番茄社区

Before the pandemic, people often didn't think twice about going about their daily lives and heading into public spaces with a runny nose, sore throat, or even a bit of a cough.

Now, years into living with COVID-19 and with a herd of other respiratory viruses hitting hard, people may be questioning whether they should still subject themselves to quarantine or isolation if they contract COVID. Most people wouldn't do as much with an unidentified case of the sniffles, but is COVID still a different story?

Public health expert Leana Wen, MD, an emergency physician and professor at George Washington University in Washington, D.C., explained to 番茄社区 that people should follow the CDC's guidelines for isolation when testing positive for COVID. Generally speaking, that means followed by 5 days of mask wearing.

That's because COVID is still being treated differently than other respiratory viruses, Wen said.

Not only is COVID a new illness unlike some of its circulating counterparts -- flu and respiratory syncytial virus (RSV) -- but people have "really feared it" throughout the pandemic, she noted. Many people "continue to feel strongly about wanting to avoid it," for reasons including severe outcomes and the possibility of long COVID.

Furthermore, she added, COVID is much more contagious than flu and RSV.

Perhaps the bigger question around whether COVID continues to be treated differently than other respiratory viruses is "what is the goal ... as a society?" Wen noted.

For now, the goal remains reducing infections, which is reflected in ongoing COVID protocols that are unlike those for other illnesses, she said. However, if the goal is to minimize severe disease from COVID, then isolation would not be the right strategy; instead, vaccination and prompt detection and treatment for those at risk of severe illness would be the way to go.

"I think there is an idea around COVID that may not be there for other illnesses," Wen said. "Out of respect for individuals who have such a strong desire to avoid COVID -- unless we as a society make that pivot -- we need to continue isolation."

Aubree Gordon, PhD, an associate professor of epidemiology at the University of Michigan School of Public Health in Ann Arbor, agreed that, at least for now, isolation is still a hallmark of COVID protocols.

For COVID, "the advice is certainly still to isolate," she said. The U.S. is still seeing some 300 deaths per day from COVID, "which is a really huge number."

"I think that's really where the difference lies," she added.

However, Gordon said that she believes the days of COVID being treated differently than other respiratory viruses are numbered, at least to some extent. "I do think we'll get to the point, eventually, where we won't need to isolate at home when we have COVID."

Public health experts continue to weigh that topic.

"There are discussions happening over cups of coffee in the public health environment, that there's so much Omicron out there and it is spreading even without symptoms," William Schaffner, MD, professor of infectious diseases at Vanderbilt University Medical Center in Nashville, Tennessee, explained to 番茄社区. "So they question the value of quarantine. What's the point, when this virus is infecting people left and right? Should we really take the few people with symptoms and ask them to lock themselves up? That probably doesn't have a noteworthy impact on transmission at all."

"This is very different from the beginning of the outbreak, when no one had any protection at all," Schaffner added. "Then, quarantine had a role. But now people are beginning to wonder, does quarantine have any role in reducing transmission of this virus?"

As challenging as the questions surrounding COVID may be, considerations concerning other respiratory viruses that are also rearing their heads can be even more nuanced.

"In an ideal world, of course you should not be around others while you could be infectious, but if you say, that's the blanket recommendation across the board, you'll have kids that will never go to school," Wen said.

However, there are certain symptoms that are more clear and potentially more problematic than others, she added. (Think nausea and vomiting, enough coughing to cause trouble breathing, and high fever.)

"Otherwise, we should be particularly careful when we're around vulnerable individuals," she noted.

RSV is an especially significant threat to very young children, Gordon said, and flu can be as well.

"For all those respiratory viruses, I'd really encourage people to stay home for a few days," Gordon advised. "We know you're most infectious for the first few days for all of these viruses [and] the amount of virus you shed potentially decreases over time."

She said she believes the amount of virus someone is exposed to and how they are exposed to it contributes to how sick they may ultimately get.

If a person is sick with a respiratory illness other than COVID, she recommended they consider wearing a mask if they need to be out in a public setting.

Another item on Gordon's wish list for combatting a scourge of respiratory viruses is at-home tests for flu and RSV that people could purchase at their local drugstore, just the same as for COVID.

Overall, "trying to cut down on that transmission can lead to a much less sharp peak," Gordon said.

"None of us want our child or us in a hospital bed, but if we need one, we want that bed to be available," she added, "and adequate care to be available."

Kristina Fiore contributed reporting to this article.

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