CDC Updates Guidance on Discontinuation of Home Isolation

July 24, 2020

On July 17, the Centers for Disease Control and Prevention (CDC) updated its guidance on the duration of isolation and precautions for adults, noting that “accumulating evidence supports ending isolation and precautions for persons with COVID-19 using a symptom-based strategy.” The revised guidance reviews the new evidence on which the updated recommendations for duration of isolation and precautions to prevent COVID-19 are based. The updated guidance will reduce transmission, while limiting unnecessary prolonged isolation and laboratory testing resources.

The key changes in the updated guidance are summarized below and highlighted in italics:

Duration of Isolation and Precautions

  • For persons with COVID-19 illness, isolation precautions can be discontinued 10 days after symptom onset and resolution of fever for at least 24 hours (this is a change from 72 hours without fever in prior guidance) without the use of fever-reducing medications and with improvement of other symptoms. For severely ill patients, isolation and precautions may be considered up to 20 days after symptom onset after consultation with infection control experts.

Role of PCR (Polymerase Chain Reaction) Testing to Discontinue Isolation and Precautions

  • A test-based strategy to discontinue isolation or precautions is no longer recommended except to discontinue isolation or precautions earlier than would occur—as described above or for immunocompromised patients

Role of PCR Testing after Discontinuation of Isolation or Precautions

  • For persons diagnosed with symptomatic COVID-19 who remain asymptomatic after recovery, retesting is not recommended within three months of symptom onset for the initial COVID-19 infection. Additionally, for those patients, quarantine is not recommended in the event of close contact with an infected person.
  • For persons who develop new symptoms consistent with COVID-19 during the three months after the date of initial symptom onset, if an alternative etiology cannot be identified by a provider, then the person may warrant retesting; consultation with infectious disease or infection control experts is recommended. Quarantine may be considered during this evaluation based on consultation with an infection control expert, especially if symptoms develop within 14 days after close contact with an infected person.
  • For persons who never developed symptoms, the date of the first positive reverse transcription-PCR test for SARS-CoV-2 RNA should be used in place of the date of symptom onset

Role of Serological Testing

  • Serological testing should not be used to establish the presence or absence of COVID-19 infection or reinfection

GNYHA will update members on whether the New York State Department of Health will adopt the updated CDC guidance