Beginning Monday, California will no longer require masks for COVID-19 prevention in health care settings — leaving isolation for those who test positive as the last vestige of the state’s formerly mandatory COVID rules.
California lifted its COVID-19 state of emergency in February, nearly three years after it was put in place, and President Biden indicated last week he won’t veto a Republican-led measure to immediately end the national COVID emergency, which was set to expire May 11.
But those moves, while symbolic, mostly affect funding for programs like vaccines, tests and treatments. Strict statewide mandates and lockdown restrictions that marked the earlier portion of the pandemic are long gone.
While local jurisdictions and private businesses can still require measures like masking, the state’s non-mandatory guidelines now largely focus on one remaining COVID-19 protocol: isolation.
But California’s guidance for when you can end isolation has loosened in the past month.
As it stands, California’s health department and the U.S. Centers for Disease Control and Prevention still recommend that anyone with COVID-19 symptoms, regardless of vaccination status or if they’ve had a previous infection, should self-isolate as soon as possible and take an at-home rapid test. People who test positive for the coronavirus are advised to isolate, including from others in their home, for at least five days and wear a well-fitting face mask for 10 days.
But in mid-March, California updated its guidance for what conditions need to be met to exit that isolation period.
Before, the state recommended that a person with COVID not exit isolation before 10 days unless they tested negative. California health officials have now adjusted those rules to say that people can exit isolation after five days if they are feeling well, symptoms are improving and they have been fever-free for 24 hours without the use of fever-reducing medications — a change the CDC made in December 2021.
Symptoms like loss of taste or smell, which can last months, should not keep a person from exiting isolation if all other symptoms have cleared, according to the state.
There are several caveats and exceptions within these guidelines:
• Isolation begins with the start of symptoms, or the day of the first positive test with no symptoms. That day is considered day 0, with the first day of isolation being the day after.
• If the results are negative but you still have symptoms, you should continue isolating and consider a PCR test, or keep testing at home every couple of days until your symptoms improve.
• If you must interact with people in your home or go out in public during the isolation period, the California Department of Public Health recommends that you as well as any caregivers wear a high-quality mask, keep windows open if possible and use portable air purifiers. You should also clean and disinfect high-touch surfaces regularly — at least once a day — as well as any surfaces in a shared bathroom after use.
• People need not continue masking for all 10 days if they have two negative tests taken a day apart.
Quarantine is no longer required for people who have been exposed to COVID, though both the state and the CDC recommend that people who were exposed wear a mask for 10 days — especially around those more vulnerable to serious disease — and test three to five days after exposure, even if they don’t have symptoms.
As with isolation, quarantine guidance comes with its own caveats and exceptions:
• Those who have had COVID in the past 90 days and do not have symptoms do not need to test after exposure.
• People should take extra caution after “high risk exposures” — such as contact with a partner or someone in your household where there are long periods of exposure, or unmasked activities with increased exertion or voice projection, such as indoor singing, contact sports or at indoor, crowded events.
• People who have been exposed to the coronavirus should also use extra caution around “high risk contacts,” or people who are more susceptible to serious disease or are regularly in contact with vulnerable populations. In those situations, the state recommends that people who have been exposed or who have come out of isolation before 10 days wear a high-quality mask.
Though public health experts maintain that isolation is important in preventing the spread of COVID-19, it may pose a challenge to students or people who cannot work remotely. In December, state workplace regulators took away the requirement that employers pay workers to stay home for 5-10 days, meaning that workers with COVID have to rely on regular sick pay instead.
California’s guidance for K-12 students says that students who get COVID should follow isolation guidelines, but it does not specify what that means for any missed school days.
Asked under what circumstances isolation guidelines might change again in the future, the state health department said it “continues to monitor COVID-19 data and science, as well as considers federal guidance and recommendations” when issuing its own guidance, and did not provide specific criteria for any possible future changes.
A CDC spokesperson said in an email that the agency writes recommendations based on the “best science available.” As of now, the CDC says that people are likely most infectious within the first five days of symptoms and infection.
“If findings from current or future studies suggest a change is needed, then we would begin to consider a change,” the spokesperson wrote.
The CDC does not enforce any rules or guidelines — but local jurisdictions can choose to have stricter guidance than the state or the CDC. Contra Costa and Alameda counties, for example, will continue requiring masks in skilled nursing facilities, even though the state requirement to do so will expire Monday. All Bay Area counties currently align with the state’s recommendations for isolation and quarantine.
And doctors and public health experts still recommend that people stay home when sick if they can, whether or not they have COVID.
“Get vaccinated and boosted, stay home & test if sick, wear a mask, wash your hands, and cover your cough/sneeze,” the California public health department tweeted.