Massetti GM, Jackson BR, Brooks JT, et al. Suggested citation for this article: Lefferts B, Blake I, Bruden D, et al. Approximately 50% of antigen tests were positive 59 days after infection, but the percentage of positive results declined during this period and was lower after asymptomatic infection, after previous infection, and in persons who have completed a primary COVID-19 vaccine series. Sometimes a swab or test kit can get contaminated during the process . Landon says it's extra information that can give you a sense of how to proceed, especially if people are banking on the CDC guidance to determine whether to end isolation. Some PCR tests can differentiate between flu and COVID-19 at the same time. If you have gotten a positive result on a test, there is no point in testing any further. If you do not, your results may be less likely to correctly indicate whether you have COVID-19 or not. "If you have enough virus in your system to be turning one of these tests positive, that means your body probably hasn't yet fully cleared the infection," says Hay. Persons were classified as symptomatic if symptoms were reported during routine case interview or isolation follow-up call. If you test too early, you may be more likely to get an inaccurate result. A negative at-home test is not a free pass if the person taking the test has symptoms. At least 5 days after your exposure If you test negative for COVID-19, consider testing again 1 to 2 days after your first test You are going to an indoor event or a gathering Immediately before the gathering, or as close to the time of the event as possible Andrejko KL, Pry J, Myers JF, et al. Take general public health precautions to prevent spreading an illness to others. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. According to the CDC: You should be retested if you tested positive for COVID within 30 days and have COVID symptoms. What are the implications for public health practice? This is partly why Baird did not bother to take a rapid test when he had COVID recently and had to decide when it was OK to return to work. They found that more than half of them still tested positive on antigen tests after six days. Several workplaces have implemented COVID-19 screening to prevent the spread of the virus. Persons were considered vaccinated if 14 days had elapsed since completion of a primary COVID-19 vaccination series and were considered to have received a booster dose if 7 days had elapsed after receipt of their booster dose. You'll need to check the testing requirements for your destination. Much of this has to do with the type of COVID-19 test used since some tests can detect the virus in your body longer than others. If you get COVID-19, take the necessary precautions, which include isolating and wearing a mask when around others. These cookies may also be used for advertising purposes by these third parties. ). Isolation and precautions for people with COVID-19, Ending isolation and precautions for people with COVID-19: Interim guidance. BMC Infectious Diseases,21(1), 18. J Infect Dis 2022;225:1908. Some have advocated for ongoing self-isolation to prevent potential transmission, and others have said that prolonged isolation is unnecessary. If you still have a fever, regardless of how many days you've been in isolation, stay home and monitor your symptoms until you no longer have a fever. Sometimes an at-home COVID-19 antigen test can have a false-negative result. The proportion of positive follow-up antigen test results was also lower after previous SARS-CoV-2 infection or vaccination and was lowest among vaccinated persons with a previous infection. You don't need to get another test to confirm the results. If you test too early, you may have an inaccurate. The chart summarizes the first follow-up antigen test result for each person during the 59 days after illness onset, or after the initial positive test result if asymptomatic. Overall, tests should be used as one factor at the end of an infection, along with a patients symptoms and immune status. With a nucleic acid amplification test (like PCR), your results may be positive. If youve tested positive, you dont need to test again. If you are in certain high-risk settings, you may need to test as part of a screening testing program. Flu cases and respiratory syncytial virus (RSV)rates are beginning todropin the U.S.; however, reported cases ofCOVID-19areincreasing. * SARS-CoV-2 infection diagnosed by NAAT or antigen test. Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. also known as post-COVID syndrome, is a chronic condition in which people continue to have symptoms three months after the onset of the initial symptoms or a positive COVID test result. Centers for Disease Control and Prevention. Saving Lives, Protecting People, https://www.ykhc.org/covid-19/situation-reports, https://www.ykhc.org/wp-content/uploads/2022/01/010522-YKHC-Guidance-for-Vaccinated-and-Unvaccinated-Individuals-1.pdf, https://www.fda.gov/media/141570/download, https://www.medrxiv.org/content/10.1101/2022.02.01.22269931v1.full.pdf, https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html, https://www.medrxiv.org/content/10.1101/2022.01.10.22269010v2, https://www.researchsquare.com/article/rs-1121993/v1, https://doi.org/10.1038/s41598-021-02197-z, Centers for Disease Control and Prevention, U.S. Department of Health & Human Services, Unvaccinated, no previous infection (Ref), Primary COVID-19 vaccination, no previous infection, Primary COVID-19 vaccination, previous infection. With an antigen test or rapid test, you can test positive for a few weeks after your initial test. Among vaccinated persons, 518 had completed a 2-dose COVID-19 mRNA vaccination series, and 23 had received 1 dose of the Janssen vaccine. Isolate for at least five days. For the most recent updates on COVID-19, visit ourcoronavirus news page. This means that it takes five days for the virus level to be high enough for the test to detect. Now Is the Time to Start COVID Testing, Antigen vs. Antibody: Differences and COVID-19 Testing, COVID Test Recall: 'Detect' Tests Pose Risk of False Negative Results. Thats why the CDC recommends that people be exempted from any sort of PCR surveillance testing for 90 days after a positive test, Gigi Gronvall, PhD, senior scholar at the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, told Verywell. I'm fully vaccinated (second dose of Pfizer back in March) and was away from home this past week. When you perform an at-home COVID-19 antigen test, and you get a positive result, the results are usually accurate. I have not had COVID-19 or I have not had a positive test within the past 90 days. Killingley B, Mann A, Kalinova M, et al. It all depends on the type of test and your results. Indeed, the CDC found, "Between 5 and 9 days after symptom onset or after initial diagnosis with SARS-CoV-2 infection, 54% of persons had positive SARS-CoV-2 antigen test results.". Sect 3501 et seq. Now researchers are trying to understand why some people test positive for longer periods of time. If you do not have symptoms of COVID-19 and do not have known exposure to a person infected with COVID-19, you do not need to quarantine. Today, antibody tests are used for population-based research. You tested positive for COVID-19. It depends on how long ago you tested positive and whether or not you have symptoms. Positive results on an antigen test are fairly reliable, meaning that the test is generally positive only when the COVID-19 virus is present in your specimen. Excluded 21 persons with partial vaccination, and 36 unvaccinated persons with previous infection (overall 57 excluded, 41 symptomatic infections and 16 asymptomatic infections). If you test positive for COVID-19 while you are traveling, you will need to follow the guidelines for isolation, testing, and treatment where you are. Persons with a positive SARS-CoV-2 NAAT or antigen test result were interviewed by a public health or clinic staff member after notification to YKHC, and at the time of a follow-up antigen test, if performed after the initial interview. "The answer to that is clear as mud," he says. If you continue to test positive on repeat testing through 10 days, you should continue to wear a mask and avoid people who are immunocompromised or at high risk for severe disease until you receive two sequential negative antigen test results. "The way that we've started to frame it, and I think many others have, is that if you're positive, you particularly need to take this very seriously.". You may need to have a negative COVID-19 test result, either a PCR or at-home antigen test, before you can return to work or school. Symptoms were reported by 564 (77.4%) persons. Use antigen tests. Gronvall works with the centers COVID-19 Testing Toolkit. Follow FDA and manufacturers instructions, including for the number of times you may need to test. CDC twenty four seven. However, if you perform an at-home COVID-19 antigen test, you could get a false . *Self-tests, or at-home tests, are usually antigen tests that can be taken anywhere without having to go to a specific testing site. Is it possible to be infected with two different COVID-19 variants at the same time? All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. J