Throughout the pandemic, the guidance from the Centers for Disease Control and Prevention has been constantly evolving to reflect changing circumstances. The latest development is a reduction in quarantine and isolation periods under certain circumstances, which will allow employers to bring employees back to work sooner than before and make other adjustments to their COVID protocols.
Because there has been some conflation of the terms, we remind employers that “quarantine” applies when there has been an exposure but it is unknown if the person is infected. “Isolation” applies when an individual is infected with COVID, with or without symptoms.
Prior Rule on Quarantine. Previously, the CDC stated that those who were fully-vaccinated (meaning that they received both shots of the Moderna or Pfizer vaccine, or the single Johnson & Johnson shot) need not quarantine following close contact with a COVID-positive individual (meaning, e.g., within 6 feet for a cumulative total of at least 15 minutes over a 24-hour period, having direct physical contact like hugging or kissing, or sharing utensils), although they should undergo testing 3-5 days following such contact and wear a face-covering for 14 days, unless they undergo testing and receive a negative result. Those who were not fully vaccinated were advised to quarantine for up to 14 days following the exposure, although those individuals who remained asymptomatic could be released from quarantine after 7 days with a negative test taken at least 5 days following contact or, if permitted by local health authorities, after 10 days without a test.
New Rule on Quarantine. Under the CDC’s latest guidance, the following individuals need not quarantine following close contact with a COVID-positive individual:
- Those age 18 or older who have received all recommended doses of the COVID vaccine – including boosters. (Note that, for the J&J vaccine, a booster is recommended two months after the single primary shot).
- Those age 12-17 who have received all primary doses of the COVID vaccine.
- Those who had COVID within the past 90 days, as confirmed by a viral test.
These individuals should still wear a well-fitting mask for 10 days following the exposure. Those who had COVID need not test, while the others should test at least 5 days after exposure.
All other individuals should quarantine for 5 days. They should also mask around others and monitor for symptoms for 10 days. If symptoms develop, they should test immediately. If there are no symptoms, they should test at least 5 days after exposure, but if no test is available, they can stop quarantine while continuing to mask and monitor. The CDC states that if the person cannot quarantine, they should continue to wear a mask for 10 days.
These exposed-but-not-fully-vaccinated/boosted individuals should avoid those who are immunocompromised or high-risk for severe disease during the 10-day time period. They should also avoid travel during the 5-day quarantine period.
Although the CDC recommends a 10-day quarantine (regardless of vaccination status) for residents in high-risk congregate settings like correctional facilities, cruise ships, and homeless shelters, it recognizes that employers facing critical staffing shortages can apply a shorter quarantine period for employees. And for healthcare employers facing crisis staffing situations, there are no work restrictions at all.
Prior Rule on Isolation. Previously, the CDC advised that infected individuals with symptoms could be released from isolation after 10 days if: (1) at least 10 days had passed since the onset of symptoms; (2) they were fever-free for at least 24 hours without the use of medication; and (3) other symptoms had improved. Infected individuals without symptoms could be released from isolation after 10 days from the date of the positive test.
The New Rule on Isolation. Now, the CDC has cut the standard isolation period in half – to five days. For those with symptoms, they may stop isolation at that point as long as they have been fever-free without medications for at least 24 hours and symptoms have improved. Those without symptoms may end isolation after 5 days.
Regardless of whether there are symptoms or not, the CDC also recommends, but does not require, antigen testing at the end of the 5 day period, and remaining in isolation if the test is positive. In addition, during that post-isolation period of days 6-10, all individuals should continue to wear a mask around others for up to ten days after the first day of isolation, and should avoid those who are immunocompromised or high-risk for severe disease. They should avoid travel during this post-isolation period, but if travel is required, they should wear a well-fitting mask.
As with quarantine above, the CDC recommends a 10-day isolation period for residents in high-risk congregate settings, but recognizes that employers facing critical staffing shortages can apply a shorter isolation period for employees. And for healthcare employers facing crisis staffing situations, there are no work restrictions at all for infected employees, with prioritization of those with no or mild symptoms.
What Employers Can Do. To the extent that (non-healthcare) employers have established protocols for quarantine and isolation of employees, those protocols can be updated to mirror the revised CDC guidance. Specifically:
- Quarantine and isolation periods can be shortened to 5 days, assuming the employee meets the criteria for release. Employers could (but need not) require employees to obtain a negative test before release.
- Employees who have been fully-vaccinated but not boosted (if eligible) should now quarantine following exposure.
- On days 6-10 following release from quarantine or isolation, employees should continue to monitor for symptoms and to wear a well-fitting mask around others at all times. They should not be allowed to eat with others during this period, as that requires the removal of the mask.
- During this same post-quarantine/isolation period, employees should avoid business travel if possible, and wear a well-fitting mask if not.