Optimal test-assisted quarantine strategies for COVID-19

Abstract

BackgroundUntil herd immunity occurs for COVID-19, quarantine will remain a pillar for disease mitigation. A 14-day quarantine, although widely recommended for self-quarantine after potential infections and mandated by many government agencies can be physically and mentally stressful for those under quarantine and leads to lost productivity. Testing during quarantine is currently implemented by businesses and governments as a promising method to shorten the duration of quarantine. However, to our knowledge, no study has been performed to evaluate the performance of test-assisted quarantines or to identify the most effective choices of testing schedule.MethodsBased on statistical models for the transmissibility and viral loads of SARS-CoV-2 infections and the sensitivities of available SARS-CoV-2 testing methods, we performed extensive simulations to evaluate the performance of quarantine strategies with one or more tests administered during quarantine. Sensitivity analyses were performed to evaluate the impact of perturbations in model assumptions on the determination of optimal strategies.FindingsWe found that SARS-CoV-2 testing can effectively reduce the length of quarantine without compromising personal or public safety. Whereas a single RT-PCR test performed before the end of quarantine can reduce the duration of quarantine to 10 days, two tests can further reduce the duration to 8-days and three tests with a highly sensitive RT-PCR test can justify a 6-day quarantine. More strategic testing schedules and one more day of quarantine are needed if tests are administrated with a less sensitive but more cost-effective antigen test.InterpretationTesting during quarantine could substantially reduce the length of isolation, reducing the physical and mental stress caused by long quarantines. With increasing capacity and lowered costs of SARS-CoV-2 tests, testing-assisted quarantines could be safer and more cost-effective than 14-day quarantines and warrant more widespread use.

Population simulations of COVID-19 outbreaks provide tools for risk assessment and continuity planning

“…Simulation revealed the efficacy of a 10-day, and other foreshortened, quarantine strategies. The command used for the simulation is listed under the flowchart ( Figure 3 ), and for full details of this implementation, we refer the reader to Peng et al ( 14 ).…”

Analyzing Breakthrough Infections in a Tertiary Care Hospital: A Retrospective Study Utilizing RAT-Based Screening

“…In a populated country like India, SARS-CoV-2 testing by RT-PCR is an uphill battle since it can detect non infectious as well as dead viral paricles which lasts as positive for long period of time. 10 In this scenario, RAT can be used as SARS-CoV-2 detection point-of-care test for rapid and massive testing, despite its lower sensitivity than RT-PCR. 11 Since January 2020, three consecutive waves occurred, in Puducherry Union territory (UT) the cases In our hospital setting, we tested surveillance samples, outpatient, and in-patient samples.…”

Latest Effective Measures to Combat COVID-19: A Review

“…Until now, asymptomatic infection tends to be identified among young people (<20 yr old) and its proportion among all confirmed cases widely differed (from 1.95% to 87.9%) ( 34 ). Isolation and close observation at home for 14 days after diagnosis are regarded as a better option for these asymptomatic infections ( 35 ), and recent findings indicated that testing during quarantine may reduce the length of isolation, decrease the physical and mental stress caused by long quarantines ( 36 ). “However, suspected and confirmed cases must be treated in isolated hospitals with effective isolation and protection conditions” ( 37 ).…”