Kettering Health Network is adopting the new CDC Recommendations to use a non-test based strategy to allow for the discontinuation of isolation and precautions for patients with COVID-19 infection in the hospital and outpatient settings:
1. For most people with COVID-19, isolation and precautions can generally be discontinued 10 days after symptoms onset and resolution of fever for at least 24 hours, without the use of fever-reducing medications and with improvement in other symptoms. Repeated testing for SARS-CoV-2 is not recommended.
2. For people with severe to critical illness* or who are severely immunocompromised**, isolation and precautions can be discontinued 20 days after symptoms onset. Repeated testing for SARS-CoV-2 is not recommended.
3. For asymptomatic severely immunocompromised people, self-isolation can be discontinued 20 days after their initial positive SARS-CoV-2 diagnostic test. Repeated testing for SARS-CoV-2 is not recommended.
4. For people previously diagnosed with COVID-19 who remain asymptomatic after recovery, retesting is not recommended within 3 months after the date of symptom onset for the initial COVID-19 infection (or, for persons who never developed symptoms, the date of the first positive RT-PCR test for SARS-CoV-2).
There may be certain situations in which repeat testing is required for acceptance at an SNF or outpatient hemodialysis unit. In those cases, a Diagnostic SARS-CoV-2 PCR can be ordered.
* Severe to critical illness is defined as Respiratory Rate > 30, SpO2 <94% on room air, lung infiltrates >50%, respiratory failure, septic shock, and/or multiple organ dysfunction.
** Severely immunocompromised includes patients on chemotherapy for cancer, untreated HIV infection with CD4<200, prednisone treatment at doses of 20 mg or more daily for 14 days, and solid organ transplant on anti-rejection medications.