Do we put frontline healthcare workers at more risk with the current CDC and WHO recommendations for ending isolation and precautions?

• Published in: Infection control and hospital epidemiology Vol. 43; no. 2; pp. 272 - 273
• Main Authors: Sun, Chenyu, Ayaz Ahmed, Mubashir, Kim, Na Hyun, Thapa, Pratikshya, Memon, Burhan, Manem, Nikitha, Ntabi, Andrew
• Format: Journal Article
• Language: English
• Published: United States Cambridge University Press 01-02-2022
• Subjects: Animal models; Asymptomatic; Centers for Disease Control and Prevention, U.S; Coronaviruses; COVID-19; Disease control; Disease transmission; Epidemics; Fever; Health care; Health Personnel; Hospitalization; Humans; Hypertension; Infections; Letter to the Editor; Medical personnel; Pandemics; Patient Isolation; Patients; Prevention; Severe acute respiratory syndrome coronavirus 2; United States; World Health Organization; United States
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1017/ice.2020.1402

Recently, isolation and precautions of an ICU patient hospitalized beyond 20 days of symptom onset were removed by infection control advisers based on Centers for Disease Control and Prevention (CDC) recommendations that patients with more severe to critical illness or severe immunocompromise likely remain infectious no longer than 20 days after symptom onset, and extending duration of isolation and precautions for up to 20 days after symptom onset for severe cases is warranted.4 A 46-year-old female patient with a past medical history of essential hypertension initially presented with fever, shortness of breath, diarrhea, and cough. COVID-19 patients who have been infectious for >20 days have been reported in a peer-reviewed journal,5 and severe COVID-19 infection has been associated with prolonged viral shedding.6 WHO recommendations on isolation cited the range of viral shedding as 0–20 days from a personal communication published on a preprint website instead of in a peer-reviewed journal,7,8 or from a study of asymptomatic patients9 or animal models.10 In the setting of an unprecedented global pandemic, this reckless recommendation on ending isolation and precautions may put frontline healthcare workers at an unnecessary higher risk of being infected and thus may exacerbate critical staff shortages. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html.