Covid isn't over.

But the Biden administration and its Centers for Disease Control (CDC) would like to pretend it is. So they're floating a trial balloon to reduce their recommendation for isolation/stay-at-home after a positive Covid test to one (1!) day. California and Oregon have recently taken this step, both with minimal notice and little explanation.

First of all, the current guidance of staying home 5 days is already too short. People infected by breathing in the SARS-CoV-2 virus start shedding the virus (breathing it out in an aerosol that hangs in the air like smoke) several days before they develop symptoms, and for 7-9 days after (range: 6-11 days). The earliest CDC isolation guidance in 2020 was for 14 days, based on this clinical evidence of infectious days after exposure and applying the precautionary principle to minimize spread; it was shortened later that year to 10 days. The change to the much shorter, inadequate 5-day period was made in late 2021, right after public lobbying pressure by airline executives. Nothing then or since changed about the science of infectious days after Covid exposure, as Julia Doubleday shows in an incisive review of CDC's relationship with Covid infection science.

In the intervening years there has been some evidence that rest is of special importance to optimal recovery from the acute phase of Covid infection, which would argue for returning to the original 10-day isolation. Even stronger support comes from the mounting pile of studies showing that repeat infections increase the risk of Covid's many and various long-term harms. In the face of those harms, especially given the number of people who've already had more than one case of Covid, public health advice should recommend no action that actually increases the chances to catch it (say, from sick schoolmates or co-workers who were only given one day off).

Minimizing Covid as a "normal seasonal respiratory illness" by grouping it with flu and RSV has been going on for a while in the Biden administration's messaging, so it's no surprise to see it deployed here as a reason for shortening the stay-home to just a day to "harmonize" with them. My question is, why not harmonize by extending the RSV and flu isolation period to 5 days? Bouts with those diseases are rough on people. Encouragingly, a doctor quoted in NPR's report on the CDC decision reacts with the same recommendation. It should be emphasized, though (and wasn't even mentioned in the NPR story), that more people die from Covid than from flu. Also ignored, as usual, is the apparently unmentionable elephant in the room: neither flu nor RSV does the kind of lasting or varied organ and systemic damage that Covid can. Unlike flu or RSV, Covid is as much a vascular as a respiratory disease; the virus binds to ACE-2 receptors, which are found in every part of the body with capillaries.

Another purported reason for shortening Covid isolation to just a day is to reflect "the new reality — with most people having developed a level of immunity to the virus because of prior infection or vaccination." There. is. no. such. new. reality. "A level of immunity" = one so weak and easily evaded, even among the diminishing population slice of the fully-vaxxed-and-boosted, that it doesn't completely prevent infection when exposed to the virus. Breakthrough infections are routine, and even more common is re-infection among unvaccinated people.

Here's the actual, stark "new reality": we've allowed a majority of the population, including growing children, to get infected repeatedly with a virus that does long-term damage to a wide variety of organs and systems, including the immune system itself -- and the risk for such damage rises with each new infection. In some non-trivial percentage of people who are infected, the virus persists in the body and causes the chronic illnesses known as Long Covid. It's a mass disabling event already; the real question is what the eventual scale and severity are going to be. The obvious priority for public health is to minimize any more infections, particularly among those who have already had multiple cases.

The best chance to keep infection by SARS-2 to a minimum is by putting in place layers of protection beyond just vaccines: mitigations like ventilation, air filtering, effective masks, testing and isolation, paid sick leave, remote options for meetings and work, etc. A bonus is that these mitigations are equally protective against all variants of the SARS-2 virus, the many other existing airborne pathogens (including colds, flu, and RSV), and those that may arrive in the future. Not to mention those that threaten to return from the past, like measles.

Update: The CDC put out a non-denial denial of the story, which only makes prompt feedback more important. The planned timing seems to be April, when infections drop, but if the stay-at-home guidance goes away it will be nearly impossible to bring back when cases rise again. Let them hear from you at their Contact Form. Shoot down this dangerous trial balloon with flaming arrows!

Update 2: The timing turns out to be Friday, March 1. There is no comment period; it takes effect immediately. The guidance explicitly ties ending isolation not to testing negative, which means no longer being infectious, but to improvement in symptoms like fever. This is unsupported by any science, and completely focused on the individual rather than the community. Between this dangerous, compromised advice in a persistent pandemic and the horrific co-genocide with Israel, the idea of voting for Joe Biden right now has become unbearable.

Assassination in a dirty war

What Digby said.

People always act like this issue is simple. But pregnancy is one situation in life that falls across all kinds of moral, emotional and rational lines, calling into question the autonomy of the very body in which we live and lifelong commitments made in the heat of the moment --- painful choices and primitive imperatives in the most basic human drive we have. Whether it's the idea that women should be "punished" with pregnancy for failing to use birth control, to the idea that adoption is a simple and painless alternative, to the insistence that women who carry a child for seven or eight months must be forced to give birth when the child has no chance at life, to the spectacle of the Octamom, the fact is that there is no broad brush answer that can be applied to all these different circumstances. Certainly, the crude instrument of the law isn't the answer as even the anti-choicers tacitly admit when they refuse to consider the women who have abortions murderers and instead focus on the doctors.

Indeed, the murder of Dr Tiller in a demented defense of a "culture of life" should be all it takes for everyone to see that this is not the simple, straightforward issue they'd like to believe it is. And once you recognize that it's a unique circumstance in which the moral boundaries are blurry and indistinct, the only possible course is to trust the person with the most knowledge of the circumstances, the symbiotic relationship to the fetus and greatest stake in the outcome --- the woman. [emphasis mine]

Pres. Obama was right in his Notre Dame address that it's unfair to impute to every individual who opposes abortion an ideological right-wing drive to coerce women and control their bodies and sexuality. That's true as long as we're dealing with individuals. But the anti-abortion movement as a political entity is waging a war on women's right to choose, to control their own lives. Their extreme fringe is literally waging that war.

My heart goes out to the family, friends, co-workers, and patients of Dr. George Tiller. May we honor his memory by calmly proceeding with the work of defending reaffirming women's right to choose.

Update: 12:30 pm, 3 June - If a war is being waged on us, why not make it a real war by fighting back with "whatever it takes"? Because, as usual, war is not the answer. It strengthens the already-too-strong state and its mechanisms of repression, which will be turned against us far more than against the right.

But neither is this moment a time for mawkish hogwash about finding common ground with organized anti-abortion, anti-choice operatives (there isn't any; they don't support contraception or sex education, either), or how abortion is always a difficult and painful decision (it's not). Dr. Tiller's murder is a clarion call to end apologetic, defensive retreat and affirm our rights as autonomous human beings. Abortion must be safe, legal, and available. Contributions to Medical Students for Choice or another pro-choice organization help make that a reality. [links via commenter John Protevi at michaelberube.com]
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Single payer health care: It's aliiiiive!

Best political news of the month: Single-payer advocates are refusing to fade quietly from the field in favor of the tiny-slice-of-the-loaf plan of Health Care for America Now:

A coalition of liberal advocacy groups and labor unions ... announced Wednesday the launch of a lobbying campaign to build support for a health care overhaul that would expand Medicare, the health entitlement for the elderly, to cover everyone and act as the "single payer," putting health insurance companies out of business.

The only hope for getting any public pool of health coverage at all is if 'Medicare for All' is a credible threat.

This diary at DailyKos outlines the changes in this Congress' version of H.R. 676 and is filled with excellent action suggestions and links to further resources.

[Hat tip Daily Kos]