Revisiting the guidelines for ending isolation for COVID-19 patients

Elife. 2021 Jul 27:10:e69340. doi: 10.7554/eLife.69340.

Abstract

Since the start of the COVID-19 pandemic, two mainstream guidelines for defining when to end the isolation of SARS-CoV-2-infected individuals have been in use: the one-size-fits-all approach (i.e. patients are isolated for a fixed number of days) and the personalized approach (i.e. based on repeated testing of isolated patients). We use a mathematical framework to model within-host viral dynamics and test different criteria for ending isolation. By considering a fixed time of 10 days since symptom onset as the criterion for ending isolation, we estimated that the risk of releasing an individual who is still infectious is low (0-6.6%). However, this policy entails lengthy unnecessary isolations (4.8-8.3 days). In contrast, by using a personalized strategy, similar low risks can be reached with shorter prolonged isolations. The obtained findings provide a scientific rationale for policies on ending the isolation of SARS-CoV-2-infected individuals.

Keywords: COVID-19; SARS-CoV-2; human; infectious disease; isolation; mathematical model; microbiology; personalized medicine.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • COVID-19 / transmission
  • COVID-19 / virology*
  • Humans
  • Models, Theoretical
  • Molecular Diagnostic Techniques
  • Pandemics
  • Patient Isolation* / methods
  • Patient Isolation* / standards
  • Practice Guidelines as Topic*
  • Precision Medicine / methods
  • Quarantine* / methods
  • Quarantine* / standards
  • SARS-CoV-2* / physiology
  • Viral Load