On Friday, July 17, the Centers for Disease Control and Prevention (CDC) updated its guidelines for people who are self-isolating with COVID-19 to prevent transmission of the virus. To limit unnecessary prolonged isolation and unnecessary use of lab tests, the latest guidelines recommend:
- The removal of the need for testing for clearance to return to work.
- Allowing most individuals with COVID-19 to be cleared to return to work after 10 days, assuming they have not had a fever for at least 24 hours and their symptoms have improved. If the person was sick enough to be hospitalized or if the person is severely immunocompromised, then this changes to 20 days.
- Not retesting persons with a positive testing result for the next 90 days after initial diagnosis unless they have new symptoms without an alternative diagnosis.
The guidelines offer an isolation approach based on symptoms, an isolation approach based on testing, and an isolation approach based on time. Except for rare situations, a test-based strategy is no longer recommended to determine when a person can return to work.
Symptom-based approach: People with COVID-19 who have symptoms may discontinue isolation 10 days after the symptoms first appeared so long as 24 hours have passed since the last fever without the use of fever-reducing medications, and if symptoms such as coughing and shortness of breath have improved.
Testing-based approach: People with COVID-19 symptoms may discontinue isolation if a fever has passed without the use of medication, if there is an improvement in symptoms, and if tests taken more than 24 hours apart come back negative.
Time-based approach (no symptoms): People without symptoms who test positive for COVID-19 may discontinue isolation at least 10 days after the date of their first positive COVID-19 diagnostic test if they have not developed symptoms since their positive test. If they develop symptoms, then the symptom-based or test-based strategy should be used. “Because symptoms cannot be used to gauge where these individuals are in the course of their illness, it is possible that the duration of viral shedding [the ability to pass the virus to someone else] could be longer or shorter than 10 days after their first positive test,” the CDC says.
The guidelines also emphasize that serologic, or antibody, testing should not be used to establish the presence or absence of COVID-19 infection or reinfection.