How long do you need to isolate if you feel sick and are concerned you have COVID, but couldn’t get tested?

The CDC’s recommendations for discontinuing home isolation were updated on July 20, 2020. Important changes include that they are no longer recommending a “test-based strategy” under normal circumstances and they changed the symptoms-based strategy as well. These changes reflect evidence that people with mild to moderate disease are no longer contagious 10 days after their symptoms began and those that have severe illness (or are severely immunocompromised) are no longer contagious 20 days after their symptoms developed. The new guidance is as follows: 

Persons with COVID-19 who have symptoms and were directed to care for themselves at home may discontinue isolation under the following conditions:

• At least 10 days* have passed since symptom onset and
• At least 24 hours have passed since resolution of fever without the use of fever-reducing medications and 
• Other symptoms have improved.

*A limited number of persons with severe illness may produce replication-competent virus beyond 10 days, that may warrant extending duration of isolation for up to 20 days after symptom onset. Consider consultation with infection control experts. 

Persons infected with SARS-CoV-2 who never develop COVID-19 symptoms may discontinue isolation and other precautions 10 days after the date of their first positive RT-PCR test for SARS-CoV-2 RNA.

(Jennifer Abrams, MD, May 11, 2020)