When can recovering COVID-19 patients leave isolation, and do they need return-to-work letters? What to tell patients

As the coronavirus outbreak continues, physicians may face questions from recovering COVID-19 patients about when they can leave isolation and return to daily activities, notes James Dom Dera, MD, FAAFP, of Fairlawn, Ohio.

As of March 16, the Centers for Disease Control and Prevention (CDC) guidance on this topic includes two options: one with testing and one without.

• For patients with access to testing, the CDC recommends they remain in isolation until they have an improvement of respiratory symptoms (cough and shortness of breath), no fever (without the use of fever-reducing medications), and two negative test results from consecutive nasopharyngeal swabs taken at least 24 hours apart. Patients who tested positive for COVID-19 but never showed symptoms should wait until it’s been 10 days since their positive test result.

• For patients without access to testing, the CDC recommends they stay in isolation until it’s been at least 10 days since their symptoms first appeared, and 72 hours since their fever resolved (without the aid of fever-reducing medications) and respiratory symptoms began to improve.

Some patients may request notes for their employer, either confirming they have tested positive for COVID-19 or confirming they have been cleared to return to work. The CDC’s guidance, as of March 21, is that employers should not require such documentation because health care providers will be extremely busy during this national public health emergency.

A script containing this guidance that your staff can use to respond to patient calls and emails may be useful to lighten the workload during what is a professionally and personally challenging time for all health care professionals.

The bottom line

Because CDC guidance on this and other topics continues to evolve, it’s a good idea to spend some time each day on the CDC website as well as local/state health department websites checking for updates (or assign someone else in your practice to do so).

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