Reducing COVID-19 Quarantine with SARS-CoV-2 Testing: A Simulation Study

Authors

Bo Peng
Wen Zhou
Rowland W Pettit
Patrick Yu
Peter G Matos
Alexander L Greninger
Julie McCashin
Christopher I Amos

Publication Date

7-16-2021

Journal

BMJ Open

DOI

10.1136/bmjopen-2021-050473

PMID

34272225

PMCID

PMC8290949

PubMedCentral® Posted Date

7-16-2021

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

COVID-19, COVID-19 Testing, Computer Simulation, Humans, Quarantine, SARS-CoV-2

Abstract

OBJECTIVE: To evaluate the effectiveness of SARS-CoV-2 testing on shortening the duration of quarantines for COVID-19 and to identify the most effective choices of testing schedules.

DESIGN: We performed extensive simulations to evaluate the performance of quarantine strategies when one or more SARS-CoV-2 tests were administered during the quarantine. Simulations were based on statistical models for the transmissibility and viral loads of SARS-CoV-2 infections and the sensitivities of available testing methods. Sensitivity analyses were performed to evaluate the impact of perturbations in model assumptions on the outcomes of optimal strategies.

RESULTS: We found that SARS-CoV-2 testing can effectively reduce the length of a quarantine without compromising safety. A single reverse transcription-PCR (RT-PCR) test performed before the end of quarantine can reduce quarantine duration to 10 days. Two tests can reduce the duration to 8 days, and three highly sensitive RT-PCR tests can justify a 6-day quarantine. More strategic testing schedules and longer quarantines are needed if tests are administered with less-sensitive RT-PCR tests or antigen tests. Shorter quarantines can be used for applications that tolerate a residual postquarantine transmission risk comparable to a 10-day quarantine.

CONCLUSIONS: Testing could substantially reduce the length of isolation, reducing the physical and mental stress caused by lengthy quarantines. With increasing capacity and lowered costs of SARS-CoV-2 tests, test-assisted quarantines could be safer and more cost-effective than 14-day quarantines and warrant more widespread use.

Comments

Associated Data