What Are the COVID-19 Guidelines These Days?

In the years since the emergence of COVID-19 as a global pandemic, much has changed.

And the guidelines about how to protect yourself from a COVID-19 infection and what to do if you catch the virus have undergone drastic shifts.

We know more about the COVID-19 virus now. And thanks to vaccines, more people have developed some level of protection from a debilitating COVID-19 infection.

With that in mind, what are COVID-19 guidelines we should be following these days? How many vaccines do you need? And how long before you can be around people if you test positive for COVID-19?

We talked with infectious disease physician Steven Gordon, MD, about the latest COVID-19 protocol.

COVID-19 guidelines: The basics

COVID-19 may not be making the headlines it once did. But that doesn’t mean we’re “safe” from it.

COVID-19 infection can still cause severe, even life-threatening illness. That’s particularly true for people who are living with a compromised immune system and other conditions that can put them at higher risk.

COVID-19 is still a part of our respiratory illness mix. Right there with things like RSV and the flu.

But the U.S. Centers for Disease Control and Prevention (CDC) states that more than 98% of the United States population has some degree of immunity from COVID-19. That’s because of prior infection, vaccination or both.

And the latest COVID-19 guidelines from the CDC reflect that.

“We’re not seeing the cases and the morbidity rates from COVID-19 that we did in the past, and so the recommendations for people with COVID-19 today are similar to what we recommend for other respiratory viruses,” Dr. Gordon shares. “Any of these viruses can be dangerous to people and can spread easily. It’s important to respect that reality.”

These days, the CDC doesn’t have specific COVID-19 quarantine guidelines or recommendations of how long to isolate if you have COVID-19. But it does suggest a variety of ways to protect yourself from COVID-19 infection and guidance for what to do if you do become ill.

Note that there are exceptions to these general recommendations that take into account your particular risk factors and the risk you pose in spreading illness to others. More on that in a bit.

How long to stay away from people if you have COVID-19

For most people with an average risk of developing complications from COVID-19, the CDC recommends following the same steps whether you’re ill with the flu, RSV, COVID-19 or other respiratory illnesses.

For people who don’t work in healthcare or have a health condition that comes with additional risk, the guidelines recommend the following:

Stay home and avoid contact with others until you are symptom-free for at least 24 hours without taking fever-reducing medications. Continue to take precautions, like wearing a mask and limiting unnecessary contact with others, for five days.

“The latest recommendations are the same for any respiratory illness,” Dr. Gordon notes. “Streamlining the guidance makes it easy for people to do the right thing when they’re ill. And it means that we can keep people from spreading the virus when they’re most contagious.”

What are the COVID-19 testing recommendations?

Having the same recommendation for what to do when you get sick with any respiratory illness also means that you can follow proper protocol even if you don’t know for sure which virus got ahold of you.

“Not everyone is testing for COVID-19 and other respiratory illnesses regularly. And unless you require treatment, you don’t necessarily need to,” Dr. Gordon states. “We think of it in terms of ‘test to treat.’ As in, if you’re ill and need medication, it's important to be tested to make sure you get the treatment you need.”

Of course, if you choose to test at home for COVID-19, it’s an option. When you’re running a fever or fighting a nasty cough, it can be reassuring to know what’s causing it. And it can help to reinforce the precautions you should take to limit your interactions with other people.

COVID-19 vaccine guidelines

Vaccination is your best line of defense against COVID-19. And while it may not provide complete protection from illness, the COVID-19 vaccine can help keep you out of the hospital.

“COVID-19 vaccination turns a bear into a cub,” Dr. Gordon illustrates. “You may still become infected with COVID-19 after vaccination. But the chance that you’ll develop severe complications from COVID-19 is much lower if you’ve been properly vaccinated.”

The CDC’s guidelines for COVID-19 vaccinations cover several scenarios. That’s because some people will benefit more from additional doses than others.

In general, adults and children 5 years and older with healthy immune systems are considered fully vaccinated if they receive a 2023–2024 formula COVID-19 vaccine. That is a one-dose vaccination for some brands (including Moderna or Pfizer-BioNTech vaccine). There is also a two-series 2023–2024 formula COVID-19 vaccination by Novavax. People getting that vaccine should receive two doses between three and eight weeks apart.

Those recommendations are the same whether you’ve been previously vaccinated against COVID-19 or not.

Kids ages 6 months to 4 years old need multiple doses to be up to date, and at least one of these doses should be the 2023–2024 formula COVID-19 vaccine. See the full vaccination schedule recommendation for kids here.

If you’re living with a compromised immune system, are over the age of 65 or are otherwise at a higher risk for more serious COVID-19 infection, your provider may recommend additional vaccinations — or annual vaccinations — to keep you safe from severe disease.

Treatment guidelines

Some cases of COVID-19 require treatment. Other times, some home remedies can get you through.

Antiviral medications like Paxlovid™ andLagevrio™ are the standard first-line antiviral medications for people with COVID-19 infection whose symptoms don’t clear up on their own. They may also be recommended for some people who are at greater risk for developing serious symptoms.

COVID-19 guidelines: Additional considerations

Again, COVID-19 (and other respiratory illnesses) can be more dangerous for some people than for others. And so the CDC has separate guidelines and recommendations to help ensure the safety of people at high risk for complications from COVID-19.

Let’s take a look at some additional guidelines to consider for select populations.

Healthcare workers

The CDC guidelines have some specific recommendations regarding COVID-19 for people who work in a healthcare setting. That is, people who have direct contact with patients.

For example, the guidelines state that if after testing positive for COVID-19 and showing symptoms, healthcare workers can return to work when they meet all three of these criteria:

1. At least 10 days have passed since your symptoms first appeared.
2. At least 24 hours have passed since your last fever (without the use of fever-reducing medications).
3. Your symptoms (like cough and shortness of breath) have improved.

Older adults

As we age, our immune systems tend to not work as well as they used to. That’s why older adults may benefit from additional strategies to lower their risk for severe cases of COVID-19.

The CDC recommendations for older adults include the following:

• Adults ages 65+ should receive annual COVID-19 vaccinations.
• All adults age 50 and older who contract COVID-19 are recommended to be treated with antiviral medication, even for mild infection.

People with weakened immune systems

If you have a weakened immune system (immunocompromise), you can be at greater risk for severe illness from COVID-19, including an increased risk for hospitalization and life-threatening complications.

If you have a weakened immune system, talk with your healthcare provider about:

• Whether you could benefit from additional COVID-19 vaccinations.
• The potential to be contagious with COVID-19 longer than other people and any additional precautions you should take to limit spreading the virus.
• The benefits of antiviral medication for COVID-19, even if your symptoms are mild.
• Whether you would benefit from additional treatments in addition to antiviral medication.

People who are pregnant

Pregnancy can weaken your immune system. So, the CDC guidelines urge people who are pregnant to be up-to-date with COVID-19 vaccinations.

Vaccination may also help pass along some degree of COVID-19 immunity to the developing fetus. That can be beneficial for when baby arrives because infants can’t be vaccinated themselves until the age of 6 months.

COVID-19 guidelines are subject to change

If there’s one thing we learned throughout the COVID-19 pandemic, it’s that viral illness protocols can change. Quickly.

Today’s CDC guidelines reflect our current reality. But new information becomes available all the time. Viruses mutate. They adapt to survive.

And so, the guidance must adapt as well. The CDC will continue to monitor the transmission of COVID-19 and other respiratory illnesses and update the guidelines as needed.

Until then, stay home until you’re symptom-free for 24 hours. Wash your hands. And talk with your healthcare provider to ensure you’re up to date with vaccinations.