As More Data Come to Light, Recommendations Concerning COVID Patient Isolation Get Murkier

Per the latest recommendations from the Centers for Disease Control and Prevention, people who’ve experienced symptomatic SARS-CoV-2 infection can stop isolating after 5 days, provided that they’ve been fever-free for 24 hours without taking fever-reducing medication and their symptoms have improved. People who’ve tested positive but experienced no symptoms can stop isolating after day 5 without conditions. New data just published by JAMA Network Open lean in the other direction, however. In a small (N=40) cohort study at Mass General Brigham, researchers discovered that 75% of subjects continued to have positive rapid antigen tests on day 6 after either diagnosis or symptoms onset, whichever came first. Further, 35% had culturable virus on day 6. Assuming the premise that culturable virus is the most reliable predictor for transmissibility, the data suggest that the 5-day recommendation may not be sufficient to prevent spread for a substantial proportion of patients with COVID-19. The researchers stopped short of recommending a blanket increase in quarantine length, however, in favor of strongly recommending mask-wearing and avoiding “high-risk transmission venues” through day 10 for COVID patients.