California Ends COVID Isolation Rule for Asymptomatic Cases as Winter Infections Climb

Students in Theresa Griffin’s sixth-grade class at Stege Elementary School in Richmond on Feb. 6, 2023. (Photo by Shelby Knowles for CalMatters)

By Kristen Hwang and Carolyn Jones, Calmatters

Californians infected with COVID-19 may go about their lives without isolating or testing negative as long as their symptoms are improving, according to new and significantly loosened guidelines from the California Department of Public Health.

California’s top public health official, Dr. Tomás Aragón, last week quietly rescinded the state’s previous order, which encouraged people infected with COVID-19 to isolate for five days.

The new health order allows Californians with COVID-19 to return to work or school as long as their symptoms are improving and they are fever-free for 24 hours without medication. Asymptomatic individuals who test positive are not considered infectious and do not need to isolate, according to the order.

“Instead of staying home for a minimum of five days, individuals may return to work or school when they start to feel better,” state public health officials said in an unsigned statement.

The guidelines came down as California tipped over the edge of a major respiratory illness surge fueled by COVID-19, seasonal influenza and respiratory syncytial virus, also known as RSV. Flu and COVID-19 hospitalizations both peaked during the first week of January and have been trending downward since, according to state data.

Masking requirements have not changed, and people with COVID-19 should wear masks for 10 days whether or not they have symptoms. The new guidelines do not apply to employees at high-risk health care settings like hospitals and nursing homes, which may also have different policies for visitors.

It is unclear whether employers can require workers to return to work if they wish to isolate until they test negative. Cal/OSHA, the agency that enforces state workplace safety laws, did not respond to a request for clarification on the rule by deadline.

Some experts say the new guidelines represent a major shift in California’s COVID-19 strategy, but they are not necessarily an unexpected change.

“I think it’s reasonable, mainly for the amount of population immunity that we have including in kids, and for the fact that we have a menu of options to prevent and treat COVID,” said Dr. Peter Chin-Hong, an infectious disease expert with UCSF Health. “It does come with responsibility…we still have to wear masks and be cautious around people who are older or immunocompromised.”

A national study from the Centers for Disease Control and Prevention in June estimated about 96% of people 16 and older had acquired COVID-19 immunity either through vaccination, previous infection or both. State data shows that while relatively few Californians are fully vaccinated with updated boosters — only about 12% — at least 82.5% of the population has gotten at least one COVID-19 shot.

The state’s move also signals a shift toward treating COVID-19 like all other endemic respiratory infections.

“Many people may be infected with COVID-19 or other respiratory infections and do not test or know what infection they may have. Updating our public health approach and recommendations incorporates our recommendations into a broader, multi-pronged approach to multiple respiratory viruses,” department officials said in a statement.

Dr. Noha Aboelata, chief executive of Roots Community Health Center in Oakland, is one of many community doctors who have expressed disappointment in the state’s new direction. COVID-19 does not necessarily behave like other respiratory viruses — hospitalizations and deaths have never dropped to zero the way flu does outside of the winter months — and it is still unpredictable, Aboelata said.

“We still believe that if there’s enough to detect (on a test), there’s enough to infect,” Aboelata said. “So I would recommend people test negative before going around others.”

California schools adjust to new COVID-19 rules

The state’s new strategy also seeks to minimize disruptions in school where long periods of quarantine and virtual instruction adversely impacted student learning and led to widespread mental health challenges for young people.

Some California school districts adopted the new guidelines immediately, while others said they were waiting for direction from their local public health agencies.

Oakland Unified was among those that notified parents of its new policy not long after the state released the guidelines. In an email to families, the district said students and staff can come to school if they test positive for COVID-19, as long as they’re asymptomatic, wear masks and avoid people who are at high risk of sickness, such as those who are immunocompromised.

In line with the state guidelines, those with COVID-19 symptoms should stay home but can return to school once the symptoms improve. The district said it will continue to stock masks and COVID-19 tests and keep air purifiers in classrooms.

“This changes nothing for most parents. We could have had these guidelines two years ago and the result would be the same. … we all know kids belong in school.

Scott Davison, parent in Carlsbad Unified school district

Los Angeles Unified, the largest school district in the state, said it was waiting for direction from the county public health agency. In a note to families, Fresno Unified recommended that students and staff who test positive for COVID-19 stay home, regardless of their symptoms.

The mixed response mirrored schools’ earlier reactions to COVID-19 in 2020. While most districts closed in March that year, some started bringing back special education students as soon as late spring while others — mainly larger districts — didn’t reopen for in-person instruction until fall 2021.

Teachers and parents on board with COVID rules

For many districts, re-opening decisions hinged on negotiations with teacher unions. This week, California’s largest teacher union was generally supportive of the state’s update to COVID-19 guidelines, saying that schools have adopted enough safety measures to keep staff, students and families safe.

“We’re always concerned about individuals who are high-risk, and we’ll continue monitoring the situation and re-open (contracts) if necessary,” said Rachel Warino, a spokesman for the California Teachers Association. “But we’re confident that negotiations that happened at the height of the pandemic — over air filtration, testing, masks, reasonable accommodations — will be sufficient for now.”

Some parents were relieved at the new guidelines because they encourage students to be in school. Thousands of students statewide are still struggling to catch up academically after remote learning, and many suffered mental health challenges during quarantine.

Scott Davison, who’s part of a parent group in Carlsbad Unified near San Diego, said parents have been sending asymptomatic students to school for a year or more, regardless of state or local guidelines.

“This changes nothing for most parents,” Davison said. “We could have had these guidelines two years ago and the result would be the same. … we all know kids belong in school.”

