Understanding the new CDC guidelines for those exposed to, or suffering from, COVID-19

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• Amna Nawaz:

  The Centers for Disease Control and Prevention is now recommending a shorter isolation period for anyone testing positive for COVID-19, from 10 days down to five, if asymptomatic, followed by five days of mask-wearing around others.

  Now, the new guidance comes as the U.S. is averaging more than 230,000 new cases per day.

  Dr. Mati Hlatshwayo Davis is the director of health at the City of St. Louis' Department of Health. And she joins me now.

  Dr. Davis, welcome to the "NewsHour." Thanks for making the time.

  It's a big change in guidance. We want to make sure it's clear to people. So, they say, if you test positive and have no symptoms, isolate for five days, wear a mask for five days.

  What do you do if you test positive and you have symptoms of some kind? What should you do then?

  Dr. Mati Hlatshwayo Davis, Director of Health, St. Louis: So, excellent question, Amna.

  And what we believe is happening here is that the guidance has been made clear to differentiate between the asymptomatic, symptomatic, but you have also seen them give this guidance around vaccination status.

  And for that population of people, what we believe is that second five-day period does not guarantee that your local health department will clear you from isolation, because you are still symptomatic, right? So you are allowed to leave after day five asymptomatic with a mask. That is not the case if you are still symptomatic.

• Amna Nawaz:

  So, they have also issued some new guidelines from the CDC for anyone who's just exposed to the virus, if you come into contact with someone who has tested positive for COVID-19.

  And I want to lay this out for people. There's a lot to digest. They are saying, if you are exposed, and you are unvaccinated, they recommend five days of isolation, plus five days of masking. If you have been vaccinated earlier, which means more than six months have passed since the time you were fully vaccinated with Pfizer or Moderna or more than two months for the J&J, the Johnson & Johnson vaccine, they say five days of isolation and five days of masking.

  If you were vaccinated recently — that means fewer than six months for Pfizer or Moderna, fewer than two months for J&J — no isolation recommended, and they say 10 days of masking. And if you have been boosted, they say no isolation and 10 days of masking.

  Dr. Davis, it's a lot to keep up with. A lot of people are very confused. How are you making sure people in your community understand this? And how are you implementing it?

• Dr. Mati Hlatshwayo Davis:

  Well, Amna, my background before I became the director of health for the City of St. Louis is, I'm an infectious diseases physician and a public health expert.

  And so one of the things you understand in my field is that infectious diseases are not static. They're not a monolith. They evolve over time, which means the guidance is going to change over time.

  So what needs to happen is that the leadership needs to do a good job of helping people to make those transitions when they occur. So, the confusion is warranted. The job now is on the CDC, on the federal government, and on local health officials to make sure that people understand the science and can make that transition.

  Now, what's also a challenge is that, while I completely agree with the science, as the director of health of a major city, the implementation may take time, because we need to do it in a way that is as safe and effective for our populations.

  And not every county or city has the same level of support measures to make sure that this is successful as the next. So, for example, my counterparts in New York are able to ramp up testing to support this, because part of these guidelines do make the recommendation for testing at day five for certain populations.

  But if you come from a city or a county where the funds and the capabilities just aren't there for that level of testing, this may not be something that you can implement right away. They're within lies the challenge.

• Amna Nawaz:

  And so does that mean you are not following these CDC guidelines and St. Louis right now?

• Dr. Mati Hlatshwayo Davis:

  Oh, for me, the CDC is always who we go to as the trusted resource.

  But, for me right now, I have to have conversations with local, state and national leaders around what this looks like. I have to take the time to responsibly look at the data that they used to support this. And then I have to make sure that those wraparound services are available.

  So we are at that stage right now. We just got these CDC guidelines yesterday. I'm having those conversations and making sure we have everything available to be able to implement.

• Amna Nawaz:

  So, what are you — what do you think you're missing right now?

  Obviously, we have seen a lack of testing across the country. Do you have tests that you need right now to implement this safely?

• Dr. Mati Hlatshwayo Davis:

  Absolutely, Amna.

  Testing has been something that all of us who advocate at the public health level have been asking for. In order to be able to really maximize and keep our population safe, we should have tests for any American, any household that requires them. And especially for this level of transition of guidelines, that would be the goal.

  And we have heard this from our leaders. We have heard this from Dr. Fauci. We have heard this across the line. In an ideal world, that's, of course, where we would be. Unfortunately, we don't have that.

  So, unfortunately, the buck stops at the local government level, where we have to make decisions about what's safest until we know we have that at a reasonable capacity.

• Amna Nawaz:

  Dr. Davis, overall, Missouri vaccination rates are pretty low, right? Across the state, I think it's only 53 percent of the population is fully vaccinated. About 62 percent have one shot.

  How concerned are you about Omicron? Where are you seeing it show up in your community?

• Dr. Mati Hlatshwayo Davis:

  Right.

  So we are currently in the same position as most of the country right now, where we're in a very concerning surge. We have seen a doubling of our case positivity rate in two weeks. And we expect that level of increase within the next week or less.

  That level of rate of increase we have not seen throughout our time in the city. And so what we know in the City of St. Louis is that we have two very highly transmissible variants, in Omicron and Delta, in circulation at the same time.

  And, as a public health official, it is important and imperative that the public understand that your best tool in your toolbox to defend against this is vaccinating, being sure to have your — the full vaccination series available. But, also, what we know is, the greatest way to prevent a serious illness from the Omicron variant specifically is to be boosted.

  So that is my number one challenge. But, again, it's an all-hands-on-deck approach. So it's education around masking, social distancing, handwashing, staying home if sick, limiting social gatherings, and, if you're going to engage in them in a limited capacity testing, testing if you are engaging with people outside of your household.

  That is what I am focused on in the City of St. Louis and now, in light of these new guidelines, really making sure that we get the available support from the state to ramp up testing for the City of St. Louis.

• Amna Nawaz:

  Dr. Davis, I will end by putting to you something we hear often from people when there is new guidance that they don't fully understand or that is a little more confusing, requires some unpacking, which is that the guidance does continue to change.

  As you mentioned, pandemics are hard. Things evolve. They follow the science. And yet we are at a point now where cases are surging, and the officials are saying this is a worrying new increase, you have to take it seriously, but, at the same time, we're going to be loosening restrictions.

  And that is very confusing for a lot of people. So what would you say to folks who hear that and think those are two very different messages?

• Dr. Mati Hlatshwayo Davis:

  What I would say is that, in my position of leadership, there is no such thing as loosening. If anything, this is an all-hands-on-deck approach.

  So I think what people do is grab headlines, right? They hear five days, and that's what they run with. Absolutely not. This is about appropriate isolation and quarantine. This is about masking, masking to the extent that you can. And we have seen — I mean, you have seen it, Amna, where you live. I know it's happening here, that I think people have gotten complacent about that part of it.

  And that's a very active part of the guidelines, right? And it's about those other mitigation strategies. So here, where I am leading, the message is very clear. We are currently in a surge. You need to be considering all of the mitigation strategies to keep yourself and our community safe. And we are not nearly where we need to be.

  Listen, our new normal is going to be difficult to get to if we do not do the best we can around vaccinations, boosting, and appropriate education and messaging around these types of transitions that we have had to overcome during this pandemic.

• Amna Nawaz:

  That is Dr. Mati Hlatshwayo Davis, the director of health at the City of St. Louis' Department of Health.

  Thank you so much for your time, Dr. Davis.

• Dr. Mati Hlatshwayo Davis:

  Thank you for having me, Amna.