College of Urgent Care Medicine Recommends Review and Community Alignment Before Implementing CDC Alternatives on COVID-19 Quarantine

On Dec. 3, the CDC released “acceptable alternatives” to shorten quarantine for contacts of persons with SARS-CoV-2 infections, which led to extensive media coverage that the CDC had lowered its quarantine recommendations. This interpretation of the CDC release is incorrect and has led to confusion and potential increase in risk for patients, providers, and employers.

The Clinical Response Task Force of the College of Urgent Care Medicine closely reviewed the CDC position and has the following recommendations:

Close review of the CDC statement in order to accurately educate staff and patients: The CDC’s recommendation for quarantine has not changed and remains a 14-day quarantine period. The “acceptable alternatives” are options based on local circumstances and resources designed to improve compliance where testing resources allow for rapid result turnaround vs. in areas where testing resources are constrained or when rapid results are not readily accessible. 

The tradeoff for possible improved compliance with the “acceptable alternatives” is increased post-quarantine transmission risk. This is estimated at 1% for 10-day quarantine without testing and 4% for 7-day quarantine with a negative molecular test vs. 0.1% with the existing 14-day quarantine guideline.

Furthermore, individuals utilizing acceptable alternatives will still require daily monitoring through day 14 post-exposure and need to be counseled on all non-pharmaceutical strategies to minimize risk of transmission.

Close alignment with local government agencies and community providers: To avoid further confusion in your communities, we strongly recommend a collaborative and comprehensive approach toward “local circumstances and resources” so that all providers and public health officials in the community are using the same quarantine guidelines with patients, employers, and staff.  Resource availability balanced with test type(s), efficacies, turnaround times and overall compliance with mitigation measures must be evaluated with a goal of community-wide consensus.

This collaboration and consensus can then lead to clear, consistent communication and community education on quarantine recommendations that are more likely to be effective in combatting the spread of COVID-19.

About the College of Urgent Care Medicine

The College of Urgent Care Medicine (CUCM) is a non-profit association of physicians, physician assistants and nurse practitioners who are dedicated to advancing the practice and specialty of urgent care medicine. CUCM is a strategic affiliate of the Urgent Care Association. For more information and to become a member, visit https://www.ucaoa.org/About-UCA/Strategic-Affiliates/College-of-Urgent-Care-Medicine.

Source: Urgent Care Association