Clin Microbiol 2022;60:e0174221. "Because of the chance of persistent positive results by a molecular test, infected individuals should not use a [PCR] to determine if they are no longer infectious," said Binnicker. Clin Infect Dis 2021. All information these cookies collect is aggregated and therefore anonymous. After a positive test result, you may continue to test positive for some time after. A negative at-home test is not a free pass if the person taking . A few recent preprint studies, which havent yet been peer-reviewed, have indicated that some people who get the Omicron variant may test positive for longer and spread the virus for longer than previous strains. If you follow the CDC guidanceisolating yourself and wearing a face mask as recommendedthere is no need to retest yourself for COVID-19. NOTE: You also should check with your employer, school district or public health department for exact isolation guidelines for you and/or your family if you test positive for COVID-19, as those guidelines may differ. When Are You No Longer Contagious With COVID-19? QUESTION: Do I need to take another COVID-19 antigen test to make sure I'm negative after a certain amount of time? doi:10.3109/08958378.2014.955932. Peter is a writer and editor for the CNET How-To team. What Should You Do If You Feel Sick but Keep Testing Negative for COVID? She's been focused on the outpatient care of COVID-19 since 2020 and is based near Boston, Massachusetts. part 56; 42 U.S.C. On January 5, 2022, the Yukon-Kuskokwim Health Corporation (YKHC) recommended that persons with SARS-CoV-2 infection isolate for 10 days after symptom onset (or, for asymptomatic persons, 10 days after a positive nucleic acid amplification or antigen test result). If You Have COVID-19, Is It Really Safe to Only Isolate for 5 Days? https://www.medrxiv.org/content/10.1101/2022.02.01.22269931v1.full.pdfpdf iconexternal icon. * Abbott BinaxNOW COVID-19 Ag (BinaxNOW) rapid antigen test. You should let your local care team know you tested positive for COVID-19 using an at-home antigen test. They help us to know which pages are the most and least popular and see how visitors move around the site. This tracks with other research. Late last year, the CDC shortened the quarantine and isolation guidelines, saying "people who test positive should isolate for 5 days and, if asymptomatic at that time, they may leave isolation. Information collected included age, sex, whether the person was of the American Indian or Alaska Native race, and whether any symptoms were reported during follow-up. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Ending isolation and precautions for people with COVID-19: Interim guidance. Key Takeaways If you get COVID-19, you may test positive for several weeks after your infection clears. 1Yukon-Kuskokwim Health Corporation, Bethel, Alaska; 2Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Diseases, CDC; 3Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC; 4CDC COVID-19 Emergency Response Team. Read our, What to Do If You Test Positive for COVID-19, Why the CDC Shortened COVID Isolation to 5 Days. endorsement of these organizations or their programs by CDC or the U.S. If you don't have access to antigen tests, the CDC recommends you continue to mask until Day 11. Correlation might vary between some tests or after introduction of the Omicron variant, although initial viral titers appear to be similar between Omicron and B.1.617.2 (Delta) variants. Fourth, approximately 22% of persons who were 59 days after illness onset or an initial positive test result opted to have a follow-up antigen test, introducing potential selection bias. A test with high sensitivity is less likely to produce afalse negative. With two sequential negative tests 48 hours apart, you may remove your mask sooner than day 10. Nonetheless, a positive or negative antigen test might be a useful proxy for the risk for being infectious. A positive antigen test was more likely after a symptomatic infection (361 of 564, 64.0%) than after an asymptomatic infection (35 of 165, 21.2%) (p<0.001). The high percentage of positive antigen test results during the 59 days after symptom onset reinforces the importance of correct and consistent mask use during this period. Diagnostics for COVID-19: moving from pandemic response to control. Nick Blackmer is a librarian, fact-checker, and researcher with more than 20 years experience in consumer-oriented health and wellness content. COVID antibody tests have other limitations. And many experts advise waiting until you test negative on an at-home test before venturing out. "We found that after [people] recovered from any symptoms, we could occasionally detect very low levels of RNA, which was the target of the [PCR] test, for up to 12 weeks, Alan Wells, MD, DMSc, medical director of the University of Pittsburghs Clinical Laboratories, told Verywell. Thank you for taking the time to confirm your preferences. