HEALTH ALERT NETWORK
HEALTH DISTRICT 3

COVID-19 ADVISORY FOR HEALTH CARE PROVIDERS

Updated CDC Guidance on COVID-19: Isolation Period Extended to 10 days for Symptom-Based Strategy to Discontinue Isolation

May 8, 2020

On May 3, 2020, the Centers for Disease Control and Prevention (CDC) changed the recommended isolation period for COVID-19 individuals (including healthcare personnel) to 10 days after illness onset when a symptom-based strategy is used.

Updated Symptom-Based Strategy for Release of Isolation (most commonly used)

Isolation should be maintained for at least 10 days after illness onset (increased from 7 days) and at least 3 days (72 hours) after recovery. Recovery is defined as resolution of fever without the use of fever-reducing medications with progressive improvement or resolution of other symptoms.

Southwest District Health Department (SWDH) asks providers to educate patients about the importance of staying home while results are pending and continuing home isolation if result is positive. A health department investigator will follow-up with COVID-19 positive patients.

Test-Based Strategy for Release of Isolation

A test-based strategy (if feasible) or a symptom-based strategy with more stringent requirements may be used for recovered individuals when there is a low tolerance for post-recovery SARS-CoV-2 shedding and infectious risk because they are:

• Individuals who could pose a risk of transmitting infection to vulnerable people at high risk of morbidity or mortality from SARS-CoV-2 infection, OR people who support critical infrastructure.
•  Normally reside in congregate living facilities (e.g., correctional/detention facilities, retirement communities, ships) where there might be increased risk of rapid spread and morbidity if spread occurs.
• Immunocompromised and may have prolonged viral shedding.

Under the test-based strategy, maintain home isolation until:

• 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 a FDA Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive upper respiratory specimens collected greater than 24 hours apart (total of two negative specimens)

Time-Based Strategy for Release of Isolation of Asymptomatic Individuals

A time-based strategy may be used for patients who had laboratory confirmation of SARS-CoV-2 and have not had any symptoms. Isolation is recommended for 10 days since the date of collection of the first positive molecular test.

Additional Resources

Symptom-Based Strategy to Discontinue Isolation for Persons with COVID-19
https://www.cdc.gov/coronavirus/2019-ncov/community/strategy-discontinue-isolation.html

Criteria for Return to Work for Healthcare Personnel with Suspected or Confirmed COVID-19 (Interim Guidance): https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html

Ending Home Isolation for Immunocompromised Persons with COVID-19
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ending-isolation.html