Self-isolating while waiting for COVID-19 test results could dramatically slow the spread of the virus, the Centers for Disease Control and Prevention says.
In fact, data from CDC models are so compelling that the Centers for Medicare and Medicaid Services will now reimburse doctors who encourage people to self-isolate until their test results come back.
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The financial incentive, announced Thursday by the CDC and CMS, rewards doctors who tell patients to stay away from others from the time they are tested until they receive their test result. Of course, if the test is positive, the patient should continue to isolate.
Test results can take anywhere from a few days to more than two weeks in some cases to come back. During that time, an infected individual who is not isolating can spread the virus to others. People can spread the virus even if they are not showing symptoms of infection.
The CDC models suggest that if people can separate from others while they await results, it could reduce transmission of the coronavirus by up to 86 percent.
Experts praised the government's decision to reimburse doctors who advise patients to self-isolate.
"If Americans with suspected or known COVID-19 do not self-isolate, the virus will continue to spread unabated," said Dr. Pieter Cohen, a physician with the Cambridge Health Alliance Respiratory Clinic near Boston.
"In settings where health care systems are not providing this essential counseling at the time of testing, the change in reimbursement will hopefully provide sufficient incentive to change practices immediately," he added.
"The cost for managing and dealing with the pandemic in terms of all the things we're doing around testing, to treatment, to patients in the hospital related to COVID-19 has really stressed our financial position," Dr. Gary Little, chief medical officer for Atrium Health in Charlotte, North Carolina, said.
"Even a partial compensation for the time it takes for a provider to counsel, reassure and inform patients is welcome," added Dr. Christopher Ohl, a professor of infectious diseases at Wake Forest Baptist Health in Winston-Salem, North Carolina.
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However, Ohl expressed doubt that people who feel well and have no symptoms would, indeed, self-isolate.
"I’m not sure how adherent asymptomatic patients who were tested for administrative or contact tracing reasons will be with isolation, pending results," he said.
Dr. Brett Giroir, who oversees COVID-19 testing for the Trump administration, said during a hearing Friday before the House Select Subcommittee on the Coronavirus Crisis that, for large commercial labs, "59 percent of all tests are reported within three days."
But that leaves 41 percent of test results that take longer than 72 hours. Citing supply and demand, Giroir said it's impossible for all tests to return results within three days, adding that some "outliers" may take up to 16 days for a test result.
The 86 percent reduction in spread applies to people isolating after a test regardless of whether they have symptoms. The CDC models found that if people isolate only after symptoms develop, transmission would be cut by only 40 percent.
Isolation not only protects others, it can also protect the person who was tested.
"While you're waiting for your test results, even if you're negative, you're still vulnerable to getting the disease from someone else," Little cautioned, adding that behaviors that will serve public health remain critical.
"It's clean hands. It's wearing masks. It's distancing. It's avoiding crowds," he said.
"Those are the things that are going to help us reduce the spread of this disease and get us back to where we want to be in terms of opening our society."
