Perspective on Quarantine and Covid 19 (Part I)

September 2, 2020

The definition of a medical quarantine applies to “those individuals who are sick or have been exposed to an infectious disease and are subsequently isolated from the healthy”. Quarantine usually does not include isolating those who are healthy.

As Covid 19, a little virus we cannot see continues to reign over the world bringing fear to some, I continually ask myself the following questions,

- What is the real incubation period of Covid 19?
- How long should we be in quarantine?
- Should we quarantine? Does quarantine really work?
- Has quarantine worked in the past?
- Who should quarantine?
- Is being quarantined when otherwise healthy, harmful?
- What else can we do besides quarantine as quarantining is an ancient form of disease control? Why have we not been able to kill viruses?
- When the next pandemic hits what have we learned to better protect us?

In an effort to scientifically answer my questions, I’ve spent the last 2 weeks researching the world’s response to Covid 19, and the effectiveness of quarantines and lockdowns in countries who did quarantine, countries having a strict lockdown, countries having not so strict lockdowns, and those with no lockdowns. This data from other countries will be presented in another blog.

What is the Real Incubation Period of Covid 19? The incubation period is the time one is infected with the virus to the onset of illness. Most studies found the incubation period of Covid 19 to be 1-11.5 days. The mean incubation period was 4.5 to 5.8 days in the US, and 2.5 to 3.3 days in South Korea?*. All countries accepted the incubation period was 11.5 days and agreed a 14 day quarantine period was adequate.

However, a 14 day quarantine is only 95 to 97.4% accurate. Why do I say only? Because as you read below, with a 14 day quarantine we will send out of quarantine 101 new cases of Covid 19 for every 10,000 people quarantined, or 1000 new cases in every 100,000. That is a lot, especially when a virus is highly contagious.

“These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine. Among those who are infected and will develop symptoms, we expect 101 in 10 000 (99th percentile, 482) will do so after the end of a 14-day monitoring period (Table 2 and Figure 3), and our analyses do not preclude this estimate from being higher. **

It appears a 14 day quarantine, especially in a larger population, will slow disease progression but not obliterate it by any means, and as Covid 19 is more highly contagious, the 14 day quarantine will not suffice for our protection. We might flattened the curve at 14 days, but after quarantine, new cases will soar.

How Long should one Quarantine to Protect Everyone from not getting Covid 19? Studies and case studies showed onset of disease up to 29 days. I personally have witnessed 2 cases of people being positive for longer than 29 days. Knowing those numbers, I would presume a 40 day quarantine of those exposed, possibly exposed, or those with symptoms would suffice to stop disease progression.

However, these statistics are only true if people truly isolate and have no contact with one another. *** Obviously, in larger cities with large apartment complexes, the disease will be spread more easily. Assuming people get infected through shared ventilation, the quarantine in those particular buildings should be 40 days past the last person who is symptomatic. Whew! That could be a long time.

Next week will look at the historical perspective on quarantines and how quarantine has worked in the past?

Have an awesome week! Dr. D