The Centers for Disease Control and Prevention (CDC) issued new guidance to public health agencies on December 2 to provide options to reduce the duration of quarantine periods for asymptomatic individuals who were exposed to coronavirus (COVID-19). Although the CDC still recommends a 14-day quarantine period after exposure, the guidance offers two alternatives that public health agencies may choose to adopt: (1) individuals may stop quarantining after 10 days without testing, provided they have no symptoms, or (2) they may stop quarantining after 7 days if they test negative for COVID-19 using a diagnostic test within 48 hours before the planned end of the quarantine.
The revised guidance is a significant departure from prior CDC guidance, which provided that individuals who had been exposed to COVID-19 should quarantine for 14 days with limited exceptions. In the new guidance, the CDC explained that based on additional scientific data, they were able to analyze the chance of residual post-quarantine transmission risk and determined that under both of the shorter quarantine scenarios, the chances of post-quarantine transmission are quite low. The CDC rationalized that given the burdens an extended quarantine period can cause, a shorter quarantine period may now be permitted for asymptomatic persons.
Ultimately, the CDC guidance is just that—guidance. Employers should continue to follow state and local requirements regarding quarantine periods. But given many states’ general reliance on or specific adoption of CDC guidance for required quarantine periods, this change could have a significant impact on the workplace and permit employers to return exposed employees to in-person work in less than 14 days.
NEW CDC GUIDANCE
Specifically, the updated guidance states that the 14-day quarantine recommendation remains in effect, and further reiterates that local public health authorities are responsible for determining and establishing quarantine options for their jurisdictions. However, this guidance offers two ways for people to shorten the quarantine period:
- Quarantine can end after day 10 of quarantine without testing, provided the individual has had no symptoms during daily monitoring. (The CDC notes that the risk of residual post-quarantine transmission with this strategy is about 1% with an upper limit of about 10%.)
- If a community has adequate diagnostic testing resources, the quarantine can end after just seven days if a person tests negative for the virus at some point in the final two days of that period and has not had any symptoms throughout the quarantine. The test can be either a rapid-response antigen test, or the more reliable PCR test that takes longer to process. (The CDC estimates the risk of residual post-quarantine transmission under this strategy to be about 5% with an upper limit of about 12%.) The guidance further notes that testing for the purpose of an “earlier discontinuation of quarantine should be considered only if it will have no impact on community diagnostic testing” and that “testing of persons seeking evaluation for infection must be prioritized.”
Under either scenario, individuals can only discontinue quarantine at these time points if they meet each of the following criteria:
- The person has been asymptomatic throughout the quarantine period and has conducted daily symptom monitoring.
- The individual continues to conduct daily symptom monitoring through quarantine day 14.
- The individual is counseled regarding the need to strictly adhere to all recommended non-pharmaceutical interventions for the full 14-day quarantine period, including the importance of correct and consistent mask use, social distancing, hand and cough hygiene, avoidance of crowds, and self-monitoring of symptoms.
- If the person develops any symptoms of COVID-19, they will be required to immediately self-isolate, and the guidance directs them to contact their local public health authority or healthcare provider.
The CDC noted that while quarantine periods are important, a “14-day quarantine can impose personal burdens that may affect physical and mental health as well as cause economic hardship that may reduce compliance.” Further, the CDC acknowledged that implementing quarantines can cause additional burdens on public health systems and communities, especially during periods of rapidly rising infection rates. The CDC also explained that the prospect of a mandatory 14-day quarantine may dissuade recently diagnosed persons from naming their close contacts or may motivate potential close contacts from responding to contact tracer outreach if they perceive the length of quarantine as an onerous burden. Therefore, the CDC explained that “[r]educing the length of quarantine will reduce the burden and may increase community compliance.”
Despite providing guidance on how to reduce the quarantine period, the CDC also stated that individuals can continue to be quarantined for 14 days without testing per existing recommendations. The CDC specifically described the 14-day quarantine period as an option that “maximally reduces risk of post-quarantine transmission risk and is the strategy with the greatest collective experience at present.”
IMPACT ON EMPLOYERS
As always, CDC guidance is just guidance, and state and local requirements and recommendations are going to control in this instance. Many states and localities have their own guidance/rules regarding 14-day post-exposure quarantines, and it may take some time for these jurisdictions to change their guidance. Additionally, as the CDC clearly recommends that individuals continue to quarantine for 14 days after exposure, some local health authorities may not revise their guidance based on these new shorter quarantine options.
While employers may be eager to modify their quarantine policies to reduce the time they will require employees to quarantine after exposure, employers should ensure that making these changes is in line with the guidance from local health authorities where they operate.
Additionally, although the described risk of continued transmission is low if individuals follow the new CDC guidance, these options do not eliminate the risk of continued transmission entirely. Therefore, employers might consider keeping a 14-day quarantine policy in place where business needs do not require an individual to return to work sooner. Instead, where permitted by local guidance and operationally possible, it may be worthwhile to rely on one of these shorter quarantine requirements only for essential personnel, so long as the revised policy is applied on a consistent basis.