What are the CDC's COVID-19 isolation guidelines for 2024-2025?

CDC 2024-2025 COVID-19 Isolation Guidelines

Individuals with COVID-19 should isolate for at least 5 days from symptom onset (or positive test date if asymptomatic), and may end isolation when fever has been absent for at least 24 hours without fever-reducing medications and symptoms are improving. 1, 2, 3

Core Isolation Duration

• The minimum isolation period is 5 days, counted from the day symptoms first appeared, not from the test date 1, 2, 3
• For asymptomatic individuals who test positive, count 5 days from the date of the positive test 2, 3
• Isolation can end after 5 days if three criteria are met: (1) no fever for 24 hours without medications, (2) symptoms are resolving or absent, and (3) ideally a negative rapid antigen test 1, 2
• Extended isolation up to 10 days is recommended if symptoms persist, fever continues, or rapid antigen testing remains positive 1, 3

Post-Isolation Precautions

• After ending isolation at day 5, individuals should wear a well-fitting mask when around others through day 10 3, 4
• This masking recommendation applies even if isolation ends early, as persons may still be infectious during days 6-10 4

Testing Considerations for Ending Isolation

• A negative rapid antigen test can support the decision to end isolation after day 5, but is not required by CDC 1, 2
• Do not use PCR/NAAT testing to determine when to end isolation, as viral RNA can be detected long after viable virus is no longer present 5, 6
• If using antigen testing, test on day 5 or later; a positive result indicates continued isolation is needed 1, 4
• Research shows that 54% of individuals still test positive on rapid antigen tests after 5-9 days, with declining positivity over time 4

Special Populations Requiring Extended Isolation

• Severely ill patients or those on immunosuppressive medications require individualized assessment and may need isolation beyond 10 days 2, 5
• Healthcare workers or those in high-risk settings may require a test-based strategy with two consecutive negative molecular tests collected ≥24 hours apart 5
• Nursing home or congregate settings may require more stringent criteria, including two consecutive negative RT-PCR tests before ending isolation 1

Isolation Setting Requirements

• Isolate in a well-ventilated single room when possible, with windows open for air circulation 1
• If single rooms are unavailable, maintain at least 1.1 meters (3.5 feet) distance from others 1
• Wear a medical mask (N95 preferred, surgical mask acceptable) when in the presence of others, including household members 1
• Avoid sharing personal items such as toothbrushes, towels, tableware, and bed linens 1

Monitoring During Isolation

• Monitor body temperature and symptoms daily 1
• Seek immediate medical attention if temperature exceeds 38°C (100.4°F) persistently, breathing worsens, dyspnea develops, or signs of pneumonia appear 1
• Clean hands immediately after coughing, sneezing, or touching potentially contaminated surfaces 1

Common Pitfalls to Avoid

• Do not count isolation days from test date if symptoms began earlier—always count from symptom onset 2, 5
• Do not require negative PCR tests for ending isolation—this unnecessarily prolongs isolation as PCR can remain positive for weeks after infectiousness ends 5, 6
• Do not delay ending isolation for isolated loss of smell or taste—these symptoms may persist for weeks without indicating ongoing infectiousness 2, 5
• Do not use public transportation when seeking medical care during isolation; use a private vehicle with windows open 1

Caregiver Precautions

• Caregivers should be healthy individuals without underlying diseases when possible 1
• Caregivers must wear N95 masks (preferred) or surgical masks when in the same room as the isolated person 1
• Caregivers should monitor their own temperature and symptoms closely 1
• Clean and disinfect frequently touched surfaces daily using appropriate disinfectants 1
• Avoid direct contact with the patient's respiratory secretions 1