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Update for Clinicians
December 2, 2020
See this update for:
Correcting Misinformation about COVID-19 Isolation and Quarantine
Criteria for release of COVID-19 cases from isolation:
Criteria for release of COVID-19 contacts from quarantine1:
1Although the Centers for Disease Control & Prevention is signaling a forthcoming reduction in the duration of quarantine for COVID-19 contacts, this has not yet been put into effect nor has it been adopted and applied in Washington State. We will notify you when that occurs, which may be soon. In the meantime, and despite what you may hear in the news, continue communicating existing quarantine guidelines to patients and families until the Health District advises otherwise.
2Household contacts should remain in quarantine through 14 days after the closure of the last isolation period in the household case(s). Such quarantines may last 24 or more days from the date of identification of the original case in the household.
Through case and contact investigation work, the Health District is becoming aware of some recurring misinformation reaching patients in clinical settings that is at odds with public health tactics and disease control directives set forth above. Lack of harmony between clinician advice and public health direction can further undermine individuals’ cooperation with and the community’s support for COVID-19 control efforts. Typical scenarios have included the following:
COVID-19 Re-infection & Re-testing
The median time in follow-up to achieve negative PCR results among PCR-confirmed COVID-19 cases is approximately 21 days. However, culturable virus is rarely if ever isolated beyond 8-10 days in experimental settings. In many cases, this shedding of incompetent viral RNA may continue for weeks or months. Detecting SARS-CoV-2 RNA >10 days beyond onset of illness does not mean that the patient is either still infectious or newly re-infected. Re-infection, while documented in the medical literature, has thus far been exceedingly rare and not of significance with respect to the overall course of the pandemic.
In summary, virtually all repeat positive SARS-CoV-2 results obtained within 90 days of the initial positive result (and even some or many collected after 90 days) are deemed unlikely to represent new infection and are unlikely be counted or managed by the Health District as a new infection. Such results also would not make an unsheltered individual eligible for admission to the Snohomish County Isolation & Quarantine Facility at the Evergreen Fairgrounds.
On a related note, recovered cases of COVID-19 who are re-exposed within 90 days of their initial diagnosis will generally not be directed to quarantine by the Health District. Conversely, when re-exposed >90 days after a prior infection, individuals will be directed to quarantine.
Washington [COVID-19] Exposure Notifications (WA Notify)