Rationale for different quarantine durations during the COVID-19 pandemic

ABSTRACT

Introduction: All contacts of individuals with a confirmed or probable COVID-19 should be quarantined in a designated facility or at home for 14 days from their last exposure. Although shorter quarantine periods may lessen health system's burdens especially when new infections are rapidly rising, prolonging the quarantine duration could be prudent for high-risk scenarios and in regions with insufficient test resources. Objectives: To describe the rationale for different COVID-19 quarantine durations during the on-going pandemic in select countries. Methods: An online search was conducted to document countries' rationale for different quarantine durations during the ongoing COVID-19 pandemic. Only countries that stated a quarantine duration and its rationale were eligible for inclusion. A country was stated to have no quarantine, reduced, or prolonged its COVID-19 quarantine duration if it recommended 0, 1- < 14, or > 14 days. Country's names were anonymized based on the focus of this study. Results: Countries that did not impose a quarantine period recommended self-isolation or quarantine on a case-by-case basis. E.g. persons who had been at sea for more than 14 days did not have to undergo quarantine. Countries that increased their quarantine period found persons testing positive after the recommended 14-day period, identified mutated viral strains, and did so in response to increased COVID-19 activity. Countries that reduced their quarantine period based it on the virus' incubation period, a day 7 COVID-19 test result, a traveler's vaccination status, the reduced risk of contagion over time and the country's prevailing COVID-19 cases. Quarantine duration was reduced based on a traveler's COVID-19 risk profile, his or her country of origin, to encourage compliance and lessen cost of governmentfunded quarantine. Conclusion: Quarantine durations was adjusted to in country disease burden, disease dynamics, the natural history of the disease, COVID- 19 vaccination status, existence of mutant strains and for efficient resources' use. Countries also wanted to encourage vaccination, testing and boost quarantine guideline's compliance. A comprehensive country-specific longitudinal analysis ought to incorporate testing guidelines and vaccination status for each quarantine duration and each country's epidemic curve would provide useful information on best practices.