CDC’s Updated Respiratory Virus Guidance: What to Do When You Are Sick

March 1, 2024, 3:40 PM EDT

Updates on respiratory illness and vaccine-preventable diseases.

CDC released updated Respiratory Virus Guidance in response to the decreasing risk that COVID-19 poses to the population. This updated Guidance includes strategies to protect people at highest risk of getting seriously ill and provides actionable recommendations for people with common viral respiratory illnesses, including COVID-19, flu, and RSV.

What is the updated guidance?

Protect Yourself from Getting Sick:

The most important thing you can do to protect yourself from COVID-19, flu, and RSV is to stay up to date on your recommended vaccines. Even when vaccines don’t prevent infection, they often tame these viruses, reducing severity, and preventing their worst outcomes, like hospitalization and death. Along with staying up-to-date on your vaccines, practicing good hygiene by covering your coughs and sneezes, washing or sanitizing your hands often, and cleaning frequently touched surfaces can help. Also, taking steps for cleaner air can help reduce the spread of respiratory viruses. This can mean bringing in fresh outside air by opening a window, purifying indoor air, or having outdoor social activities.

If You Get Sick:

Even if you practice these core prevention strategies, you may still catch a virus and develop respiratory symptoms. If that happens, the updated Guidance recommends two actions:

  • Step 1: Stay at home. As much as possible, you should stay home and away from others until at least 24 hours after both:
    1. Your symptoms are getting better overall, and
    2. You have not had a fever (and are not using fever-reducing medication).

This advice is similar to what has been recommended for flu for decades and will help reduce the spread of COVID-19 and other respiratory viruses during the most contagious period after infection. Not all respiratory virus infections result in a fever, so paying attention to other symptoms (cough, muscle aches, etc.) is important as you determine when you are well enough to leave home. If your symptoms are getting better, and stay better for 24 hours, you are less likely to pass your infection to others and you can start getting back to your daily routine and move on to step 2.

  • Step 2: Resume normal activities, and use added prevention strategies over the next five days, such as taking more steps for cleaner air, enhancing your hygiene practices, wearing a well-fitting mask, keeping a distance from others, and/or getting tested for respiratory viruses. People can choose to use these prevention strategies at any time. Since some people remain contagious beyond the “stay-at-home” period, taking added precautions can lower the chance of spreading respiratory viruses to others.

People who are at higher risk for severe illness who start to feel sick should seek health care right away so that they can access testing and/or treatment. Early treatment for COVID-19 or flu may prevent severe disease in people at higher risk, even if they are up to date with their vaccines.


Depending on your circumstances, here are a few examples of what updated guidance could look like if you come down with a respiratory infection:

Example 1: Person with fever and symptoms.

Example 1: Person with fever and symptoms.

Example 2: Person with fever but no other symptoms.

Example 2: Person with fever but no other symptoms.

Example 3: Person with fever and other symptoms, fever ends but other symptoms take longer to improve.

Example 3: Person with fever and other symptoms, fever ends but other symptoms take longer to improve.

Example 4: Person gets better and then gets a fever.

Example 4: Person gets better and then gets a fever.

Why was the guidance updated?

We are in a different place with COVID-19 than we were.

Weekly hospital admissions for COVID-19 have decreased by more than 75% and deaths by more than 90% compared to January 2022. Importantly, these decreases have continued through a full respiratory virus season, despite levels of viral activity similar to prior years. Almost 98% of people in the United States have antibodies against COVID-19 because of prior vaccination, infection or both. We also have effective and widely available vaccines and treatment that work, but more than 95% of people hospitalized with COVID-19 this last season were not up to date on COVID-19 vaccines and most had not received antiviral treatment.

The updated guidance change will not significantly increase COVID-19 community spread and severe disease. Real-world experience in states like Oregon and California and countries like the UK, Australia, Denmark, France, Norway, and Canada found no significant change in spread or severe disease after implementing similar guidance updates.

Clear, simple, and actionable guidance, regardless of the respiratory virus, will help protect Americans. Symptoms are an easy way to know when someone should use prevention strategies. These strategies, like staying home, can be done without a test. A CDC survey found that a majority of Americans take precautions when sick with cold or cough symptoms (such as avoiding contact with people at higher risk and avoiding large indoor gatherings) even if they don’t know what virus is causing the illness. Different guidance for different viruses makes it difficult to make a prevention plan when you don’t know what is causing your symptoms.

Keeping you healthy: CDC’s work continues

COVID-19, flu, and RSV contribute to severe illness and disruptions in our everyday lives. CDC remains committed to protecting everyone’s health, and will continue to provide information about respiratory virus activity to inform people on what actions they can take to stay healthy. This includes informing people with a range of risk factors that can increase the chance of getting very sick (severe illness). Generally, people at higher risk of severe illness from respiratory viruses are older adults, young children, people with compromised immune systems, people with disabilities, and pregnant people. CDC has included additional guidance for these populations to help protect them from severe illness.