The American Nurses Association (ANA) and National Nurses United (NNU) expressed concerns over the shortened return-to-work isolation and quarantine guidance for health care workers infected with or exposed to COVID-19 issued by the US Centers for Disease Control and Prevention (CDC) on December 23, 2021.

In general, health care workers who have received all recommended COVID-19 vaccine doses and a booster dose do not need to quarantine following high-risk exposures as long as they are asymptomatic and do not test positive for COVID-19, the CDC stated in the updated guidance. Health care workers infected with COVID-19 can return to work as soon as day 7 following their first positive test if they are asymptomatic and have a negative antigen or nucleic acid amplification test (NAAT) obtained within 48 hours before returning to work. The isolation time can be shortened further if there are staffing shortages.

The CDC said the new guidance is designed to provide health care facilities with the strategies to limit the effects of staff shortages caused by COVID-19 on patient care.

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National Nurses United asked the CDC to maintain previous guidelines regarding isolation in COVID-19-infected health care workers and said that no longer requiring fully vaccinated and boosted health care workers to quarantine after a high-risk exposure “ignores the basic tenets of infection control and the precautionary principle.”

“Weakening guidance on isolation is not the solution to the staffing crisis in health care settings; improving protections is,” NNU President Zenei Triunfo-Cortez, RN, wrote in a letter to CDC Director Rochelle Walensky, MD, MPH.

The ANA said it is “deeply concerned” about the shortened time for isolation in the latest CDC guidance for health care settings and cited insufficient evidence, concern for health care workers’ safety, and the potential for the shortened isolation and quarantine time to lead to an increase in COVID-19 cases.

“Nurses have endured intense stress for almost 2 years as the pandemic has persisted and evolved with the emergence of new variants. Despite exhaustion, nurses continue to provide care to patients under extremely difficult conditions,” said ANA President Ernest J. Grant, PhD, RN, FAAN. “While staffing shortages are challenging for facilities experiencing a surge in cases, we must prioritize health care workers’ and patients’ health and safety, including allowing for sufficient time off for health care employees. I urge the CDC to reconsider these guidelines and for policymakers to aggressively pursue other strategies to bolster the health care system. We support the Administration’s steps to call up more surge teams and use the Defense Production Act to increase access to testing while continuing to use every strategy to increase the number of Americans who are fully vaccinated and boosted.”   

In September 2021, ANA also urged the US Department of Health and Human Services (HHS) to declare the current and unsustainable nurse staffing shortage facing our country a national crisis.


1. ANA deeply concerned about CDC’s updated guidance, urges policymakers to prioritize health care workers’ safety as surge continues. American Nurses Association; December 28, 2021. Accessed January 5, 2021.

2. Nurses condemn CDC’s dangerous decision to weaken isolation guidance for employers. News release. National Nurses United; December 23, 2021. Accessed January 5, 2022.