Widespread Coronavirus 2019 (COVID-19) in Alaska – Reminders and Updated Release from Isolation Criteria
The considerable increase in COVID-19 cases throughout Alaska has delayed the ability for public health to connect individually with all cases and their close contacts in a timely manner. During times when case counts are high, it may take 3-4 days for public health staff to contact patients. Therefore, we request that health care providers do the following:
When evaluating and testing symptomatic patients for possible COVID-19, please inform them to stay at home and self-isolate until they receive their test result.
Providers ordering COVID-19 tests should ensure they have a process in place to notify patients of their test results as promptly as possible.
Providers should instruct patients who are positive that they will need to remain in isolation for at least 10 full days, in accordance with the CDC guidance for release from isolation. Some of the key changes to the updated CDC guidance are as follows:
A test-based strategy is no longer recommended to determine when to discontinue home isolation, except in certain circumstances.
Symptom-based criteria were modified as follows:
Changed from “at least 72 hours” to “at least 24 hours” have passed since last fever without the use of fever-reducing medications.
Changed from “improvement in respiratory symptoms” to “improvement in symptoms” to address expanding list of symptoms associated with COVID-19.
For patients with severe illness, duration of isolation for up to 20 days after symptom onset may be warranted. Consider consultation with infection control experts.
For persons who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of specimen collection for their first positive RT-PCR test for SARS-CoV-2 RNA.
Providers should instruct patients who test positive to inform all persons with whom they had close contact starting 2 days prior to illness onset (or 2 days prior to the date of specimen collection if they are asymptomatic) up until the time when they went into isolation.
Close contact is defined as being within 6 feet of the person for at least 15 minutes.
In most instances, this would mean that everyone in the patient’s household will need to be quarantined for 14 days beyond the time that the index patient is no longer infectious.
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