A Test-Based Strategy for Safely Shortening Quarantine for COVID-19

Quarantine for COVID-19 is hard and could safely be made easier. Lengthy quarantine is difficult for many individuals to rigorously observe. To date, 14 days has been recommended as the quarantine period for people who are exposed to a confirmed COVID-19 case, because most infections appear by then. For household close contacts, there remains a 0.5% chance that a COVID-19 infection may appear after that time, because the COVID-19 incubation period is up to 21 days. However, the risk of transmission after 14 days is so small that public health authorities have decided that 0.5% is an acceptable risk to balance the impact of quarantine on individuals, their communities, and our economy. Therefore, this 0.5% risk of infection is a useful benchmark to consider additional strategies for reducing the burden on individuals while reducing spread of COVID-19. With appropriately timed testing and awareness of possible symptoms, a non-symptomatic individual with a negative COVID-19 test at day 7-8 would be at lower risk of being or becoming infectious than someone completing a 14-day quarantine without testing. If we implemented a test-based strategy for determining the end of quarantine, these individuals could be safely released from quarantine at an earlier date, and would be able to more rigorously quarantine themselves while potentially most infectious.