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.**. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. A positive test result for coronavirus (COVID-19) means it's very likely you had COVID-19 when the test was done. For some, that may mean still testing positive at 10 days or more. Compared with unvaccinated without previous infection. 2014;26(13):811828. QUESTION: Should I let my local health care team know I tested positive for COVID-19? Sect. Antigen tests are far less sensitive than PCRs. However, a positive antigen test result does not necessarily mean that a person is infectious; similarly, a negative test result does not necessarily mean that a person is not infectious. Different types of tests may or may not be persistently positive.. Isolation is recommended during acute infection with SARS-CoV-2, the virus that causes COVID-19, but the duration of infectiousness varies among individual persons. However, the multivariable model accounted for changes in reported characteristics over time. By the day of the initial positive test, 541 (74.2%) had completed a primary COVID-19 vaccination series 14 days earlier, including 215 (39.7%) who had also received a booster dose; 21 (2.9%) persons were partially vaccinated, and 167 (22.9%) were unvaccinated. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Abbreviation: NAAT = nucleic acid amplification test. PCR tests are designed to pick up viral RNA, or the virus' genetic material, David Dowdy, MD, an Epidemiologist with the Johns Hopkins Bloomberg School of Public Health, told Health. Routsias JG, Mavrouli M, Tsoplou P, Dioikitopoulou K, Tsakris A. Sensitivityindicates how likely a test is to detect a condition when it is actually present in a patient. Professional Resources on Testing: Healthcare Workers | Health Departments| Labs. Fully vaccinated and boosted, if eligible or tested positive for COVID-19 within the last 90 days: No quarantine necessary. In these cases, your body will have a harder time fighting off and getting rid of the virus, and isolation for you will last a while longer than five days. The 7 Best At-Home COVID-19 Tests of 2023, Tested and Reviewed, Why Even a Faint Line on Your Rapid Test Still Means You're COVID-Positive, FDA Now Recommends Taking Up to 3 At-Home COVID Tests to Confirm Negative Result. Read our, PCR vs. Isolate for at least 5 full days after symptom onset and until fever free for at least 24 hours. YKHC provides health care and public health services to approximately 27,000 persons in an area of southwest Alaska that includes 50 remote communities; high rates of COVID-19 have been reported in this region. J Clin Microbiol 2021;59:e0089621. Get tested at least 5 days post exposure . You are more likely to get very sick if you are an older adult or have an underlying medical condition. People can continue to test positive after recovering from COVID-19. QUESTION: Does my entire household need to be tested to ensure they are not positive following my positive COVID-19 antigen test? How long after COVID exposure could you test positive? MMWR Morb Mortal Wkly Rep 2022;71:2126. Highly sensitive tests, like PCR, will show a positive result for up to three months later. You should continue wearing a mask and wait at least 48 hours before taking another test. How To Prepare for Possible COVID-19 Infection, How Long Does COVID-19 Last? Almendares O, Prince-Guerra JL, Nolen LD, et al. Medium or high levels: If you're at high risk of getting sick, wearing a mask offers an additional layer of protection. Here's what the CDC recommends if you do test positive for COVID-19: If you have symptoms, isolation will be a little bit different. If the result is negative, repeat testing should be done. 2005 - 2023 WebMD LLC. QUESTION: Do I need to have another COVID-19 test before I return to work or regular activity following the five days of isolation? But if you feel fine, it can be frustrating to wait, especially if you're in the subset of those who test positive past 10 days. A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021. Rapid Test for COVID-19: Pros and Cons. Day zero is your first day of symptoms. Can You Test Positive for COVID If You're Vaccinated? Low COVID-19 levels in the community: While you can mask up anytime you want, wearing a mask on public