• Introduction:

    COVID-19 is a respiratory disease caused by SARS-CoV-2, a coronavirus discovered in 2019. The virus spreads mainly from person to person through respiratory droplets produced when an infected person coughs, sneezes, or talks. Some people who are infected may not have symptoms. For people who have symptoms, illness can range from mild to severe. Adults 65 years and older and people of any age with underlying medical conditions are at higher risk for severe illness. The CDC advises that everyone aged 6 months and older stay Up-to-Date with all recommended COVID-19 vaccine doses to decrease the risk of getting and spreading COVID-19 illness and severe disease.

COVID-19 Updates

COVID-19 is a respiratory disease caused by SARS-CoV-2, a coronavirus discovered in 2019. The virus spreads mainly from person to person through respiratory droplets produced when an infected person coughs, sneezes, or talks. Some people who are infected may not have symptoms. For people who have symptoms, illness can range from mild to severe. Adults 65 years and older and people of any age with underlying medical conditions are at higher risk for severe illness. The CDC advises that everyone aged 6 months and older stay Up-to-Date with all recommended COVID-19 vaccine doses to decrease the risk of getting and spreading COVID-19 illness and severe disease.

Coronavirus

On March 1, 2024 CDC released updated recommendations for how people can protect themselves and their communities from respiratory viruses, including COVID-19. The new guidance brings a unified approach to addressing risks from a range of common respiratory viral illnesses, such as COVID-19, flu, and RSV, which can cause significant health impacts and strain on hospitals and health care workers. CDC is making updates to the recommendations now because the U.S. is seeing far fewer hospitalizations and deaths associated with COVID-19 and because we have more tools than ever to combat flu, COVID, and RSV.

As part of the guidance, CDC provides active recommendations on core prevention steps and strategies:

  • Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
  • Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
  • Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors.

Visit CDC for more information.

Symptoms of Covid-19

Symptoms of Covid-19

People with Covid-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Anyone can have mild to severe symptoms.

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

COVID-19 Guidance

COVID-19 and other respiratory diseases can be very contagious. If you have COVID-19 you should follow the Centers for Disease Control and Preventions recommendations for respiratory illness found here.

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Respiratory Virus Guidance Update FAQs

  • We have more and better tools and protection to fight serious respiratory illness
    • Effective vaccines against all three major viruses are now widely available:
      • COVID-19 vaccines cut the risk of severe disease in half, and over 95% of hospitalized adults were not up to date with their COVID-vaccine in fall 2023.
      • Flu vaccines similarly cut the risk of severe disease by close to half.
      • For the first time in fall 2023, we had an immunization against respiratory syncytial virus (RSV) for older adults, pregnant people, and young children.
    • Effective treatments are also widely available:
      • Paxlovid cuts the risk of hospitalization by over half and the risk of death by even more (75%).
      • Treatment of flu with antiviral medications can lessen symptoms and shorten the time you are sick by about a day. Starting antiviral treatment shortly after symptoms begin also can help reduce some flu complications.
    • Population immunity to COVID-19 is high:
      • >98% of U.S. population now has some protective immunity against COVID-19 from vaccination, prior infection, or both.
  • As a result, far fewer people are getting seriously ill from COVID-19.
    • Fewer hospitalizations and deaths:
      • Weekly hospital admissions for COVID-19 are down more than 75% from the peak of the initial Omicron wave in January 2022, and deaths are down by more than 90%. In 2022, COVID-19 accounted for more than 245,000 deaths. Last year, that number was around 76,000.
    • Fewer complications:
      • Complications like multisystem inflammatory syndrome in children (MIS-C) are now also less common, and prevalence of Long COVID is also going down.

While still posing a significant health threat to those at higher risk, COVID-19 health impacts are now increasingly similar to other respiratory viruses, like flu, which are also important causes of illness and death, especially for people at higher risk. As a result, this the right time to issue unified Respiratory Virus Guidance, rather than additional guidance for each specific virus. Issuing Respiratory Virus Guidance brings a unified, practical approach to protecting against a range of common respiratory viral illnesses so that people can protect themselves and loved ones from these illnesses. These viruses share similar routes of transmission, symptoms, and prevention strategies. Although COVID-19 is starting to look like other respiratory viruses like flu when we look at the number of hospitalizations and deaths, it continues to differ in important ways, such as Post-COVID Conditions. Flu, COVID-19, and RSV continue to be significant health burdens, especially to people at higher risk, and require ongoing actionable prevention strategies such as those recommended in our updated Respiratory Virus Guidance. This updated guidance continues to protect those most at risk, and evidence indicates it will not significantly increase severe disease related to COVID-19 or other respiratory viruses.

