As more people become infected again with COVID-19, there continues to be some confusion regarding prevention and how the CDC guidelines should be used to protect yourself and others. We have received numerous inquiries regarding these guidelines and the best practices to stay healthy, maintain spread, and protect public health. Amid rising COVID-19 cases and hospitalizations, I want to update you on where we are on COVID-19, provide you with helpful information on COVID-19 preventive measures and mitigation, and address concerns regarding misinformation on CDC guidelines. 

Where We Are on COVID-19 

• As of September 28, there are 2,745 new COVID-19 cases in Massachusetts, likely an undercount given most testing is done privately and a likely reduction in testing and reporting practices.
• There have been 28 confirmed COVID-19 deaths this week and 381 patients hospitalized due to COVID-19 complications. 
• The Commonwealth’s current COVID-19 test positivity rate is 10.06%, slightly lower than the national test positivity rate of 11.6%.
• In the last 7 days, 80,427 COVID-19 vaccine doses have been administered and reported across Massachusetts.

CDC Guidelines

1. The CDC has been instrumental in guiding public health measures and has been a crucial source of information throughout the pandemic. Guidelines have shifted multiple times throughout the pandemic, making people unclear or confused about how they should handle testing positive for COVID-19 in a way that prioritizes the safety and health of those around them. Since the onset of the pandemic, the CDC has loosened its recommended precautions for preventing the spread of COVID-19. Current recommendations reflect an approach aimed to mitigate the spread, not to prevent the spread. There is a debate within the public health community about whether these measures are centered around public health or just a means to get workers and kids back to school and work. The guidelines raise concerns among health experts trying to understand the timing for release from isolation, who question if the significant reduction in the CDC’s recommended isolation period - from 10 days to 5 days - is sufficient to ensure the broad safety of infected individuals and the community. A study led by researchers at Boston University and Boston Medical Center investigated this concern, and results showed that the majority of those in the study who first tested positive were no longer positive after five days in isolation; however, 17% of individuals in the cohort remained positive after isolation.  
2. You can find these guidelines below: 

1. 1. When to Isolate: 

• Regardless of your vaccination status, you should isolate yourself from others if you believe you may have COVID-19 but have not yet tested or if you received a positive COVID-19 test.
• If you test positive and have symptoms, Day 0 of isolation is the day of initial symptom onset, regardless of when you tested positive, and Day 1 is the first day after symptom onset.
• You should isolate for a minimum of 5 days after you test positive. As long as you are testing positive on the Antigen (most commonly known as the rapid tests), you are contagious and can spread COVID-19 to anyone around you during this period. 

1. Ending Isolation:  SEE Important ***

• If symptoms improve, you may end isolation after day 5 if you are fever-free for 24 hours without using fever-reducing medication. 
• If your symptoms are not improving, you should continue to isolate until they improve and you are fever-free for 24 hours. 
• If you experience shortness of breath or have difficulty breathing, you need to isolate for 10 total days. 
• If you experienced severe illness, were hospitalized, or were immunocompromised, you must isolate for ten days and consult your physician before ending isolation.
• Regardless of whether you end isolation after 5 or 10 days, you should wear a high-quality mask around others and avoid being around people vulnerable to COVID-19 for at least 11 days. 

1. Removing your mask:

• After ending isolation, you should wear a mask around others through day 10. 
• You can remove your mask before day 10 if you test negative twice in a row using at-home rapid antigen tests. These tests should be done 48 hours apart from each other.
• If your rapid test results are positive, you are still infectiousand should continue to test until you receive negative results. This may mean masking up after day 10 for some. 

***Keep in mind that the above guidelines are based on the average time for someone to test negative for COVID-19. They may not apply to everyone perfectly and should not be used as a definitive timeline to determine when someone is no longer COVID-positive and contagious. No matter how faint, any positive result on a rapid antigen test indicates you are still infectious. Consider if it is feasible to continue to mask and self-isolate until you test negative, regardless of the CDC’s recommendations and guidelines. This is essential to control and reduce the spread of COVID-19, and protecting people contracting COVID-19 can be more harmful.    The most recent CDC COVID-19 guidelines can be found here.

