New process for discontinuing isolation for inpatients with COVID-19

The Centers for Disease Control and Prevention (CDC) updated their guidelines for discontinuing isolation for inpatients who are suspected or confirmed to have COVID-19.

Starting Tuesday, Sept. 22, all Cleveland Clinic locations in Ohio and Florida will implement these guidelines, which supports ending isolation and precautions for inpatients with COVID-19 using a symptoms-based strategy instead of the test-based strategy we had previously used.

Using a symptoms-based strategy involves a safe, thoughtful approach to deciding whether to discontinue isolation for inpatients suspected or confirmed to have COVID-19. This process also incorporates recent evidence that indicates a person who has recovered from COVID-19 may continue to test positive for the virus for up to three months of being diagnosed, even though they are no longer infectious.

By consulting the expertise of local infection preventionists, the symptoms-based strategy to discontinuing COVID-19 isolation limits unnecessary prolonged isolation and use of laboratory testing resources.

Criteria for discontinuing COVID-19 isolation

The infection preventionist may enter an order to discontinue isolation for inpatients who:

  1. are asymptomatic if at least 10 days have passed since the patient tested positive for COVID-19
  2. have mild/moderate illness if they meet the following criteria:
    1. At least 10 days have passed since first positive COVID-19 test and
    2. At least 24 hours have passed since the last fever occurred without the use of fever-reducing medications and
    3. Symptoms (e.g., cough, shortness of breath) have improved
  3. have severe to critical illness if they meet the following criteria:
    1. At least 20 days have passed since first positive COVID-19 test and
    2. At least 24 hours have passed since the last fever occurred without the use of fever-reducing medications and
    3. Symptoms (e.g. cough, shortness of breath) have improved

Questions? Contact your local infection preventionist. Visit the COVID-19 toolkit for more resources.

Thank you for your dedication to ensuring safe, high quality care for our patients.