.D., said in a statement. “That includes taking enhanced precautions that can help protect people who are at higher risk for getting seriously ill.”

Editor’s note: This story, first published Feb. 16, 2024, has been updated to reflect a change in guidelines.

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