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Network Adopting New CDC Recommendations for Non-Test Based Strategy

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.

July 28, 2020