CDC updates quarantine guidance

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The Centers for Disease Control and Prevention updated its guidelines for close contacts of someone with COVID-19 to provide options to reduce the time those individuals must quarantine.

The CDC had required close contacts of a known positive case to quarantine for 14 days, but its new advice allows for those people to shorten their quarantine to seven or 10 days based on test results and symptoms. 

“Reducing the length of quarantine may make it easier for people to quarantine by reducing economic hardship if they cannot work during this time,” the CDC said when announcing the change. “In addition, a shorter quarantine period can lessen stress on the public health system, especially when new infections are rapidly rising.” 

The agency also said a shorter quarantine should reduce the chance of negative effects on individuals’ physical and mental health and may increase compliance. 

Monroe County Health Department Administrator John Wagner applauded the new guidelines, but he also downplayed their significance. 

“That will help a little bit,” he said of the changes. “It’s better. You went from 14 to 10 days.” 

Wagner also stressed, as the CDC did, that it is up to local health agencies to determine the length of quarantines. 

The Illinois Department of Public Health adopted the new guidelines, but Wagner said his office will only allow people to stop quarantining after 10 days because of logistical difficulties with having people test out of quarantine. 

Those are exacerbated by the health department’s contact tracing and vaccine preparation efforts. 

“We personally just can’t handle it,” Wagner said of letting individuals leave quarantine after a week and a negative test. 

The 14-day quarantine is based on “estimates of the upper bounds of the COVID-19 incubation period” and that somewhere between 20 to 40 percent of people who are infected with the virus are asymptomatic, per the CDC’s website. 

Quarantining close contacts reduces the risk that they might unknowingly transmit the virus to others. 

To end a quarantine after day 10, an individual would need to have had no symptoms in all those days. The CDC estimates those who meet that criterion will have a post-quarantine transmission risk of about 1-10 percent. 

“They’re not saying that there won’t be anybody who turns up positive in the last four days of a quarantine,” Wagner explained. “They’re saying the percentage of people that turn up positive in the last four days of a quarantine is low enough that the impact isn’t worthwhile.” 

Quarantine can end after just seven days if an individual has no symptoms over all those days and gets a negative polymerase chain reaction test for the virus. 

That molecular test takes longer but is considered the most accurate COVID-19 test. Individuals can take the test within 48 hours of when they plan to stop quarantining.  

The CDC estimates that post-quarantine transmission risk with this strategy is approximately 5-12 percent. 

At least currently, Wagner said it takes three or four days to get the results of a PCR test. 

In addition to the requirements outlined above, to end quarantine in seven or 10 days individuals must continue monitoring symptoms for 14 days after exposure and strictly adhere to normal public health guidelines like wearing a mask and social distancing. 

The CDC also notes that testing for the purpose of ending quarantine should only be considered if there will be no impact on diagnostic testing in the community and that quarantining for 14 days “maximally reduces” the potential spread of the virus. 

Given it is unlikely people will be able to halve their quarantine time, at least right now, Wagner said he did not think these updated measures would have a significant impact on compliance with quarantine requirements. 

“If they’re quarantined for 10 days, they’re going to quarantine for 14 days if they’re asked,” he said. “The ones that we have problems with, they’re not going to quarantine at all. It’s not like all of a sudden they decide to break quarantine at the 10-day period.

“You’re either going to get compliance or you’re not.” 

A particular area that may benefit from this change in quarantine guidance is schools, as many of the problems they face revolve around having to quarantine teachers and students who are close contacts of known COVID-19 positive individuals. 

Wagner again said this would have a relatively minimal impact on education, adding he hoped Illinois would adopt rules similar to states that have been less stringent with pandemic guidelines regarding children in schools. 

For example, Wagner cited Missouri’s rule that not every student who is a close contact with one of their classmates who tests positive for the coronavirus needs to be quarantined because of the low spread seen in schools as one he hopes Illinois implements. 

To read this week’s latest COVID article, click here.

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