Quarantine and Isolation Timing in Long-Term Care

Posted on November 25, 2020 by Kari Everson

There have been many questions regarding quarantine periods in long-term care communities over the past several weeks. In order to clarify, here is information about the quarantine period for staff in various circumstances:

1) A HCW tests positive for COVID-19 and has symptoms. The 10-day isolation period begins on the day symptoms appear. This is Day 0 and the HCW can return to work, at a minimum, on Day 11.

2) A HCW is asymptomatic and tests positive for COVID-19. The 10-day isolation period begins on the date of specimen collection. The date of specimen collection is Day 0 and the HCW can return to work, at a minimum, on Day 11.

3) A HCW with symptoms that tests negative for COVID-19. They should follow the following guidance. Potentially, they may not have to stay home the full 10 days if they have a negative COVID test: 

• If the persistent symptoms are consistent with an established chronic health condition, the HCW may return to work after consultation with their manager and occupational health department. Evaluation of acute symptoms by the HCW’s health care provider might also be indicated. 
• If persistent symptoms are not consistent with a known chronic health condition, the HCW should be evaluated by a health care provider. If the health care provider provides an alternate diagnosis, criteria for return to work should be based on that diagnosis. 
• If the health care provider does NOT provide an alternate diagnosis and the HCW does NOT have a known high-risk exposure to a person with confirmed COVID-19, the HCW should remain isolated and not return to work until at least 24 hours have passed since recovery, defined as resolution of fever without the use of fever-reducing medications and improvement in symptoms (e.g., cough, shortness of breath). 
• If the health care provider does NOT provide an alternate diagnosis and the HCW does have a known high-risk exposure, the HCW should obtain a second SARS-CoV-2 RT-PCR test. The HCW should remain isolated until the test results are known. Minnesota continues to experience high levels of community transmission, and the potential consequences of working with COVID-19 are serious. If positive, follow the COVID-19 work exclusion and isolation guidance.
• If negative, the HCW can return to work following the test-based strategy if at least 24 hours have passed since resolution of fever and symptoms are improving.

For reference, consult the MDH Recommendations for Health Care Workers updated 11/23/20. If you have questions regarding this information or other quarantine and isolation issues, please contact Kari Everson, keverson@leadingagemn.org or 651-380-2032.