12.4.20 – COVID-19 Quarantine Guidance Update

On December 2, 2020, the Centers for Disease Control and Prevention (CDC) issued the following new quarantine-related guidance: Options to Reduce Quarantine for Contacts of Persons with SARS-CoV-2 Infection Using Symptom Monitoring and Diagnostic Testing. In this guidance, CDC acknowledges that any quarantine period shorter than 14 days balances the reduced burden on persons in quarantine with a small possibility of increasing the spread of the virus. With that balance in mind, CDC provides two new shorter quarantine options.

Based on this new CDC guidance, the Maryland Department of Health makes the following update to quarantine recommendations:

A. For most situations, quarantine of asymptomatic persons can end either after 7 days or 10 days following the last exposure to a COVID case, depending on whether a COVID test is performed, as follows:

1. After Day 7 with a Negative Test: When diagnostic testing resources are sufficient and available, quarantine can end after Day 7:

  1. If no symptoms were reported during daily monitoring; AND
  2. if a diagnostic specimen tests negative.

Note: The specimen may be collected and tested within 48 hours before the time of planned quarantine discontinuation (e.g., in anticipation of testing delays), but quarantine cannot be discontinued earlier than after Day 7. Therefore, the specimen must be collected on or after Day 5.

2. After Day 10 Without a Test: Quarantine can end after Day 10 without testing if no symptoms have been reported during daily monitoring.

When people meet these criteria and end quarantine early, these individuals must continue symptoms monitoring and meticulous mask use through day 14. 

B. For nursing homes and assisted living facilities, given the increased consequences of unidentified COVID being transmitted within the facility, quarantine of asymptomatic newly admitted residents and asymptomatic residents in observation/quarantine units because of potential exposures to COVID can end after 10 days if a diagnostic specimen (PCR or Antigen) collected on or after Day 10, tests negative AND if no symptoms were reported during daily monitoring. If a resident in observation/quarantine does not have a negative test collected on or after Day 10, that resident should remain in observation/quarantine for the full 14-day period.

Note that this does not change the existing workplace guidance related to quarantine of healthcare workers in nursing homes and assisted living facilities (and other healthcare facilities), which is available in the document distributed on November 20 entitled “MDH Contingency Capacity Staffing Guidance”

Contact tracing workflows, including the initial script, follow up script and logic, and the quarantine excuse and release letters, are being modified to incorporate these revised quarantine guidelines. These updates are anticipated to go live late in the week of December 7, 2020 and we will keep you apprised of the timeline. In the meantime, we are developing workaround processes for releasing contacts from quarantine according to these new guidelines and will disseminate those directly to local health department contact tracing points of contact.  

MDH will continue to monitor the situation overall, the available data and guidance, and the effect of these new recommendations and will make changes to this guidance as indicated.

This information will also be distributed to Maryland hospitals, healthcare facilities and via clinician letter to Maryland healthcare providers.

For questions, please contact the Infectious Disease Epidemiology and Outbreak Response Bureau at 410-767-6700.