When to stop the isolation of the COVID-19 patients according to the Centres For Disease Control and Prevention and the Fighting Against Coronavirus guidelines:
According to the Centres for Disease Control and Prevention guidelines the isolation of COVID-19 patients can be stopped according to the followings criteria:
The patient have no fever for at least 3 days, the respiratory symptoms (cough, shortness of breath and else) are improved and there have been at least 10 days since the symptoms started or there have been a total of two negative Polymerase Chain Reaction (PCR) tests from at least two consecutive respiratory specimens collected at least 24 hours apart or more and the asymptomatic patients should be isolated for at least 10 days after the first positive PCR test result or if there have been a total of two negative PCR tests from at least two consecutive respiratory specimens collected at least 24 hours apart or more.
Although the Centres for Disease Control and Prevention guidelines may reduce the risk of viral transmission from the infected patients but it is not completely prevent the viral transmission and also it has deficiencies because the period of 10 days for isolation after coronavirus infection is small since there have been reports of more prolonged time for shedding the virus from the infected patients and the guidelines generalize the period of 10 days isolation to all patients and this do not take into account the severity of symptoms since the patients with severe or critical symptoms may take up to 6 weeks to recover from the disease so these lead me to develop a new guidelines that is intended to reduce more the risk of viral transmission from the infected patients termed Fighting Against Coronavirus which take into account the guidelines of the Centres for Disease Control and Prevention and the average time for recovery after coronavirus infection according to the World Health Organization which found that the average time for recovery after coronavirus infection may take 2 weeks for mild cases but the severe or critical cases can take up to 6 weeks and the criteria of this guidelines are:
The asymptomatic COVID-19 patients should be isolated for at least 2 weeks after the first positive PCR test result or if there have been a total of two negative PCR tests from at least two consecutive respiratory specimens collected at least 24 hours apart or more, the patients with mild symptoms should be isolated for at least 2 weeks since the symptoms started and until all the symptoms are completely resolved or until the fever is resolved, the respiratory symptoms (cough, shortness of breath and else) are improved and there have been a total of two negative PCR tests from at least two consecutive respiratory specimens collected at least 24 hours apart or more and the patients with severe or critical symptoms should be isolated for at least 6 weeks since the symptoms started and until all the symptoms are completely resolved or until the fever is resolved, the respiratory symptoms (cough, shortness of breath and else) are improved and there have been a total of two negative PCR tests from at least two consecutive respiratory specimens collected at least 24 hours apart or more.
The immunocompermised patients with COVID-19 may have more prolonged time for shedding the virus so may need extension of the isolation period for them.
Although the Fighting Against Coronavirus Guidelines may reduce most of viral transmission from the infected patients but may not completely prevent the viral transmission so the decision to stop isolation of COVID-19 patients should be made in the context of local circumstances.
Both guidelines may subject to change if there is a new information about COVID-19 in the future.
Dr.Mazin Muzamil Abdel-Ghaffar
https://fighting-against-coronavirus.tribe.so/home/posts
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