August 18, 2020
People who have recovered from the coronavirus should not need a test to get back to work. The Texas Medical Association (TMA) COVID-19 Task Force announced support of the Centers for Disease Control and Prevention (CDC) recommendation that individuals should not be required to provide a negative COVID-19 test result or a note from a physician to return to the office or classroom after being sick, unless in specific circumstances.
“We know that time and reduction of symptoms are the most accurate indications that a person is no longer infectious,” said Valerie B. Smith, a Tyler pediatrician and TMA COVID-19 Task Force member. “People diagnosed with COVID-19 can shed [inactive and noncontagious] viral particles for several weeks after they are no longer infectious and may continue to have a positive test,” because it could reveal those viral particles. “Requiring a test to return to work or school would potentially require a person to stay in isolation while no longer infectious.”
Except in specific circumstances, CDC no longer recommends using COVID-19 testing results to end self-quarantine. That’s because some tests can yield false negatives if taken too soon. Alternately, false positives can occur on tests when individuals with confirmed COVID-19 continue to test positive even after the infectious period has passed, due to the inactive viral particles showing up on a test. Also, during periods of high disease transmission, testing facilities may be experiencing higher than usual volumes, resulting in strained capacity, limited availability, and higher wait times both to get tested and to receive results.
Instead, CDC had adopted a symptom-based strategy to determine when patients diagnosed with COVID-19 can end their self-quarantine. People with mild to moderate COVID-19 remain infectious no longer than 10 days after their symptoms began, according to CDC researchers. People with more severe illness or who are severely immunocompromised remain infectious no longer than 20 days after their symptoms began.
“The symptom-based strategy allows COVID-19-positive patients to return to work or school after 10 days of isolation as long as they have been without fever for 24 hours and have improvement of their other symptoms,” said Dr. Smith. “The TMA approach to return to school and work is consistent with the CDC guidance that will allow us to protect our community and allow those infected with COVID-19 to return to their daily lives as soon as possible.”
The few patients who might still need testing to return to work or school include those who are severely immunocompromised and whose infectious disease physician recommends a test, or people seeking to end their isolation or other precautions earlier than would occur under the symptom-based strategy. They would need two consecutive negative test results taken at least 24 hours apart.
TMA is the largest state medical society in the nation, representing more than 53,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.
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