A Better Way to Talk About COVID Isolation
If you’re caught in COVID seclusion today, you’re making muffins. If that’s actually real, great for you, and I can advise these. However I’m talking metaphorically. Today, the infection you’re nursing, and the infectious danger it brings, is—hear me out—raw batter in an oven. You really, really don’t want to remove it too soon.
Yes, we are in crisis right now. The pandemic’s been raging for two years, and I am talking about muffins. But just bear with me a second. Muffins are warranted at this bizarre pandemic juncture because the CDC has starved us of proper guidance. This week, the agency debuted new guidelines that told people who have been infected by the coronavirus that they can spring from isolation as little as five days after their symptoms start, or their first positive test result, rather than the typical 10—regardless of vaccination status, and without confirming that they’re not still infectious by taking a coronavirus test. The agency did this despite evidence that it cites on its own website suggesting that some 30 percent of people may remain contagious after their fifth day in solitude. (And these data largely predate Omicron, which might rejigger the transmission math.)
The CDC says that people can take tests if they want to, and that anyone who continues to test positive or still feels pretty sick should remain in isolation. You’re also still supposed to mask until after day 10. But a slew of experts I spoke with earlier this week called this tepid guidance reckless, unscientific, and punishingly complex—the ifs and thens of the recommendations run nearly 2,000 words long—and they worry that the rest of us have essentially been left to navigate the rules of infection prevention for ourselves.
This brings us back to the muffins, and the solace they can offer in times of despair. Here, muffins aren’t just tasty. They can provide actual clarity on how to exit isolation. Muffins, like infected people, need to incubate for a set period of time before they’re ready for a public debut. There’s pressure to get them out of the oven somewhat speedily: People are hungry; muffins are delicious; overcooked muffins are not. But removing them too soon is even worse. You danger a lot of people … well, getting sick.
I apologize if I’m ruining muffins for you. But like infections, all muffins are unique. The ideal time to bake them may vary by ingredients, by oven, even by the color of the pan the batter’s baked in—a whole slew of factors that actually track decently well with how infection also works. With SARS-CoV-2, people who are very sick or immunocompromised might carry and transmit it for longer; people who are young, healthy, vaccinated, and didn’t snarf up too much of the virus might be only briefly contagious. Any decent muffin recipe will account for that degree of variation. Most will give a range of cooking times: 20 to 30 minutes, say, in a 350-degree oven. They’ll also ask you to look for visual cues, and test the batch when it seems to nearly be done.
Our public-health guidelines would benefit from such flexibility. You can think of the virus, crudely, as the rawness of the batter; a proper tenure in a hot oven should burn the contagion out. External appearance, or symptoms, can be a clue. Intense illnesses are like visibly runny, shiny, snotlike (again, sorry) batter—a sign that something’s undercooked. (Fast-resolving symptoms? Golden-brown muffin tops that feel lightly springy to the touch? That’s more encouraging.) Vaccines can play a big role here too, because they’re known to curb contagiousness. Like a hotter oven or a darker-colored pan, they can speed the cooking process along.
Stay with me now. This is for your health, and your batter’s still cooking! Given that outsides can sometimes be deceptive, it’s nice to also test what’s going on inside. For SARS-CoV-2, many experts (though not the CDC) advise using a test around the five-day mark, and to not exit isolation until you’ve received one or 2 negative results. It’s the COVID equivalent of the toothpick trick: Stick one into a muffin when it’s looking crisp; if just a couple soft crumbs cling, it’s done. Neither method is perfect. The toothpick test can deceive, and coronavirus tests can ping back false negatives, especially if they’re the rapid, at-home kind that look for antigens. (Omicron, which appears to prefer the throat early in infection, may be eroding antigen tests’ performance further.) To make matters worse, the current at-home test shortage has made it as though every grocery store in America has suddenly run out of toothpicks. But when possible, gathering this kind of evidence is far better than fumbling in the dark. In any case, a positive result—a blazing line on an antigen test, or a toothpick coated with goop—should be incentive enough to shut the door again.
I’ll level with you here: This comparison is silly. But we need these sorts of communication tactics because we’re not finding many of them elsewhere, especially from the agencies that are supposed to be shepherding us through this mess. In a way, the fact that I needed to reach for muffins at all is more proof that, two years into this pandemic, we’re still very bad at speaking about it. As Omicron cases shatter records and expensive tests remain in woefully short supply, we don’t have the equipment we need to do shortened isolations justice. However that is little reason to shrug and say that 5 untested days is enough. By now, we know how to avoid infecting one another. And yet, we’re still depriving ourselves of the opportunity to whip up the best batch.
Jobber Wiki author Frank Long contributed to this report.