Concern for vulnerable Californians

Disability and equity advocates are particularly critical of the new guidelines. They contend the change could increase risk of infection for vulnerable Californians.

“This policy is not based in science, equity or public health. It devalues the lives of immunocompromised and disabled people, and completely ignores the risk of long COVID,” said Lisa McCorkell, co-founder of the Patient-Led Research Collaborative, which studies the impacts of long COVID.

There is no treatment for long COVID, which can leave some patients debilitated for years, and increased transmission will disproportionately harm poor communities, McCorkell said.

California officials have made other significant changes to the state’s COVID-19 response strategy in recent months, including returning the majority of the state’s Paxlovid stockpile to the federal government in December, effectively ending California’s free antiviral program.

The free COVID-19 hotline where residents could get Paxlovid prescriptions and vaccine appointments will also shut down at the end of February, state public health officials told CalMatters in a statement. The state has spent $2.3 million on the hotline since July 2022.

These changes, too, are worrisome for equity advocates.

“Not everybody has a primary care doctor. If you don’t have a primary care provider or good access to a primary care provider that’s knowledgeable about treating, then you’re going to have a difficult time accessing it,” Aboelata said.

State-regulated health insurance plans are required to permanently cover in-network COVID-19 testing, vaccination and treatment free of charge, although about 6 million Californians are enrolled in federally regulated plans that are only required to cover vaccines. You can ask your employer what kind of coverage you have.


Written by CalMatters is a nonprofit, nonpartisan media venture explaining California policies and politics. (Articles are published in partnership with

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  1. So, treat it like a cold…? Like it should have been from the beginning?
    Finally, people who are compromised should take precautions. I am part of that group, have taken every precaution, and still get Covid at least once a year. Maybe Fauci prevented me from it being worse OR maybe it’s the reason for my enlarged heart. Either way, I still get boosters. Yes, I only have a bachelor’s. Maybe that’s the problem? Too sheepy to disregard people who are supposed to know more than me. Crazy how most people haven’t gotten boosters, but immunity is rampant. I guess natural immunity is a thing now.

  2. Sounds right OG. Only a small fraction of our population is truly immune-compromised, medically. If you are, yes, wear the mask if you’re concerned. Or avoid crowded places, etc.
    For everyone else this is treated like a cold. Nothing else. There will be plenty more. Coronaviruses, etc. heading our way every year, as they have been forever, so no panic.

    • Basic- Exactly. Take care of your own shit if you need to. Everyone else, don’t spread your cold. BTW my opinion is not based on the media or political party. It’s based on engaged discussions with A LOT of physicians in person, during care. I’m 100% concerned about my health and I’m responsible for figuring it out. Just like everyone else should.

    • “For everyone else this is treated like a cold. Nothing else. There will be plenty more. Coronaviruses, etc. heading our way every year, as they have been forever, so no panic.”

      No physician would make these appallingly ignorant claims. 4 out of 5 colds are caused by coronaviruses, but these are not the SARS-CoV-2 virus, which has far worse symptoms and far greater mortality.

  3. Let’s see – when exercising critical thinking skills on this subject, should I give greater weight to

    a) Overwhelming numbers of professionals throughout the world who deal with infectious diseases, backed by the world’s history of disease progression and eradication, as amply documented over centuries.

    b) A small number of disturbed internet loons, loud but incoherent.

    It’s a tough decision, I’ll admit. And there’s not a bit of politics involved.
    Willful ignorance, as displayed in these anti-vax screeds, is a sad symptom of the post-fact society inhabited by people with no critical thinking skills.

  4. Big pharma has donated to the majority of D.C and State politicians campaigns. 82% in California.
    WASHINGTON — State lawmakers in Oregon have tried to lower high drug prices from nearly every angle: They’ve sought to cap how much people can pay for insulin, install a panel that could determine how much state agencies should pay for medicines, and even import drugs in bulk from Canada. Nearly every proposal has failed.

    One reason, at least according to the effort’s supporters: Two-thirds of the state legislature accepted at least one campaign check from the drug industry during the 2020 election cycle. The trade group PhRMA, alone, wrote checks to 43 of the legislature’s 90 lawmakers.

    It was even more dramatic in Louisiana, where 84% of lawmakers accepted funding from pharmaceutical companies. In California, it was 82%, and in Illinois, 76% of legislators cashed a check.

    “It’s gross,” said Rachel Prusak, a Democratic state representative in Oregon who has introduced a number of drug pricing bills. “I’m sure it influences other people that take a lot of money. That’s why we can’t get bills passed.”

    The same dynamic has played out in nearly every state across the country. In the last two years, at least 2,467 state legislators — over one-third of all state lawmakers nationwide — used pharmaceutical industry cash to fund their campaigns, according to a new STAT analysis of campaign finance records that spans the full 2020 election cycle. The industry wrote over 10,000 individual checks totaling more than $9 million.

    STAT’s findings provide an unprecedented look at drug industry influence in state capitols across the 2020 election cycle. The dataset includes the largest 23 U.S. drug manufacturers by revenue plus the trade groups PhRMA and BIO. It builds upon a previous analysis that STAT published prior to the election, and now includes complete data from nearly every state, including all contributions made through Dec. 31, 2020.

  5. Take it easy Dalgorf. You sound pretty wound up. I know you can’t believe I’m a doctor, but that’s fine. Here’s what showed up today from the state. They’re finally realizing some things others knew all along. But hey, keep ranting.

    “California Ends COVID Isolation Rule for Asymptomatic Cases as Winter Infections Climb”
    – Noozhawk.

    Timely, isn’t it?

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