Importantly, states (California, Oregon) and countries (Australia, Canada, Denmark, France, and Norway) that have changed their recommended isolation times have not seen increased hospitalizations or deaths related to COVID-19.

CDC will continue to evaluate the available evidence, including public health and clinical trends, virology, behavioral science, and social practices, to ensure the recommendations in the guidance provide the intended protection. 

COVID-19, flu, and RSV are very common respiratory viruses that cause significant amounts of disease, especially in the fall/winter season. We also have immunizations and treatments that help prevent severe outcomes of these viruses. As such, these are key examples we have highlighted, but the Respiratory Virus Guidance covers most common respiratory viral illnesses. It should not replace specific guidance for viruses that transmit through the air and require special control measures, such as measles. However, the recommendation in this guidance may still help reduce spread of various other types of infections. The guidance may not apply in certain outbreak situations when more specific guidance may be needed. In addition, CDC offers separate, specific guidance for healthcare settings (COVID-19, flu, and general infection prevention and control) and Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 that is not currently changing.

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Prior Guidance: The previous COVID-19 guidance recommended a minimum isolation period of 5 days plus a period of post-isolation precautions and was created during the public health emergency with lower population immunity, fewer tools to combat respiratory viruses, and higher rates of severe illness, including hospitalizations and deaths.

Updated Guidance: The updated Respiratory Virus Guidance recommends that people stay home and away from others until at least 24 hours after both their symptoms are getting better overall, and they have not had a fever (and are not using fever-reducing medication). Note that depending on the length of symptoms, this period could be shorter, the same, or longer than the previous guidance for COVID-19.

It is important to note that the guidance doesn’t end with staying home and away from others when sick. The guidance encourages added precaution over the next five days after time at home, away from others, is over. Since some people remain contagious beyond the “stay-at-home” period, a period of added precaution using prevention strategies, such as taking more steps for cleaner air, enhancing hygiene practices, wearing a well-fitting mask, keeping a distance from others, and/or getting tested for respiratory viruses can lower the chance of spreading respiratory viruses to others.

We considered multiple options for adjusting isolation guidance at different lengths of time. In addition to fewer people getting seriously ill from COVID-19 and having better tools to fight serious illness, CDC considered other factors such as the personal and societal costs of extended isolation as well as the timing of when people are most likely to spread the virus (a few days before and after symptoms appear). The updated guidance is easy-to-understand, practical, and evidence-based, as well as more aligned with long-standing recommendations for other respiratory illnesses.

CDC offers separate, specific guidance for healthcare settings (COVID-19, flu, and general infection prevention and control) and Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 that is not currently changing.

The updated Respiratory Virus Guidance recommends that people stay home and away from others until at least 24 hours after both their symptoms are getting better overall, and they have not had a fever (and are not using fever-reducing medication).

It is important to note that the updated guidance states that testing is an option during the 5 days of additional precautions following the “stay home” period. While COVID-19 at-home testing can give a rough approximation of whether a person is still infectious, at-home testing for other respiratory viruses is not widely available. CDC guidance throughout the pandemic recognized that repeated testing through the course of illness is not practical for many people.

Several factors were considered in updating this recommendation:

  • The severity of certain symptoms for COVID-19 and flu, most prominently fever, correlates to some extent with duration of viral shedding—an indicator of contagiousness. In other words, as symptoms improve, especially fever, infectiousness tends to go down in most people.
  • Regardless of which respiratory virus is the cause, symptoms are a simple indicator for determining when to act.
  • The total number of days of precautions when sick, that is, a period of staying home and away from others plus 5 days of additional actions, covers the period during which most people are still infectious.
  • Most people do not know what virus is causing their infection, and at-home tests (antigen tests) are only widely available for COVID-19.
  • This recommendation is similar to longstanding public health practice based on symptoms for flu and other respiratory viruses.

