There are no longer any federal COVID-19 mandates in the United States. The national public health emergency ended in May 2023, and since then, COVID rules have shifted from requirements to recommendations. What remains is a set of CDC guidelines for when to stay home, when to test, who should get vaccinated, and who qualifies for treatment. Here’s where things stand.
When to Stay Home if You’re Sick
The CDC simplified its isolation guidance in March 2024, aligning COVID with other respiratory viruses like the flu and RSV. You no longer need to isolate for a fixed five or ten days. Instead, you can return to normal activities when two conditions are met: your symptoms have been improving overall for at least 24 hours, and any fever you had has been gone for at least 24 hours without using fever-reducing medication like ibuprofen or acetaminophen.
After you return to your regular routine, the CDC still recommends taking precautions for the next five days. That means wearing a mask around others, keeping your distance when possible, improving ventilation indoors, and washing your hands frequently. This applies to everyone regardless of age or vaccination status.
Masking Is Recommended, Not Required
There are no federal mask mandates anywhere in the U.S. Most states have dropped their requirements as well. Even in healthcare settings, hospitals and clinics now set their own masking policies rather than following a blanket rule. California, for example, replaced its mandatory healthcare masking requirement in April 2023 with recommendations tied to local transmission levels.
High-risk settings like hospitals, long-term care facilities, homeless shelters, and correctional facilities are encouraged to develop their own plans based on their patient population and community conditions. In practice, this means you may still be asked to wear a mask when visiting a hospital or nursing home, especially during a winter surge, but the decision rests with the individual facility. If you’re immunocompromised or visiting someone who is, wearing a high-quality mask in crowded indoor spaces remains one of the most effective precautions available.
Testing: What’s Available and When to Use It
Rapid antigen tests are still the most accessible way to check for COVID at home. They produce results in 15 to 30 minutes, and a positive result is reliable. A negative result, however, is less definitive. A single rapid test can miss an active infection, particularly if you don’t have symptoms yet.
The FDA recommends repeating the test if your first result is negative. If you have symptoms, two negative tests taken 48 hours apart give you reasonable confidence you’re not infected. If you were exposed but feel fine, you need three negative tests spaced 48 hours apart before ruling out infection. A lab-based PCR test (sometimes called a NAAT) is more sensitive and can confirm a negative rapid test result with a single sample.
The federal government has periodically offered free at-home test kits through COVIDTests.gov, where households can order up to four kits shipped free by the U.S. Postal Service. No payment or financial information is required. Check that site to see if the program is currently accepting orders. Be cautious of any website or message asking for payment or promising extra tests, as those are scams.
Who Should Get Vaccinated
The CDC recommends that everyone six months and older receive the current season’s updated COVID vaccine. The 2024-2025 formula targets the most recent circulating variants, similar to how the flu shot is reformulated each year.
For most people, a single dose of the updated vaccine is sufficient. Two groups are advised to get a second dose six months after their first: adults 65 and older and people who are moderately or severely immunocompromised. Those with weakened immune systems can also discuss additional doses beyond the second with their healthcare provider. The emphasis from the CDC is strongest for older adults and immunocompromised individuals, who face the highest risk of severe outcomes.
Antiviral Treatment Eligibility
Prescription antiviral treatment for COVID is available for people who test positive and are at higher risk of becoming seriously ill. To qualify, you generally need to be 18 or older (or at least 12 and weighing at least 88 pounds), have mild to moderate symptoms that don’t require hospitalization, and have one or more risk factors for severe disease. Those risk factors include conditions like obesity, diabetes, chronic lung or heart disease, and immune suppression.
Timing matters. Antivirals work best when started within the first five days of symptoms. If you test positive and fall into a higher-risk category, contact a healthcare provider promptly rather than waiting to see if symptoms worsen. Treatment is a short oral course taken at home, not something that requires a hospital visit.
Long COVID Recognition
Long COVID is now formally defined as a chronic condition that develops after a COVID infection and persists for at least three months. Symptoms vary widely and can include fatigue, brain fog, shortness of breath, heart palpitations, and joint pain, among others. It can occur after any severity of initial infection, including mild cases.
There is no single test that diagnoses long COVID. The diagnosis is based on a pattern of symptoms that started after infection and can’t be explained by another condition. If you’re experiencing persistent symptoms months after having COVID, a primary care provider can help coordinate evaluation and management, which often involves addressing individual symptoms like fatigue, sleep disruption, or exercise intolerance rather than a single targeted treatment.