Mid-quarantine testing may increase compliance among college athletes without increasing risk

Catherine O'Neal, MD, Assistant Professor of Clinical Medicine at LSU Health New Orleans School of Medicine's branch campus in Baton Rouge, is a co-author of a paper reporting that shortening the length of quarantine due to COVID exposure when supported by mid-quarantine testing may increase compliance among college athletes without increasing risk. The findings are published in the Centers for Disease Control and Prevention's January 8, 2021 Morbidity and Mortality Weekly Report (MMWR), available here.

CDC partnered with representatives of the NCAA conferences to analyze retrospective data collected by participating colleges and universities. De-identified data from a total of 620 athletes with positive SARS-CoV-2 test results during quarantine were included in a time-to-event analysis.

The analysis showed that nearly 49% of the positive test results occurred by day 2 of quarantine and by day 5 for 73% of the athletes. The positivity rate for all of the SARS-CoV-2 RT-PCR tests administered decreased over the quarantine period. Among those whose test results remained negative at day 5, the estimated probability of having a positive test result was 26.9% after day 5, 14.2% after day 7, and 4.7% after day 10. Among the 29 athletes who received positive test results during days 11-14, 89.7% had not been tested previously during their quarantine period.

The researchers noted that despite the potential risk for transmission from frequent, close contact associated with athletic activities, more athletes reported exposure to COVID-19 at social gatherings (40.7%) and from roommates (31.7%) than they did from exposures associated with athletic activities (12.7%).

The revised quarantine guidance from CDC is an important step in reducing the hardship of a 14-day quarantine while maintaining public safety. Routine surveillance for COVID-19 in athletes participating in NCAA college athletics provided the opportunity for a critical evaluation of the quarantine period in the 20-year-old population."

Dr. O'Neal, Infectious Diseases Specialist, Chief Medical Officer, Our Lady of the Lake Medical Center

The authors wrote that new shortened quarantine options (after day 10 without testing or after day 7 with negative test result) were based on decreasing transmission risk over the duration of quarantine (5). Findings from this investigation support shortened quarantine options for collegiate athletes, given the low proportion of athletes who had positive test results after day 10.

Concludes Dr. O'Neal, who is LSU's representative on the NCAA Southeastern Conference Committee on Return to Activity and Medical Guidance Task Force, "This data supports the CDC's new recommendation and highlights the importance of mid-quarantine testing as an effective way to detect asymptomatic infection in this population."