Some people have risk factors that put them at increased risk for severe illness from respiratory viruses and the Respiratory Virus Guidance includes important considerations and protections for these populations. Examples of groups of people risk can be higher for include, but are not limited to:

  • Older adults whose immune systems tend to not work as well and are more likely to have underlying health conditions. Recommendations include vaccines that can protect older adults (additional dose of the COVID-19 vaccine, the high dose or adjuvanted flu vaccine, and the RSV vaccine for older adults) and flu and COVID-19 treatments that are recommended for all older adults.
  • Young children have immune systems that are still developing and small airways. Recommendations include maternal immunization to protect very young infants, nirsevimab to protect against RSV, and treatment considerations based on age.
  • People with weakened immune systems can have lower defenses against infections and their bodies may have a harder time building lasting protection from immunization or prior infection. Recommendations include options for receiving additional COVID-19 vaccines and guidance on which types of flu vaccines to use, as well as information about flu and COVID-19 treatments that are recommended for people with immunocompromise. Since it may take people with weakened immune systems longer to recover from respiratory viruses, this may influence choices on precautions after returning to normal activities following time at home sick.
  • People with disabilities. People with disabilities are more likely to have underlying medical conditions, live in congregate settings, or experience factors and conditions stemming from social determinants of health that increase their risk for poor outcomes from respiratory infections. Recommendations include antiviral treatments for some people with disabilities and unique considerations for working with support providers.
  • Pregnant and recently pregnant people. Pregnancy can cause changes in the immune system, heart, and lungs that make people who are pregnant or recently pregnant more likely to get very sick from respiratory viruses. Recommendations include vaccines during pregnancy to help protect the mother as well as the baby after birth, and special considerations about treatment during pregnancy.

Schools

In response to feedback from education partners, CDC has been working with education partners to develop infection prevention and control guidance for schools, which will include information on infection spread and prevention strategies across a number of pathogens that can affect school settings (e.g., norovirus, flu, strep pharyngitis). This guidance will align with the updated Respiratory Virus Guidance and other disease-specific guidance and include considerations for children with special health care needs. We anticipate this guidance being released prior to the 2024-2025 school year.

Healthcare Settings

No. CDC’s Respiratory Virus Guidance is intended for a general audience and community settings and does not apply to healthcare settings. CDC offers separate, specific guidance for healthcare settings (COVID-19, flu, and general infection prevention and control) and Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 that is not currently changing.

Correctional facilities and shelters

This guidance applies to community settings, including non-healthcare portions of correctional and detention facilities and non-healthcare portions of shelters for people experiencing homelessness. These settings continue to have high risk for transmission of respiratory viruses due to congregate living conditions, and people living in these settings often have underlying health conditions that increase their risk of severe outcomes from respiratory illnesses. Healthcare workers who provide care in these settings should refer to the and Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 that is not currently changing.

Because individuals’ personal prevention decisions are often limited during confinement, many will rely on correctional and detention facilities to provide what they need to protect themselves. It is important for facilities to make sure that the populations in their care and custody can protect themselves from respiratory viruses through the core prevention strategies listed in this guidance: providing recommended vaccinations and everyday hygiene supplies including soap and running water, cleaning frequently touched surfaces, taking steps for cleaner air in the facility, providing access to healthcare (including treatment for respiratory illness and monitoring for people at higher risk for severe outcomes), and providing spaces for people with respiratory illness to stay away from others to prevent spread (sometimes called “medical isolation”).

It is important that shelter and essential services are available for people experiencing homelessness, and that people are not turned away when they have symptoms of respiratory illness. It is also important for homeless service sites to provide access to supplies for everyday hygiene, clean frequently touched surfaces, and take steps for cleaner air in their facilities.

We do not expect an increase in COVID-19 hospitalizations and deaths as a result of this updated guidance. Instead, by focusing on core prevention strategies with the best evidence and highest impact, this updated guidance is intended to help reduce illness and death from COVID-19 and other respiratory disease threats.

COVID-19 remains a health threat, but it makes far fewer people seriously ill because our immunity is stronger with over 98% of the U.S. population now having some protective immunity against COVID-19. We also have the tools needed to fight serious illness and death caused by COVID-19. For example, effective vaccines and treatments for COVID-19 cut the risk of severe disease in half.

