| Approach | When to Use | Instructions |
| Non-Test Based Waiting 10 days from symptom onset (or 10 days from specimen collection date if persistently asymptomatic) | Mild to moderate illness AND no severe immune compromise | Can discontinue isolation after 10 days from symptom onset (or 10 days from positive test collection date if never had symptoms), provided that the individual is afebrile (without the use of fever-reducing medications) and symptoms are improving for at least 24 hours. Absence of cough is not required for those known to have chronic cough or who are experiencing reactive airways post-infection. Mild to moderate illness includes the majority of cases of COVID-19, and includes all those who do not meet the definition of severe illness or severe immune compromise (below). |
| Non-Test Based Waiting 20 days from symptom onset (or 20 days from specimen collection date if asymptomatic and severe immune compromise) | Severe illness (requiring ICU level of care) OR severe immune compromise | Can discontinue isolation 20 days from symptom onset (or 20 days from positive test collection date if asymptomatic and severe immune compromise), provided that the individual is afebrile (without the use of fever-reducing medications) and symptoms are improving for at least 24 hours. Absence of cough is not required for those known to have chronic cough or who are experiencing reactive airways post-infection. Studies informing this approach did not have a consistent definition of severe illness or severe immune compromise. For the purposes of a clearance assessment: • Severe illness is defined as requiring ICU level of care for COVID-19 illness (e.g.,respiratory dysfunction, hypoxia, shock and/or multi-system organ dysfunction). • Examples of severe immune compromise include cancer chemotherapy, untreated HIVinfection with CD4 T lymphocyte count <200, combined primary immunodeficiency disorder,taking prednisone >20 mg/day for more than 14 days and taking other immune suppressivemedications. • Factors such as advanced age, diabetes, and end-stage renal disease are generally notconsidered severe immune compromise impacting non-test based clearance. |
