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Experts are worried if people are asymptomatic they could still spread the virus. Getty Images
  • The new guidance from the CDC has sparked a fiery debate among health experts.
  • The guidance will allow asymptomatic people who’ve been exposed to the virus to go back to work as long they take certain steps.
  • Some experts say the guidance could mean triggering a second wave of COVID-19.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date.

The Centers for Disease Control and Prevention (CDC) has eased some of the physical distancing guidelines for people who’ve been exposed to the new coronavirus, SARS-CoV-2.

The guidance, which updated Wednesday, will allow asymptomatic people who’ve been exposed to the virus to go back to work as long they take their temperature twice a day, practice physical distancing, and wear a face mask.

The new guidance has sparked a fiery debate among health experts.

Some think letting people exposed to the new coronavirus get back to essential work is crucial to keep certain essential businesses and hospitals in motion.

Others believe doing so will open the floodgates and trigger a second wave of COVID-19.

In certain states, like California, new reported cases of COVID-19 are starting to drop, which shows strict measures work and do help flatten the curve.

The concern among healthcare professionals is that lifting these protective guidelines before we’ve really got a handle on COVID-19 could reverse what’s already been achieved.

“I think what people are worried about is if we relax these measures too soon, we may be inviting a second wave, kind of what was seen in the 1918–1919 pandemic flu shortly after World War I,” Dr. Dean Winslow, an infectious disease specialist at Stanford Health Care, told Healthline.

Many healthcare workers are worried about what would happen if people who are contagious but don’t know they’re carrying the virus went back to work.

“I am concerned about a loosening of restrictions contributing to an increase in cases, especially as we are beginning to see a slowing in COVID-related admissions, intubations, and ICU level treatment this week, despite the number of fatalities increasing,” said Dr. Sanjey Gupta, the chairperson of the emergency department at Southside Hospital in Bay Shore, New York.

Gupta, who’s in the epicenter of the pandemic in New York, says it’s been estimated that about 25 percent of people who have an infection are asymptomatic. Other reports show that figure may be even higher, nearing 50 percent.

A study from Singapore found that presymptomatic patients, or those who’ve contracted the virus but hadn’t yet experienced symptoms, accounted for about 6 percent of locally acquired cases.

According to Winslow, it’s a big concern that presymptomatic people with an infection can shed the new coronavirus for around 2 to 3 days before they develop respiratory symptoms, or may even realize they have COVID-19.

Winslow says that’s the main reason why the CDC advised people to wear face masks, at least when they’re out in public and unable to maintain the 6 feet (2 meters) distance between others.

“It’s not for their protection. It’s actually for the protection of other people in case the person wearing the mask is shedding virus,” Winslow said.

The best way to limit the accidental spread of COVID-19, as of right now, is to self-isolate and monitor for symptoms for at least 14 days if you’ve been exposed to someone with COVID-19, says Gupta.

Face masks, while effective to a degree, aren’t foolproof. There’s still a chance you could contract or spread the virus while wearing one, especially if it’s homemade.

“It is not advisable for people who have been exposed to the virus and symptom-free to go back into public due to the potential of asymptomatic or presymptomatic spread, especially since the length of time for the onset of symptoms is so variable,” Gupta said.

On the other side of the argument, Dr. Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins University Center for Health Security, says he thinks loosening the guidelines and letting essential workers, particularly healthcare workers, get back to work would actually be a good thing and “allow hospitals to function” during the pandemic.

“I’m not concerned. This is something I’ve been advocating for, for a long time,” Adalja said.

According to Adalja, the home exposure orders for healthcare workers who’ve been exposed to people with COVID-19 are currently so cumbersome “they could actually paralyze a hospital because they end up with many of their workers being at home and they can’t take care of patients.”

He says there are ways for people exposed to the virus, whether they work in a healthcare setting or another profession, to get back to work safely. Workers should wear a protective face mask and self-monitor for symptoms.

“If asymptomatic transmission is occurring from those individuals, a face mask would be something that would be used to counter that possibility,” Adalja said.

One thing is clear: There are a lot of unknowns about asymptomatic transmission.

“I don’t think really any of us have a real clear picture on a crystal ball at this point to know exactly what the right thing to do is,” Winslow said.

With any type of decision, Winslow says you have to weigh the risks against the benefits.

Typically, it’s easier to make that call with something we’ve encountered before, but what we’re going through is completely unprecedented. Infectious disease experts must learn about the new coronavirus’ pathology and call the shots in real time.

Adalja says we don’t know just how contagious asymptomatic people are.

The data’s not there, he says, and he doesn’t think asymptomatic spreading is the main way the virus is getting around.

Adalja suspects asymptomatic spreading does occur, but more so in special circumstances, like “when people are singing or when they’re in intimate contact with people for more than 10 minutes,” not so much at the grocery store or other everyday encounters.

Given the lack of evidence, many others say it’s better to play it safe and stay at home since the risk of asymptomatic transmission looks substantial.

More research is needed before it’s clear what the best protocol is.

“We’ll have more answers as our knowledge of the biology and epidemiology of the virus continues to improve,” Winslow said.

The CDC eased some of the physical distancing guidelines for people who’ve been exposed to the new coronavirus, SARS-CoV-2.

The new guidance will allow asymptomatic people who’ve been exposed to the virus to go back to work as long they take their temperature twice a day and wear a face mask.

Health experts are divided on the guidance, but most seem to think that strict measures are necessary to blunt the spread of COVID-19.