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New CDC Quarantine and Travel Recommendations

Updates to the CDC's quarantine and testing recommendations

December 2, 2020

The CDC had an unplanned media call at 11am EST today to announce some new updated recommendations. Here's what's new...

Options for Reduced Quarantine Length

CDC continues to recommend quarantining for 14 days as the best way to reduce the risk of spread. They introduced 2 new “acceptable alternative periods for quarantine”:

  1. After 10 days without test if the person has no symptoms
  2. After 7 days with a negative test result if the person has no symptoms (negative test must be in the 48 hours before the person is set to end their quarantine, and can be via PCR or rapid antigen test.

The tricky part is that they’ve also said that they are sharing these options with public health agencies so that they can individually determine how long quarantine periods should last based on their specific needs. Local jurisdictions can determine what works best for them.

We’re still in the process of evaluating how state and local health departments are responding before we make a formal recommendation for how our clients should move forward, and we’ll share that ASAP. We do expect that we'll make some updates to our exclusion chart shortly, and will continue to update this article and our app as we learn more.

Travel Testing Recommendations

CDC recommends postponing holiday travel for the winter holidays this year. For those who do choose to travel, CDC now recommends testing 1-3 days before travel and 3-5 days after travel. They also recommend reducing non-essential activities for a full 7 days (or a full 10 if not tested), and monitoring for symptoms for a full 14 days after travel.

They reminded those on the call that testing doesn't reduce all risk, but combined with reducing non-essential activities, social distancing, and wearing a mask, it can help keep folks relatively safe and healthy.

FAQs:

Why is now the best time to make these alternative recommendations? Do you fear people will hear this and think it’s not that bad?

Cases and number of contacts are rising rapidly, including number of ppl who need to quarantine. Public health authorities are responsible for helping confirm that people complete their full quarantine. If more people complete the full quarantine period, overall it will result in fewer infections. By reducing this now, it increases the likelihood that people will actually stay at home during their quarantine, and it reduces the stress on our overburdened public health systems, like contact tracers.

There's also the hope that by making quarantine shorter, more people are willing not only to adhere to it, but also to honestly share the full list of their close contacts. It may also increase willingness for people to pick up the phone when a contact tracer calls.

What's the data that backs up this recommendation? 

Dr. Brooks of the CDC said that this was based on extensive modeling. The model accepts that there is a residual risk that someone leaving quarantine early will transmit to others.

By their model, the "residual risk" for reducing quarantine to 10 days ranges from 1%-12%. For a 7 day quarantine, the residual risk with a negative test is 5%-10%.

This modeling is based on a test that must be collected within 48 hours of when the person would discontinue their quarantine.  And the risk estimates are assuming that people actually monitor symptoms during the quarantine period and for the remainder of the 14 day period. The risk may be higher if people don't properly monitor for symptoms during the full time.

Why 10 days?

Residual risk is between 1 and 12%, and the CDC was aiming for what they deemed an acceptable risk threshold. It also aligns nicely with 10 day isolation period for those sick with COVID, which can reduce confusion. We get the question all the time: "Why do I have to quarantine for 14 days when my sick friend only needs to stay in for 10 days?!" This helps reduce confusion and make it more consistent.

Are any states and local health jurisdictions indicating what they'll do? 

It's still very early, but our sources say that certain state task force including Illinois, are meeting ASAP to make recommendations and early indicators show that they are NOT necessarily going to adopt all of these, and may stick with just 10- or 14-day exclusions without introducing the option of testing out of quarantine.

Our Recommendation:

We’ve connected with many industry leaders, our contacts at major health departments across the country, and our clients over the past day to get an understanding of how local jurisdictions and industry leaders will move forward.

We have decided to move forward with the recommendation to reduce exposure-related exclusions from 14 days to 10 days. 

See our updated COVID Exclusion Chart here.

We do not recommend allowing any employees to return earlier than 10 days, even with a negative test, for a number of reasons. It doesn’t align with the most recent data around average symptom onset time, particularly given that the testing would happen on day 5 or 6 which may be before most people experience symptoms. It also doesn’t account for the increasingly long sample processing time and limited testing availability.

For questions, reach out to us through the app! We're available 7 days a week, 7am to 12am EST!