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Experts say CDC’s latest guidelines pose barriers to some workers

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Coronavirus cell

The Centers for Disease Control and Prevention issued new COVID-19 isolation and quarantine recommendations last week. Some experts say the guidelines will most likely disadvantage low-wage and frontline workers in Kentucky, where there is less access to paid sick leave than in other states.

The CDC cut the isolation time from 10 to five days for people who test positive and are either asymptomatic or have “resolving” symptoms. 

Dustin Pugel, a senior policy analyst with the Kentucky Center for Economic Policy, said not everyone can afford to take time off to care for their wellbeing. That isn’t just a threat to them, but to public health, too. 

“When folks have to choose between keeping their job or earning a paycheck, and going into work sick, we know that most of them will choose to go into work sick,” Pugel said. “Requiring them to come in without any kind of paid sick leave is a really big problem for them, for their colleagues and for the folks they interact with.”

Pugel said low-wage workers — such as those with restaurant, healthcare and retail jobs — often face this difficult decision. 

A 2021 report from the U.S. Bureau of Labor Statistics showed workers in the southeast region — including in Kentucky, Tennessee and Mississippi — have the least access to paid sick leave in the country. 

“In that region, 29% of the civilian workforce doesn’t have access to paid leave — and 33% of private sector employees don’t have paid leave, compared to the national averages which are 21% and 23%, respectively,” Pugel said. “The lower the wages, the less likely the worker is to have paid leave.”

According to the BLS report, only 6% of the country’s highest wage earners don’t have access to paid sick leave, compared to 46% of low-wage workers. 

“It’s clear that a lack of paid sick leave among lower wage-earning Kentuckians would disproportionately hurt Kentuckians of color who earn less than white Kentuckians on average due to historical and structural barriers to equity,” Pugel said. 

Dr. Keisha Bentley-Edwards is an associate professor of medicine at Duke University’s School of Medicine. She said the CDC’s latest recommendations prioritize systems over people. 

“A lot of it is seen as being tied to the economy, and not necessarily being tied to actual individual health and public health at large,” Bentley-Edwards said. “It’s about ‘How can we get people in grocery stores and pharmacies back to work as soon as possible?’”

On Dec. 23, the CDC initially released emergency guidance for health care workers. That decision followed staffing shortages caused by omicron-driven case surges. If a healthcare worker tests positive for COVID-19, the guidance says they can return to work a week later with a negative test, or sooner if staffing is low. 

The agency also said fully-vaccinated and boosted healthcare workers don’t need to quarantine at home after high-risk exposures.

“These guidelines are not about how to care for yourself with COVID,” Bentley-Edwards said. “It creates that push and pull because the CDC says you can come back to work in five days, even though your body may say I can't, I'm not fit to work right now.”

Bentley-Edwards said the new guidelines add another layer of complication for primary caretakers of young children or older family members.

“The heavier burden of these issues falls on women, particularly women of color, who can't afford to pay for outside help — and if you have COVID, you can't even get that outside help with your caretaking responsibilities,” Bentley-Edwards said. 

She added the CDC’s recommendations assume a perfect system when it comes to testing access and well-intentioned employers — and she said the agency failed to simplify directives. 

“They're not necessarily written for the everyday person to understand. So, when do we start counting? Do we start counting from when I tested positive? When I was exposed? Or when I started having symptoms?”  Bentley-Edwards said. “All of these things start to become confusing.” 

Bentley-Edwards said another point of confusion is knowing the difference between isolation, the course of action if you personally test positive for COVID-19, and quarantine, which is what to do after being around someone else who tests positive.

The CDC’s latest isolation guidelines for the general public, regardless of vaccination status are:

  • Stay home for five days.
  • If you’re asymptomatic or feeling better, you can leave the house after the fifth day, but must continue masking around others for another five days. 
  • If you have a fever, remain home until it subsides.


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