This past Wednesday, December 2, 2020, the CDC updated its guidance on quarantining for those who have been in contact with others with COVID-19.
The amended guidance states that the quarantine period can end after 10 days without testing if the individual has no symptoms during daily monitoring for the 10-day period. The agency hedges the recommendation, however. The CDC reiterates that it “currently recommends a quarantine period of 14 days,” but the 10-day quarantine period is acceptable if local circumstances and resources permit.
In addition, “when diagnostic testing resources are sufficient and available,” quarantine may end after the 7th day if the individual receives a negative COVID-19 test and did not experience symptoms during that period (again with daily monitoring). The test in this scenario can be collected within 48 hours prior to the 7th day — meaning an individual can be tested on day 5 in anticipation of the quarantine period ending on the 7th day.
An individual may end his or her quarantine as stated above only if:
- There is no clinical evidence of COVID-19 based on daily symptom monitoring during the entire quarantine period;
- The individual who is quarantining conducts daily symptom monitoring for 14 days; and
- Quarantining individuals “are counseled regarding the need to adhere strictly through quarantine Day 14 to all recommended non-pharmaceutical interventions.” If any symptoms develop, the individual “should immediately self-isolate and contact the local public health authority or their healthcare provider to report this change in clinical status.”
These are CDC recommendations. It remains the case that local public health officials set the quarantine options for their jurisdictions. Moreover, the CDC stands by its recommendation for a 14-day quarantine period to “maximally reduce risk of post-quarantine transmission risk.”
As a reminder, “quarantine” means the separation of “someone who might have been exposed to COVID-19 and may develop illness” from others. “Isolation” is the separation from others of an individual who has tested positive for COVID-19 or who is sick.
The rationale for the CDC’s update is to avoid disincentives to quarantining and contact tracing. The CDC explains (emphasis added):
Quarantine is intended to reduce the risk that infected persons might unknowingly transmit infection to others. It also ensures that persons who become symptomatic or are otherwise diagnosed during quarantine can be rapidly brought to care and evaluated. However, a 14-day quarantine can impose personal burdens that may affect physical and mental health as well as cause economic hardship that may reduce compliance. Implementing quarantines can also pose additional burdens on public health systems and communities, especially during periods when new infections, and consequently the number of contacts needing to quarantine, are rapidly rising. Lastly, the prospect of quarantine may dissuade recently diagnosed persons from naming contacts and may dissuade contacts from responding to contact tracer outreach if they perceive the length of quarantine as onerous.
The CDC’s update is an attempt, based on scientific evidence, to balance the burdens of quarantining and testing with the risk of a shortened quarantine period. The CDC acknowledges that the 14-day quarantine remains the more effective option to reduce risk and employers may want to consider sticking with this period for employees who may be exposed instead of the shorter quarantine option.