Journal-based CME Course: Association of COVID-19 Quarantine Duration and Postquarantine Transmission Risk in 4 University Cohorts

Activity ID

12640

Expires

March 7, 2025

Format Type

Journal-based

CME Credit

1

Fee

30

CME Provider: JAMA Network Open

Description of CME Course

Importance  Optimal quarantine length for COVID-19 infection is unclear, in part owing to limited empirical data.

Objective  To assess postquarantine transmission risk for various quarantine lengths and potential associations between quarantine strictness and transmission risk.

Design, Setting, and Participants  Retrospective cohort study in 4 US universities from September 2020 to February 2021, including 3641 university students and staff who were identified as close contacts to individuals who tested positive for SARS-CoV-2 infection. Individuals were tested throughout the 10 to 14–day quarantine, and follow-up testing continued at least weekly throughout the 2020-2021 academic year.

Exposures  Strict quarantine, including designated housing with a private room, private bathroom, and meal delivery, vs nonstrict, which potentially included interactions with household members.

Main Outcomes and Measures  Dates of last known exposure, last negative test result, and first positive test result during quarantine.

Results  This study included 301 quarantined university students and staff who tested SARS-CoV-2–positive (of 3641 quarantined total). These 301 individuals had a median (IQR) age of 22.0 (20.0-25.0) years; 131 (43.5%) identified as female; and 20 (6.6%) were staff. Of the 287 self-reporting race and ethnicity according to university-defined classifications, 21 (7.3%) were African American or Black, 60 (20.9%) Asian, 17 (5.9%) Hispanic or Latinx, 174 (60.6%) White, and 15 (5.2%) other (including multiracial and/or multiethnic). Of the 301 participants, 40 (13.3%; 95% CI, 9.9%-17.6%) had negative test results and were asymptomatic on day 7 compared with 15 (4.9%; 95% CI, 3.0%-8.1%) and 4 (1.4%; 95% CI, 0.4%-3.5%) on days 10 and 14, respectively. Individuals in strict quarantine tested positive less frequently than those in nonstrict quarantine (10% vs 12%; P = .04).

Conclusions and Relevance  To maintain the 5% transmission risk used as the basis for US Centers for Disease Control and Prevention’s 7-day test-based quarantine guidance, our data suggest that quarantine with quantitative polymerase chain reaction testing 1 day before intended release should be 10 days for nonstrict quarantine and 8 days for strict quarantine, as ongoing exposure during quarantine may be associated with the higher rate of positive test results following nonstrict quarantine.

Disclaimers

1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

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