When Is It Safe to Clear COVID-19 Positive Patients Who Are Isolated and Being Treated at Home?

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CDC Updates Guidelines for Discontinuing Isolation in Persons with COVID-19

Symptom based strategy: For persons recovered from COVID-19 illness, CDC recommends that isolation be maintained for at least 10 days after illness onset and at least 3 days (72 hours) after recovery. Illness onset is defined as the date symptoms begin. Recovery is defined as resolution of fever without the use of fever-reducing medications with progressive improvement or resolution of other symptoms. Ideally, isolation should be maintained for this full period to the extent that it is practicable under rapidly changing circumstances.

While this strategy can apply to most recovered persons, either a test-based strategy (if feasible) or a symptom-based strategy with more stringent requirements may be used for recovered persons for whom there is low tolerance for post-recovery SARS-CoV-2 shedding and infectious risk because they are:

  1. Persons who could pose a risk of transmitting infection to
    1. Vulnerable individuals at high risk for morbidity or mortality from SARS-CoV-2 infection, or
    2. Persons who support critical infrastructure
  2. Persons normally residing in congregate living facilities (e.g., correctional/detention facilities, retirement communities, ships) where there might be increased risk of rapid spread and morbidity or mortality if spread were to occur.
  3. Persons who because they are immunocompromised[1] may have prolonged viral shedding.Test-based strategy (simplified from initial protocol) Previous recommendations for a test-based strategy remain applicable; however, a test-based strategy is contingent on the availability of ample testing supplies and laboratory capacity as well as convenient access to testing. For jurisdictions that choose to use a test-based strategy, the recommended protocol has been simplified so that only one swab is needed at every sampling.

Test Based Strategy

  • Resolution of fever without the use of fever-reducing medications and
  • Improvement in respiratory symptoms (e.g., cough, shortness of breath) and
  • Negative results of an FDA Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart** (total of two negative specimens).
  • See CDC post here.

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