Is quarantine still recommended for Coronavirus disease 2019 (COVID-19)?

From the Guidelines

Quarantine is still recommended for individuals with close contact to someone with suspected or confirmed SARS-CoV-2 infection, with a recommended duration of 14 days after last contact, or potentially shortened to 10 days or 7 days with diagnostic testing, as per the Centers for Disease Control and Prevention guidance. According to the national psoriasis foundation covid-19 task force guidance 1, patients with psoriatic disease who become infected with SARS-CoV-2 should follow Centers for Disease Control and Prevention guidance on home isolation.

Key points to consider:

• The decision to quarantine should be based on individual risk assessment and local public health authority guidance 1.
• Individuals who have had COVID-19 within the past 3 months do not need to quarantine after close contact with someone who is infected, as long as they do not develop symptoms again 1.
• The use of treatments such as remdesivir, hydroxychloroquine, and convalescent plasma should be individualized and guided by the latest evidence, with restricted use to clinical trials for hydroxychloroquine and convalescent plasma 1.

It is essential to note that public health guidance may vary by location, and individuals should check local guidelines for specific requirements. Additionally, vulnerable individuals should take extra precautions when exposed to someone with COVID-19. The guidance provided by the Centers for Disease Control and Prevention 1 should be followed, and healthcare providers should be consulted for individualized advice on quarantine and treatment.

From the Research

Quarantine Recommendations for COVID-19

• Quarantine is still considered an effective solution in controlling the spread of COVID-19, especially in the early stages of an epidemic 2.
• The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recommend quarantine as a significant guideline to prevent the disease 2.
• However, the duration of quarantine is a topic of discussion, with some studies suggesting that a 14-day quarantine may not be sufficient for all individuals, especially those with uncommon infections such as presymptomatic, asymptomatic, and recurrent test positive patients 3.
• A study found that 34.1% of uncommon infections developed symptoms or were identified beyond 14 days, suggesting that a longer quarantine duration may be necessary for high-risk scenarios and in regions with insufficient test resources 3.
• Another study suggested that testing contacts to avert onward transmission and to replace or reduce the length of quarantine for uninfected contacts could be an effective strategy 4.
• The study found that self-isolation on symptom onset alone can prevent 37% of onward transmission potential from secondary cases, while 14 days of post-exposure quarantine reduces transmission by 59% 4.
• Quarantine in combination with other public health measures, such as school closures, travel restrictions, and social distancing, may have a larger effect on reducing new cases, transmissions, and deaths than measures without quarantine or no interventions 5.
• However, compliance with quarantine requirements is a concern, with one study finding that nearly half of patients did not quarantine for the entire period, often due to the need to buy groceries or go to work 6.

Factors Affecting Quarantine Effectiveness

• Early implementation of quarantine and combining quarantine with other public health measures is important to ensure effectiveness 5.
• The level of adherence to quarantine and self-isolation can impact the effectiveness of these measures, with moderate levels of adherence assumed in some studies 4.
• The use of testing, such as PCR or lateral flow antigen tests, can help to identify individuals who are no longer infectious and can be released from quarantine earlier 4.
• The duration of quarantine and the type of testing used can impact the effectiveness of quarantine in preventing onward transmission 3, 4.