The end of the COVID public health emergency this spring and the White House’s decision to wind down the federal response to the pandemic has brought with it even further relaxing of the vaccine and masking requirements that already seem a distant thing of the past.
While there used to be at least some widely acknowledged standards of “sick etiquette” for those who had a COVID diagnosis or had interacted with someone who had tested positive, as COVID hospitalizations increase in the U.S., many people find themselves navigating this new phase of the pandemic without much of a national playbook.
It’s the latest in what some have criticized as confusing messaging and poor communication about COVID and the ever-changing public health guidance. And while the new director of the Centers for Disease Control and Prevention (CDC) has vowed to create more transparency and build more trust in the agency, for many, questions still remain about current COVID best practices as we get ready for a likely spike in cases this fall and winter.
Here’s what public health experts say about some frequently asked questions regarding COVID protocols.
How effective are the new COVID boosters?
On Sept. 11, the U.S. Food and Drug Administration approved and authorized updated boosters by Pfizer and Moderna that are aimed at protecting against Omicron variant XBB.1.5. That was followed by The CDC's Advisory Committee on Immunization Practices recommending the updated vaccines on Sept. 12.
The CDC has said that the new BA.2.86 variant (nicknamed "Pirola") may be more likely than older variants to infect people with presumed immunity derived from vaccines or prior infections, but Moderna and Pfizer have claimed that their new shots generated strong responses to the new variant in testing.
“I don't think we have a sense yet of the exact vaccine effectiveness for when the boosters come out,” Justin Lessler, an epidemiology professor at the University of North Carolina at Chapel Hill Gillings School of Global Public Health tells Yahoo Life. “But what we do know is that the boosters will be a lot more effective against circulating strains — including BA.2.86 — than the previous vaccine, because they'll be based on a more closely related strain. And we also know that being boosted ups your immunity sort of in general.”
Who should get a booster?
The CDC recommends that everyone 6 months and older get an updated COVID-19 vaccine to protect against the variants currently circulating in the U.S. The new boosters from Pfizer-BioNTech and Moderna will be available later this week, according to the CDC.
Dr. Paul Offit, a member of the FDA's expert vaccine committee, predicted that the CDC would recommend that anyone over 6 months old be eligible for the booster, as they did last year, but he doesn’t believe those who’ve had at least one booster really need the new shot — unless they're a senior, pregnant or immunocompromised. However, other experts Yahoo Life spoke with said that while certain high-risk groups should be a priority, everyone could benefit from an immunity boost.
“Folks who are at higher risk for COVID-related complications should definitely get boosted, but everyone else should also strongly consider it,” Anne Liu, an associated professor of infectious diseases at Stanford University School of Medicine, tells Yahoo Life. “If more people get vaccinated, there could be less spread of the virus throughout the community, which means less time lost from school and work." She added that a booster also "protects immunocompromised people and limits the disruption to our daily lives by this virus.”
Mask or no mask?
Some individual businesses and hospital networks have reintroduced mask mandates as COVID cases rise, while many others are recommending masks but leaving the final decision up to individuals.
The CDC recommends wearing a mask around others for up to 10 days after being exposed to someone with COVID-19. But in general, experts say masking all comes down to personal risk assessment and reading the room to determine whether a mask may be a good idea. For example, if you’re around relatives or friends who are immunocompromised, it's a good idea to mask up for their protection.
“I think it gets more complicated when people have to make these assessments of themselves as well as the assessment of the environment, so it does require one being quite attuned to where we're at,” Dr. Wafaa El-Sadr, an epidemiology professor at Columbia's Mailman School of Public Health and lead of the New York City Pandemic Response Institute, tells Yahoo Life. “With fewer and fewer people masking in public, it's really important that there's a sense of people respecting each other's decisions with regard to masking, and to not judge people, not try to figure out, 'Why is this person wearing a mask?' but just accept that this person is wearing a mask. It's an individual's decision to do so, and be respectful of that decision.”
Lessler says that while wearing a mask public if you have COVID-like symptoms is the courteous thing to do for those around you, there are currently no hard rules on places where masks must be worn.
“Personally, I think we're probably entering a phase where at least in health care facilities, everybody should be masking, because that's a really high concentration of both at-risk people and people who are potentially infected,” he says. “But on airplanes and things like that, particularly given some people's feelings about masks, I think that that is a harder question.”
One circumstance where masking should be a no-brainer is if you’re currently infected with COVID, Liu says.
“Mask up in public but preferably stay home,” she says. “If you live with other people, then masking at home will reduce the chances of in-home COVID spread.”
Is social distancing or isolating still a thing?
Yes, although that depends on the situation, say experts. Here's what you need to know:
If you have COVID: The CDC currently recommends isolating for at least five days, and you can end isolation after five days if you’re fever-free and symptoms are improving — an isolation period that’s much less stringent than past recommendations. "Personally, whenever I've tested positive I have always stayed in isolation until I have two negative tests in a row, but that's, I think, a more conservative approach," Lessler says.
If you were in contact with someone with COVID: "Contacts who test negative and do not have symptoms do not have to isolate as long as those two things remain true," Liu says — though Lessler adds that he would "certainly would recommend judicious use of tests and being really aware of symptoms" after being exposed.
Despite some public criticism of the agency’s COVID guidance, experts still say the CDC is a good source of information for staying up to date on COVID advice — which will likely continue to evolve as we leave the health emergency phase behind and enter a more endemic stage of the virus.
Wafaa also recommends following the guidance of state and local health departments — which will have more localized data and suggestions based on what’s happening in your own community — as well as keeping in touch with your health care provider for individualized advice.
"I encourage people to always be kind of analytic and think about their own situation, as well as their environment, and to always go to reliable sources of information," she says. "Avoid all the disinformation and misinformation that's out there."
This article was originally published on Sept. 11, 2023 and has been updated.