State health officials issue updated guidance for COVID-19 quarantines

The Minnesota Department of Health (MDH) today issued updated COVID-19 quarantine guidance that integrates new recommendations from the U.S. Centers for Disease Control and Prevention (CDC), including options for shorter quarantines under certain conditions.

Quarantine is one of several public health tools commonly used to reduce the risk of a person spreading an infectious disease to others. A person goes into quarantine after they have had a high-risk contact with someone who was infectious with that disease, but before they are sick or test positive for a disease. Quarantining is an important public health measure because diseases like COVID-19 can spread person-to-person before people know they are infected.

For months, CDC had recommended a quarantine period of 14 days for those exposed to someone with COVID-19. This guidance was based on evidence showing that a person can develop a COVID-19 infection as many as 14 days after being exposed. While a 14-day quarantine remains the recommendation for greatest protection, last week CDC announced an update to that long-standing guidance that includes options for 10-day or seven-day quarantines under certain conditions: Options to Reduce Quarantine for Contacts of Persons with SARS-CoV-2 Infection Using Symptom Monitoring and Diagnostic Testing.

“Evidence indicates the risk of a person becoming infected and passing along that infection is highest in the early days of the quarantine, and much lower in the last few days of the 14-day period,” said Minnesota Commissioner of Health Jan Malcolm. “CDC determined there is a public health benefit to offering shorter quarantine options that boost compliance and do not significantly increase risk. After reviewing the available information, we agreed with that conclusion and adopted their new guidance.”

Malcolm emphasized that while the risk goes down as one gets into the final days of the 14-day period after exposure, there is still a small risk. If a person leaves quarantine and then develops any symptoms of COVID-19 up through day 14, they still need to stay away from others and get tested as soon as possible.

“Monitoring for symptoms for all 14 days after an exposure is a really important part of this process,” Commissioner Malcolm said. “Even minor symptoms associated with COVID-19, like a headache, should not be ignored. If you are just getting out of a shortened quarantine and you develop even minor symptoms, you need to isolate and get tested.”

The new CDC guidance adopted by Minnesota includes several specific conditions. For example, shortening your quarantine period to 10 days after your most recent exposure to someone with COVID-19 may be considered if:

• You have not tested positive for COVID-19, you don’t have symptoms, and you will continue to watch out for possible symptoms through day 14.

• You will continue to mask, maintain at least 6 feet of distance from others, and follow other prevention guidance.

• You will isolate and get tested as soon as possible if you develop any symptoms of COVID-19.

The updated guidance allows for the quarantine period to be shortened to seven days if the person meets all the above conditions and has a negative COVID-19 test result – so long as that test was a PCR test (from saliva, or nose or throat) and was conducted at least five full days after the start of the quarantine period. In this scenario the person may return to regular activities if they do not have symptoms and continues to self-monitor for symptoms through day 14, continues to mask, maintains at least 6 feet of distance from others, and follows other prevention guidance.

Shortening quarantine from 14 days is not recommended in the following scenarios:

• You have a household exposure. This is because it is difficult for household members to quarantine separately and household exposures have a particularly high risk of transmission.

• You are in a congregate living situation, including a long-term care facility, correctional facility, homeless shelter or other setting. In these settings, it can be very difficult for people to quarantine individually and there is higher risk of exposing multiple people, including those at high-risk of severe disease.

• You work in health care settings, correctional facilities or shelters. The updated state guidance has specific language for health care workers. Because health care workers provide care for the most vulnerable and those most at risk for severe complications from COVID-19, they should be excluded for 14 days from working in health care setting. If a facility is experiencing a staffing shortage, the facility may ask the health care worker to return prior to the end of their 14-day quarantine. In such a situation, health care workers returning to work should be proactively tested and monitored as outlined in the MDH COVID-19 Recommendations for Health Care Workers (PDF).

For more information, visit Close Contacts and Tracing: COVID-19.

-MDH-