CDC Updates Quarantine Guidance: What Does This Mean to Your Business?

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Q. I see that the CDC is updating its quarantine guidance. Does TAG recommend that I change my business practices around this?

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A. In the past, the CDC had recommended a full 14 days of quarantine for people who have been in close contact with someone who has COVID-19. Its recently updated recommendation, however, includes two additional options for shortening the length of quarantine. Based on local availability of viral testing, people without symptoms quarantine can end on day 10 without testing or on day 7 after receiving a negative test result.

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While CDC has provided these options, recognizing that a shorter period may increase the number of people actually quarantining, and “make it easier for people to quarantine by reducing economic hardship if they cannot work during this time,” the Center continues to endorse the 14-day quarantine as the best option.  The CDC also has left implementation of these guidelines to state and local health authorities, so implementation will vary nationally. 

Because there is a low incremental risk reduction in post-quarantine transmission between Day 10 and Day 14, TAG is generally in agreement with the CDC guidance. We advise that businesses make an operational assessment before changing to its COVID practices.  If you determine that the new options are a fit, TAG has a few additional recommendations:

• TAG recommends the test be taken as close to day 7 as possible, preferably on day 7. 

• If using the testing option, be sure the employee receives a PCR test, not an antigen test, as the reliability of a single antigen test in asymptomatic people is not well understood.

• Watch for symptoms until 14 days after exposure.

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Additionally, if either option is selected, upon return from quarantine, the employee is to:

• Immediately self-isolate and contact their healthcare provider if symptoms arise.

• Follow the standard protective practices (e.g., wear a mask, stay 6 feet from others, wash hands, avoid crowds, etc.).

• While not new to this guidance, it’s important to ensure your employees understand that if a household member Is positive, that the “clock” for quarantining does not start until the positive household member has completed their isolation period (currently 10 days after symptom onset or a positive test).

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In Case You Missed It:

• In Monday’s Recommendations for Industry, we discussed the current COVID-19 pandemic’s third wave. Will recent lessons learned bring about new quarantine or isolation scenarios?

• In Wednesday’s Recommendations for Industry, we discuss this week’s 50-State Risk Matrix. This week, things seem to be getting better with the general trend going down. But this may be due to increased stringency or lack of testing over the holiday. The next 10 days will be very telling on what post-Thanksgiving trends will be like.

• A systematic review and meta-analysis in The Lancet found that researchers could not detect live virus beyond day 9 of illness, even with persistently high viral loads. In fact, SARS-CoV-2 viral load in the upper respiratory tract appeared to peak in the first week of illness.  This new analysis may cause the US CDC to consider shortening isolation guidelines in coming weeks.

• On Tuesday, an independent panel that advises the CDC recommended that “residents and employees of nursing homes and similar facilities” be among the first in the U.S. to receive the COVID-19 vaccine (NYT). Additionally, health care workers and those especially at-risk of exposure are on that list, too. As CIDRAP reports, there won’t be enough vaccine doses to cover everyone in the first set of vaccinations.

• Last Wednesday, we discussed a few of the vaccines that hold promise to protect us against COVID-19.

• Recent CDC studies have found that fewer than 10% of Americans had contracted COVID-19 through September. While there were some wide variances, another CDC study found increasing declines in antibody levels post-infection that may negatively represent the number of previously infected individuals. CIDRAP summarizes these findings here.

• A recent article provides five recommendations as guideposts to ensure that policies and practices at the federal, state, local, and tribal levels support equity, transparency, accountability, availability, and access to upcoming COVID-19 vaccines

• In California, the Cal/OSHA Standards Board has proposed a COVID-19-related emergency standard that may take effect soon. Some of the requirements include a written COVID-19 prevention program; notifying potential COVID-19 close-contact exposures within one (1) business day; ensuring physical distancing measures; requiring employers to provide face coverings and ensure their wearing; new return-to-work guidelines; and new testing requirements especially for businesses with multiple outbreaks within their business. Read a summary here.

• The FDA published a comprehensive new page with answers to frequently asked questions about face masks, surgical masks, and respirators.

• The University of Massachusetts Amherst’s Reich Lab has put together a COVID-19 Forecasting Hub that, based on the current data, can provide a predictive model of how future cases of COVID-19 may turn in your area. TAG has reached similar conclusions and predictive thoughts. 

• The “COVID-19 Symptoms Comparison Chart” is now downloadable at our COVID-19 Resources page.