Coronavirus Disease 2019 (COVID-19) Outbreak, Update # 27
Quarantine Guidance Update
Weekly Partner Call Changes
Quarantine Guidance Update
THIS IS AN OFFICIAL NH DHHS HEALTH ALERT
Distributed by the NH Health Alert Network
December 3, 2020 Time 1430 (2:30 PM EDT)
Key Points and Recommendations:
• NH Division of Public Health Services (DPHS) is decreasing the required quarantine period for people potentially exposed to COVID-19 from 14 to 10 days, which is consistent with the U.S. Centers for Disease Control and Prevention (CDC) new quarantine guidance:
o A person who is close contact to another person infectious with COVID-19 must stay home and away from public locations for 10 days starting from the last day of exposure to the infectious person.
o A person who has traveled outside of New England must stay home and away from public locations for 10 days starting from the last day of travel outside of New England (see NH DPHS Travel Guidance for exceptions to travel-related quarantine).
o Any person who ends quarantine after 10 days must still monitor themselves daily for symptoms of COVID-19 and strictly adhere to all recommended non-pharmaceutical interventions (social distancing, avoiding social gatherings, face mask use, hand hygiene, etc.) for a full 14 days after last potential exposure or high-risk travel. Any person who develops symptoms should immediately isolate and seek testing.
o Organizations serving vulnerable populations or congregate living settings that are high-risk for transmission (e.g., long term care facilities, jails/prisons, etc.) should consider maintaining a 14 day quarantine for residents and staff to minimize risk of transmission in their facilities.
• NH DPHS does not recommend routinely adopting the “test out” option in the new CDC guidance. This “test out” option suggests a person could end quarantine after 7 days if the person tests negative for active SARS-CoV-2 infection within the 48 hours before ending quarantine. Currently testing resources are not sufficiently available to adopt this approach, and risk of transmission is increased.
• If a critical infrastructure business (e.g., healthcare) is experiencing significant staff shortages due to employees being out on quarantine resulting in inability to maintain operations, the business should follow the current NH DPHS Employer Travel, Screening, and Exclusion Guidance “exceptions to quarantine requirements”, but may also choose to implement SARS-CoV-2 molecular testing for essential employees to end quarantine after day 7 if all the following apply:
o An appropriate respiratory specimen is collected on days 6-7 of quarantine (i.e., within 48 hours before ending quarantine after day 7)
o The specimen is tested for the SARS-CoV-2 coronavirus by a molecular test (e.g., a PCR-based test) and is negative
Although the CDC guidance suggests testing can be with either a molecular or antigen test, antigen tests are not sufficiently sensitive to detect infection in asymptomatic persons. Therefore, in New Hampshire, antigen tests are not appropriate to end quarantine early. Antigen-based tests should continue to be used for symptomatic persons (see NH DPHS guidance on antigen testing).
o The person remains asymptomatic
o The person conducts daily self-monitoring for symptoms for a full 14 days after last potential exposure or high-risk travel
o The person strictly adheres to all recommended non-pharmaceutical interventions (social distancing, avoiding social gatherings, face mask use, hand hygiene, etc.) for a full 14 days after last potential exposure or high-risk travel
o If the person develops symptoms of COVID-19, they should immediately isolate and seek out testing for COVID-19, even if that person has previously or recently tested negative
• NH DPHS continues to prioritize our contact investigations for people diagnosed with COVID-19, as outlined in HAN Update #25. Therefore, not every person diagnosed with COVID-19 will be contacted by public health. Healthcare providers should continue to provide their patients with the following guidance, if applicable, which will be updated with the new quarantine
Message Type: Alert
Sensitivity: Not Sensitive
Message Identifier: NH-HAN 20201203 COVID-19, Update 27
Delivery Time: 12 hours
Distribution Method: Email, Fax
Distributed to: Physicians, Physician Assistants, Practice Managers, Infection Control Practitioners, Infectious Disease Specialists, Community Health Centers, Hospitals, Hospital CEOs, Hospital Emergency Departments, EMS, Nurses, NHHA, Pharmacists, Laboratory Response Network, Manchester Health Department, Nashua Health Department, Public Health Networks, DHHS Outbreak Team, DPHS Investigation Team, DPHS Management Team, Northeast State Epidemiologists, Zoonotic Alert Team, Health Officers, Deputy Health Officers, MRC, NH Schools, EWIDS, Dialysis & Transplant Clinics, STD Clinics, Immunization Practices, Travel Centers, Influenza Sentinels, Urgent Care Centers, Ambulatory Surgical Centers, Walk-in Clinics, Poison Center, Alcohol and Other Drug Treatment Centers, Long-Term Care Facilities, Community Mental Health
Centers, Health Departments, Internal Medicine, Occupational Health, Gastroenterology, Schools and Daycare Providers, Regional Public Health Networks, Environmental Services, Family Planning Programs, Department of Corrections, Home Care Providers, Local and State Partners, Area Agencies From: Benjamin P. Chan, MD, MPH, State Epidemiologist
Originating Agency: NH Department of Health and Human Services, Division of Public Health Services