The updated guidance continues to focus on those who are at higher risk for severe illness and includes specific recommendations for groups at higher risk including older adults, young children, people with compromised immune systems, people with disabilities, and pregnant people.

States and countries that changed their COVID-19 isolation guidance to recommendations similar to CDC’s updated guidance did not experience clear increases in community transmission or hospitalization and death rates. Examples include the most populous Canadian provinces (Ontario, Quebec, and British Columbia), Australia, Denmark, France, and Norway, as well as California (on January 9, 2024) and Oregon (May 2023). In California and Oregon, for the week ending February 10, COVID-19 test positivity, emergency department visits, and hospitalizations were lower than the national average.

This means that a person is starting to feel better, and the body is returning to normal after an infection. Symptoms can be used as simple indicators to help people make decisions about preventative strategies, such as how long to stay home or when to return to work or school. A respiratory virus infection can have many types of symptoms, some of which can last beyond when someone is infectious, such as a lingering cough. So having a single symptom or a combination of symptoms is not as important as the overall sense of feeling better and the ability to resume activities. Fever is mentioned as a specific symptom in the guidance because people tend to be more infectious when they have a fever.

Treating COVID-19

Test-Soon-Treat-Early

If you have COVID-19 and are more likely to get very sick from COVID-19, treatments are available that can reduce your chances of being hospitalized or dying from the disease. Medications to treat COVID-19 must be prescribed by a healthcare provider and started as soon as possible after diagnosis to be effective. Contact a healthcare provider right away to determine if you are eligible for treatment, even if your symptoms are mild right now.

Don’t delay: Treatment must be started within days of when you first develop symptoms to be effective.

People who are more likely to get very sick include older adults (ages 50 years or more, with risk increasing with age), people who are unvaccinated, and people with certain medical conditions, such as chronic lung disease, heart disease, or a weakened immune system. Being vaccinated makes you much less likely to get very sick. Still, some vaccinated people, especially those ages 65 years or older or who have other risk factors for severe disease, may benefit from treatment if they get COVID-19. A healthcare provider will help decide which treatment, if any, is right for you. Check with your healthcare provider or pharmacist if you are taking other medications to make sure the COVID-19 treatments can be safely taken at the same time.

Treatments

The FDA has authorized antiviral medications to treat mild to moderate COVID-19 in people who are more likely to get very sick.

  • Antiviral treatments target specific parts of the virus to stop it from multiplying in the body, helping to prevent severe illness and death.

The National Institutes of Health (NIH) provides COVID-19 Treatment Guidelines for healthcare providers to help them work with their patients and determine the best treatment options for them. Several options are available for treating COVID-19. They include:

Treatment Who When How
Nirmatrelvir with Ritonavir (Paxlovid)
Antiviral
Adults; children ages 12 years and older Start as soon as possible; must begin within 5 days of when symptoms start Taken at home by mouth (orally)
Remdesivir (Veklury)
Antiviral
Adults and children Start as soon as possible; must begin within 7 days of when symptoms start Intravenous (IV) infusions at a healthcare facility for 3 consecutive days
Molnupiravir (Lagevrio)
Antiviral
Adults Start as soon as possible; must begin within 5 days of when symptoms start Taken at home by mouth (orally)

Some treatments might have side effects or interact with other medications you are taking. Ask a healthcare provider if medications to treat COVID-19 are right for you. If you don’t have a healthcare provider, visit a  Test to Treat location or contact your local community health center or health department.

If you are hospitalized, your healthcare provider might use other types of treatments, depending on how sick you are. These could include medications to treat the virus, reduce an overactive immune response, or treat COVID-19 complications.

Convalescent Plasma

Some people with COVID-19 who are immunocompromised or are receiving immunosuppressive treatment may benefit from a treatment called convalescent plasma. Your healthcare provider can help decide whether this treatment is right for you.

Know COVID-19 Levels in Your Area

United States COVID-19 Deaths, Emergency Department (ED) Visits, and Test Positivity by Geographic Area

COVID Data Tracker

Maps, charts, and data provided by CDC, updates weekly for the previous MMWR week (Sunday-Saturday) on Fridays by 8 pm ET†