On December 2, 2020, CDC released options that health departments could use to shorten COVID-19 quarantine periods within their jurisdictions. These options were intended to reduce the personal, community and operational burden of quarantine with the understanding that so doing balances reduced burden against a small possibility of spreading the virus. Â These options were developed based on models which estimated the remaining risk of transmission based on individual quarantine where the exposed individual could physically separate and stay isolated from others during the quarantine period and could strictly adhere to mitigation measures if released from quarantine prior to 14 days.
Congregate settings, including correctional and detention facilities, are characterized by a diverse and varying set of factors that affect exposure to and transmission of COVID-19. In particular, incarcerated/detained persons exiting quarantine prior to 14 days may not be able to comply with the mitigation measures necessary to reduce the risk of post-quarantine transmission (e.g., mask-wearing, physical distancing). So, models that estimated the remaining risk of reducing quarantine duration do not apply to correctional/detention facility settings. Failure to detect early post-quarantine transmission can result in a repeated cycle of medically isolating infected people and quarantining their close contacts, placing an even higher operational burden on the staff and further stretching limited healthcare resources and space constraints. Thus, the benefits of reducing quarantine duration are unlikely to outweigh the risks for additional transmission in correctional facilities already burdened by limited onsite healthcare services, as well as limited options for physical and social distancing. For this reason, CDC recommends continued use of a 14-day quarantine in correctional and detention facilities to minimize transmissions, illness and secondary clusters, and additional operational costs that could be incurred with shortened quarantine. This recommendation applies to both incarcerated persons as well as the staff of these facilities.
Facilities considering a shortened quarantine duration should do so in consultation with federal, state, tribes, territories, and local public health authorities and with an understanding of the risks. Employers/management should carefully weigh the risks of increased transmission and secondary clusters, and consider individual facility characteristics (e.g., level of community transmission, ability to maintain social distancing, compliance with universal masking policies, ability to properly ventilate, proportion of employees and incarcerated/detained people at increased risk for severe illness from COVID-19 and availability of resources for broad-based testing and outbreak response), before implementing a reduced quarantine option. If a reduced quarantine duration is implemented for staff, facility management should require staff to continue to self-monitor for symptoms through day 14, immediately self-isolate if symptoms occur during the 14 days after exposure, and adhere to all recommended mitigation strategies during the full 14 days (e.g., mask wearing, social distancing, hand hygiene, cleaning and disinfection, and proper ventilation).
Refer to CDC guidance for correctional and detention facilities for further details regarding how to most effectively lower the risk of post-quarantine transmission.