Health Advisory

SUMMARY

On December 2, 2020, the CDC released Options to Reduce Quarantine for Contacts of Persons with SARS-CoV-2 Infection Using Symptom Monitoring and Diagnostic Testing. The Fairfax County Health Department (FCHD), like the CDC and the Virginia Department of Health, continue to recommend a 14-day quarantine period after the last close contact to a person with COVID-19 as the safest and preferred length of quarantine. Except in rare circumstances, FCHD Contact Tracers will continue to advise close contacts to quarantine for 14 days. Additionally, health care workers would not be eligible for these reduced quarantine periods. Healthcare facilities in the Fairfax Health District that have exhausted all staffing options and need quarantined staff to work while under quarantine (modified quarantine) are required to request this exemption through FCHD by calling (703) 246-8756.

SUGGESTED ACTIONS

Updated CDC Quarantine Guidance

• Manage expectations of COVID-19 patients, their families and other close contacts by supporting the full 14-day quarantine period as the safest option. For patients who may have heard of or request alternate quarantine approaches, share information that will be consistent with Health Department recommendations to avoid confusion on non-adherence.
  • Close contacts are defined as persons with >15 cumulative minutes of exposure in a 24-hour period within 6 feet of an infectious COVID-19 case (regardless of if the person is wearing a cloth face covering). This definition excludes HCWs wearing appropriate PPE. 
• All close contacts should continue to separate themselves from others at home, monitor for symptoms, maintain social distancing, wear a mask if around family members, and wash hands often throughout the entire quarantine period.
• Refer patients to their local health department if they are requesting to shorten their quarantine. Fairfax Health District residents can call the FCHD call center at 703-267-3511.

Modified Quarantine Process for Healthcare Workers

• Modified quarantine is an expansion of an individual’s quarantine to a safe workplace and should be used as a last resort after other staffing solutions have been exhausted to ensure that critical infrastructure (such as healthcare facilities) can remain operational.
• Healthcare workers cannot report to work under a modified quarantine until FCHD has approved the request. Modified quarantine can be requested by calling (703) 246-3756.
• The approval process of a modified quarantine requires both the employer and the quarantined employee to attest to public health measures (https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html) in an online survey. Failure to agree to these measures will result in the request being denied.

ADDITIONAL INFORMATION

CDC Quarantine Guidance: Risk Associated with Alternate Strategies

• Mathematical modeling was used by CDC to estimate the additional risk associated with alternate quarantine options. 7-day quarantine with a negative diagnostic test after 5-days led to an estimated 5% residual post-quarantine transmission risk with an upper limit of about 12% and a 10-day quarantine without testing led to an estimated 1% residual post-quarantine transmission risk with an upper limit of about 10%.  

COVID-19 Data Trends

• Fairfax Health District, like most jurisdictions in Virginia and throughout the Country, has experienced a significant surge in cases over the past few weeks. 
• VDH modeling suggests a Northern VA peak in cases in early 2021 (January-February).
• COVID-19 Case Data for the Fairfax Health District are updated daily at: https://www.fairfaxcounty.gov/covid19/case-information. Data for the rest of the Commonwealth can be found here: https://www.vdh.virginia.gov/coronavirus/covid-19-in-virginia/. 

Contact Investigations at Healthcare Facilities

• FCHD has conducted numerous contact investigations at healthcare facilities across the County. 
• Assisting the Health Department in contact investigations is crucial to ensure the safety of your employees, their families, and your patients. Any delay in this process puts these individuals at further risk.
• FCHD continues to complete case and contact investigations on all persons with COVID-19 in the Health District to identify, inform, and provide needed support to individuals who require isolation or quarantine protect those in our community. The Fairfax County Health Department is authorized to conduct investigations and receive information, including HIPAA-protected information, pursuant to the Code of Virginia.
• Our staff are specifically trained to protect the privacy and confidentiality of conversations and information on all cases and contacts.