Prevention 

1. Getting Vaccinated

• Updated COVID-19 vaccines are a safe and reliable way to help build protection from infection and severe disease. The CDC recommends that everyone 6 months & older should receive anupdated COVID-19 vaccine (recommended doses vary by age and immune status).
• A new booster shot for COVID-19 was approved by the Food and Drug Administration (FDA). The latest version of the COVID-19 booster is a monovalent vaccine designed to target the XBB.1.5 strain of the Omicron variant, offering more protection against the strain lineage and circulating related subvariants. Most insurance companies are expected to provide coverage for COVID-19 boosters. Amid rising cases and hospitalizations nationwide, the Centers for Disease Control and Prevention (CDC) has also recommended COVID-19 vaccination updates for everyone aged 6 months and older to protect against serious illness. 
• The CDC’s Bridge Access Programwill provide free COVID-19 vaccines until December 2024 to ensure uninsured adults can continue free access to these vaccines. Read more information about recommendations for the 2023-24 COVID-19 vaccines here. 
• Visit govto identify pharmacies with available doses and those participating in the Bridge Access Program.

1. Wearing a Face Mask: NOT ALL MASKS ARE EQUAL 

• Wearing a KF94 or KN95 mask provides stronger protection if you have COVID-19 and leave isolation. Experts say that those vulnerable with a high chance of getting severe COVID-19 should consider wearing a mask indoors or in crowded spaces. This is especially true if you have a weakened immune system, are at increased risk for severe disease because of your age or an underlying medical condition, or if someone in your household has a weakened immune system or is at increased risk for severe disease. 
• Although masks effectively reduce transmission, it is essential to know which type of mask is best for you to wear to offer the highest level of protection. To learn more about the different types of masks and how they are used, click here.

Testing 

1. Types of Testing

• There are different types of diagnostic tests to identify COVID-19. In most situations, a rapid antigen test or a PCR can tell you if you currently have COVID-19. 
• Confusion has emerged regarding antibody tests, which detect the presence of antibodies to COVID-19 in your blood that may be produced during infection with COVID-19 or by vaccination, as they have resulted in high false favorable rates. It is essential to know that the CDC does not recommend antibody testing to determine whether someone is currently infected with COVID-19 and should therefore not be used to guide decisions on whether to stop isolation, return to work, or other places where people congregate. 

1. When to Get Tested 

·       The CDC recommends testing immediately if you are experiencing symptoms of COVID-19.  

·       If you have been exposed to COVID-19 but do not have symptoms, the CDC recommends waiting at least 5 full days after your exposure before taking a test.

• The FDA has extended the expiration date of some COVID-19 tests that still deliver accurate results past their printed expiration dates. Find out if your test has a new expiration date here. 

Treatments and Medications

1. Treatment Options

• There are several FDA-approved prescription antiviral medications to treat COVID-19. 
  • The preferred treatment option is Paxlovid, an oral antiviral pill that must be taken within 5 days of symptom onset. 
  • The IV antiviral remdesivir,also known as Veklury, is shown to be just as effective as Paxlovid, and treatment must be started within 7 days of symptom onset. Remdesivir is administered intravenously once daily over three days and is appropriate for inpatient and outpatient use. 
  • If neither Paxlovid nor remdesivir is available or these treatments are inappropriate for you, Lagevrio, another oral antiviral, is also available. 
  • These medications are only meant for those at risk of severe illness and complications due to COVID-19. Find out if you qualify for these treatments here. 
  • When you test positive for COVID, make an appointment with your healthcare providers to discuss treatment options and determine which treatment is best for you. 
  • Find more information about Paxlovid, remdesivir, and Lagevrio here.

1. Remdesivir Treatment Centers

• Several state-sponsored sites administering remdesivir are located in Boston/Roxbury, Worcester, Pittsfield, Plymouth, Lawrence, Hyannis, Fairhaven/New Bedford, and Everett. These sites will work to arrange transportation to and from the treatment site with patients if needed. Contact information for each remdesivir administration site can be found here.