CDC Updates Isolation Guidelines; COVID-positive Employees May Return to Work Sooner

Last week, in a little-noticed health advisory, the Centers for Disease Control and Prevention (CDC) updated its guidance regarding the discontinuation of home isolation for persons with COVID-19. These subtly-revised guidelines are notable for employers, as the CDC’s return-to-work guidance incorporates its recommendations on the discontinuation of home isolation. As a result, the manner and timeframe in which individual employers return their COVID-positive employees could change.

For persons known to be infected with COVID-19 and symptomatic, isolation can now be discontinued if:

• At least 10 days have passed since symptom onset;
• At least 24 hours have passed since resolution of fever without the use of fever-reducing medications; and
• Other symptoms have improved.

Under its previous version of the guidance, the CDC recommended that at least 72 hours pass since the resolution of fever without the use of fever-reducing medication, and that respiratory symptoms improve before an infected person discontinue isolation. Obviously, these revisions shorten the suggested isolation period, and maintain the importance of self-monitoring symptoms of COVID-19.

The CDC still recommends a 10-day home isolation period for persons known to be infected with COVID-19 but asymptomatic.

Testing Recommendation Also Updated

In addition to its updated symptom-based isolation recommendations, the CDC no longer generally recommends a test-based strategy for discontinuing home isolation, except for the severely immunocompromised or to discontinue isolation earlier than the time-based guidelines. Previously, one recommended way to end isolation was to have two negative diagnostic tests, from samples taken at least 24 hours apart. However, numerous studies have shown that mildly ill people are almost never infectious 10 days after symptom onset (20 days for severely ill persons). This revised testing recommendation will likely relieve the burden on the nation’s testing infrastructure, which is currently battling testing delays of up to two weeks.

For both employees and employers, the CDC’s updated isolation guidelines provide flexibility in determining how infected employees may return to the workplace. Employers can choose to return these employees in accordance with the now shortened isolation timeline, or they can still accept two negative COVID-19 tests. In some instances, producing two negative diagnostic tests could lead to the discontinuation of home isolation sooner than even the shortened timeline.

Notably, the CDC’s new guidelines do not affect the recommended 14-day quarantine period for persons exposed to a known case of COVID-19, even if they never develop symptoms or test positive. Additionally, the CDC has set forth distinct isolation guidelines for healthcare providers.

As summer progresses and the expected uptick in cases looms, employers should consider now the most efficient yet effective way to return their infected employees to work.