COVID-19: Status Update and Guidance on Isolation and Quarantine

The following was originally released by the Philadelphia Department of Public Health on March 19, 2020.

Summary Points

  • Community transmission of SARS-CoV-2 is being recognized in Philadelphia.
  • Duration of isolation for infected persons may be provisionally reduced to 7 days, as per details in this advisory.
  • Guidance to healthcare workers for self- monitoring and isolation/quarantine is provided.

SARS-CoV-2 continues to spread in southeastern PA. As of March 18th, almost 600 Philadelphia residents have been tested, of whom 44 (7.3%) persons have tested positive. The age distribution of laboratory-confirmed cases is as follows: 0 (no) cases in ages <20 years; 23 (52%) cases in ages 20-39 yrs, 2 (5%) cases in ages 40-49 yrs, 11 (25%) cases in ages 50-59 yrs, and 8 (18%) cases in persons older than 60. Most cases have occurred in returning travelers or in persons with direct contact with a known case of COVID-19. However, community transmission is also occurring. As the volume of testing for SARS-CoV-2 has increased, the number of cases with no apparent exposure risk has also increased.

Testing capacity for SARS-CoV-2 is increasing across the city. The Pennsylvania Bureau of Laboratories, LabCorp, Quest, and several healthcare system laboratories are now accepting specimens for diagnostic testing. In addition, many screening sites capable of collecting specimens from patients are also opening. We encourage providers to collect and submit SARS-CoV-2 diagnostic specimens through their usual mechanisms. If you need assistance in testing patients, please contact the Health Department at 215-685- 6741. Due to the volume of calls, there may be significant wait times.

Duration of Isolation for Confirmed COVID-19 Cases
Persons who have been confirmed with COVID-19 may discontinue isolation under the following circumstances:

  • NP swab is negative for SARS-CoV-2; or
  • Minimum of 7 days after onset of symptoms and 3 days after resolution of fever (off antipyretics) and improvement in respiratory symptoms.

Duration of Quarantine for COVID-19 Exposed Individuals
Household contacts of COVID-19 cases may discontinue quarantine 7 days after their last household exposure. Generally, this will be 7 days after the case has been released from isolation.

Healthcare Worker Guidance

  • Healthcare workers should self-monitor for illness consistent with COVID-19 because all healthcare workers are at risk for unrecognized exposures. The purpose of self-monitoring is to identify illness early and self-isolate at home to reduce the potential of transmission to patients and co-workers. Report suspected illness to your institution(s) in accord with their procedures.
  • Healthcare workers diagnosed with COVID-19 must be isolated for a minimum of 7 days after symptom onset, and at least 72 hours after being afebrile (off antipyretics) and feeling well. Follow institutional guidance on wearing a surgical mask or limiting patient contact until 14 days after onset of symptoms.
  • Asymptomatic healthcare workers (critical workforce) who are under quarantine for exposure to a person with COVID-19 may return to work if:
    • 14 days have passed since the most recent exposure; or
    • 7 days have passed since the most recent exposure and s/he has a negative SARS-CoV-2 NP swab.

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