Barbara Sibley's four New York restaurants had already weathered the city's initial Covid-19 wave, the prevaccine surge last winter and this summer's Delta spike when last weekend it finally happened: Fearing an outbreak and struggling with staffing after one of her workers got sick with
Ms. Sibley was worried about more than that. She had to think about how long the employee should be isolated before she could return to work. Public health experts did not give a clear-cut message.
The Centers for Disease Control and Prevention recommended that most people who tested positive for the coronaviruses should stay home for 14 days. The recommended isolation period was reduced to 10 days. The policies were implemented before the availability of rapid tests because they were based on data from unvaccinated individuals. A growing number of health and policy professionals suggest that people who are vaccine-free can be released from isolation after seven days if they test negative for any diseases.
The C.D.C. reduced the number of days it recommends that health care workers who test positive for the coronaviruses isolation themselves, but it did not address other businesses.
Joseph Allen, an associate professor at the T.H. Chan School, said that it was shortsighted to not apply shorter isolation times to schools, colleges, sports, and airlines. All of them are facing the same problem of having to isolated people for extended periods without the option to return.
The C.D.C. will update the public as appropriate as it learns about the Omicron variant of the coronaviruses.
Critical workers who have been fully vaccined can return to work five days after they test positive if they have no symptoms or a high temperature for 72 hours. She said that the workers would have to wear a mask.
Omicron has intensified staffing shortages across industries, and the spike in cases has disrupted travel during the holidays, stranding thousands of customers. Some economists are warning about the impact of shutdowns on consumer spending.
Delta asked the C.D.C. to cut isolation time to five days for fully vaccined people, warning that the current 10-day period may affect operations. Airlines for America is a trade group that represents eight airlines.
The C.D.C. was told by the Association of Flight Attendants that the decision to reduce isolation times should be made by public health professionals.
Nelson said flight attendants should not have to return to work until they are healthy. She wrote a letter to the C.D.C.'s director that she didn't see the justification for reducing the number of days.
Many employers are feeling angst because of uncertainty around isolation guidelines.
It is difficult because you have to keep your family and guests safe. She wants to do what's best for her workers, even if that means asking employees who test positive to be isolated for 14 days.
If you don't want to make sure 150 people survive and pay rent, you can do 14 days.
With scientific understanding of the coronaviruses moving more quickly than public health guidelines, some business owners feel forced into playing epidemiologist.
Dr. Megan Ranney, an associate dean at the School of Public Health at Brown University, said she would not go outside recommendations if she were an employer. The C.D.C. needs to be updated if the science supports it.
The dean of Brown's School of Public Health said that requirements for longer isolation periods could discourage people from getting tested. He said that a lot of people who have mild symptoms will not test or report because it is really substantial to be out for 10 days.
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The C.D.C. has been asked by Delta Air Lines to reduce the isolation period from 10 to five days.
Diana Mora, the owner of Friends and Lovers, a bar in Brooklyn with just over a dozen employees, said trying to follow public health guidelines while keeping her business running was a constant source of worry.
She said that the bar doesn't have enough staff to tell everyone to stay home. We are stuck in a lurch if there are more than two exposed people.
The budget is a concern. Ms. Mora said that they were able to continue to pay people, but that it was getting difficult.
In industries where employees can work remotely, like technology, companies seem to feel little need to move faster than the C.D.C. Even employers that need large numbers of workers on site, like Target, Kroger and DoorDash, say they continue to follow the agency's recommendations.
The National Football League allows players who test positive to return the next day if they test negative twice. The chief medical officer of the organization said that it was unnecessary for vaccine players to sit out if they feel healthy because the Pandemic had reached a stage where it was no longer necessary.
If infections spike during the holidays, calls to reduce the isolation period could grow. Broadway shows have canceled performances. Staffing shortages caused CityMD to temporarily shut down 19 sites in New York and New Jersey. A number of New York restaurants have been temporarily closed due to positive tests.
Many companies are trying to put in policies right now because they know their employees are going to get infections in high numbers.
The United States might take a different direction. Britain said on Wednesday that it was reducing the number of days people have to stay away from each other.
The National Health Service pinged hundreds of thousands of workers after the British government lifted its restrictions on the coronaviruses. Economic growth may have slowed in July because businesses complained of being short-staffed.
New tools are on the way in the United States to help manage the Pandemic.
The FDA approved two pills to treat Covid. The treatments have been shown to stave off severe disease and have potential to reduce transmission of the virus, though supply of both pills, especially Pfizer's, will be limited in the next few months.
President Biden said on Tuesday that he would use the Defense Production Act to give away 500 million rapid antigen tests, a crucial tool in detecting transmissibility, though those tests will not be available for weeks or longer.
If a combination of the pills and rapid tests can get people back to work faster, that is a big economic point, said Dr. Eric Topol, a professor of medicine.
Some employers are proceeding with caution. The owner of an ice cream business with just over 100 employees said she had kept guidelines for isolation conservative.
She said that she was on the side of protecting people over getting them back to work. It is the slowest time of the year for an ice cream company, so that is in my favor.
If the C.D.C. shortens its guidelines on isolating, employers could try to get workers to come back before they are fully recovered.
Dr. Ranney of Brown doesn't want this to be used as an excuse to force people to come back.
Policies can be difficult to put in place. Some companies don't have a system for tracking which of their workers have gotten a vaccine, while others do. The question of whether the C.D.C. will include booster shots in its definition of fully-vaccinated adds another layer of complexity.
It is not just sick employees who may have to stay home, as companies are grappling with whether to require vaccinations for workers exposed to Covid-19, which C.D.C. guidelines do not require.
Karen Burke is an adviser at the Society for Human Resource Management.
It is almost two years into the pandemic and employers are still in that position.
Ms. Sibley said that every moment you make life or death decisions. That is not what we signed up for.
Rebecca Robbins was involved in reporting.
