The current COVID-19 outbreak, which started in December 2019 in
Wuhan, Hubei province, China has 219,332 confirmed cases, and 8,969 people died
as of March 19, 2020, in 176 Countries and Territories around the world.
The quarantine
period for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),
according to the World Health Organisation(WHO) and the Centers for Disease
Control and Prevention (CDC) is 14 days. This is derived from the various data
that showed that the coronavirus incubation Period is 2 - 14 days.
However, more
recent reports have shown that there are incubation period outliers. A report
from Hubei province local government of China suggest an incubation period can
be up to 27 days. Similarly, another study from the same china by Yan et al.
identified an incubation period of up to 19 days and Guan et al. 24 days. Lauer
et al. in their publication in Annals of Internal Medicine suggested longer
monitoring for extreme cases who will develop symptoms, especially those with
more extended infection period.
While all these are
outliers, does it mean that the quarantine period for a case should be
adjusted? Does it mean with these identified more extended incubation period,
should regulatory bodies such as WHO change its recommendations?
However, WHO appears not ready to change its regulation; it is believed that outlier should
be viewed carefully and that this observation may be reinfection. Furthermore,
the prominent public health regulatory bodies such as CDC, and China's National
Health Commission (NHC) in addition to WHO have not reviewed the incubation
period of 14 days based on their available situation reports.
Why a change may
never come to this regulation, on the other hand, such change means a severe
implication on the cost burden of active monitoring or quarantine against the
potential or perceived costs of failing to identify a symptomatic case, and
strain on the already overstretched health workforce.
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