transportation is advised. Now Is the Time to Start COVID Testing. You will be subject to the destination website's privacy policy when you follow the link. They help us to know which pages are the most and least popular and see how visitors move around the site. More information is available, Travel requirements to enter the United States are changing, starting November 8, 2021. In multivariable models, a positive antigen test result was more likely after 5 days than after 9 days (aOR=6.39; 95% CI = 3.3912.03), symptomatic infection (aOR=9.63; 95% CI = 6.0315.37), and less likely after previous infection (aOR=0.30; 95% CI = 0.190.46), receipt of a primary COVID-19 vaccination series (aOR=0.60; 95% CI = 0.390.93) or after both previous infection and receipt of a primary COVID-19 vaccination series (aOR=0.17; 95% CI = 0.090.33) (Table 2). Massimiliano Finzi/Getty Images That dropped in the following days for most people, but about 20% still tested positive on day 11. Compared with day 9, where the day is defined as symptom onset (if symptomatic) or initial positive NAAT or antigen test result (if asymptomatic). You can end isolation after five days if you are fever-free for 24 hours without using fever-reducing medication and your other symptoms have improved. Between 5 and 9 days after symptom onset or after initial diagnosis with SARS-CoV-2 infection, 54% of persons had positive SARS-CoV-2 antigen test results. You followed the Centers for Disease Control and Preventions (CDC) recommendations by isolating yourself for five days and wearing a mask for another five days. By Valerie DeBenedette Antibody or serology tests look for antibodies in your blood that fight the virus that causes COVID-19. It depends on several factors, experts say, and the most important part is which test you use. Testing before then may lead to a false negative result. However, the CDC advises against policies that require employees to have a negative COVID result before they can return to work. ** 45 C.F.R. Centers for Disease Control and Prevention. If you test positive for COVID-19, with or without symptoms, the CDC recommends that you stay home and isolate for at least five days. Health departments say if you test positive, dont keep testing repeatedly in search of a negative test, Amler said. There are two main types of viral tests: nucleic acid amplification tests (NAATs) and antigen tests. Compared with asymptomatic infection. Multivariable logistic regression models were used to identify factors independently associated with a positive follow-up antigen test result, adjusted for age group, previous infection, vaccination status, presence of symptoms, and number of days since symptom onset or the initial positive test result. This COVID-19 test detects certain proteins in the virus. After a week, when he was feeling better, he came back to the office, where everyone's required to wear an N95 mask. It depends on how long ago you tested positive and whether or not you have symptoms. There is a simple reason why people with compromised immune systems stay contagious longer. If you had no symptoms but develop symptoms within 10 days of testing positive, you would restart the clock at Day 0. (2021). Therefore, lower prevalence of positive test results over time and after asymptomatic infections might reflect lower infectiousness. How Long Do People Usually Test Positive for COVID-19? WhenToTest.orgis an online, mobile-friendly tool that helps you make decisions about COVID-19 testing. A positive test indicates antigen from the COVID-19 virus was detected and you are presumed to be infected. She taught residents and medical students at Brown University in RI. CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. You are likely most infectious. Free At-Home TestsTesting LocatorTreatment Locator. Scientific evidence and studies behind specific COVID-19 guidance and recommendations You are likely most infectious. Their family had plans to get together over the holiday a gathering that included an older relative who was vulnerable to COVID. But if you have symptoms and you test negative, you should not rule out COVID-19 just yet. Need additional help with COVID-19 testing? https://www.ykhc.org/wp-content/uploads/2022/01/010522-YKHC-Guidance-for-Vaccinated-and-Unvaccinated-Individuals-1.pdfpdf iconexternal icon, https://www.fda.gov/media/141570/downloadexternal icon. Rapid tests are less sensitive, but a person will probably still test positive for six or seven days after they are no longer having symptoms, Gronvall said. Testing to get out of isolation is tempting because it promises a straightforward answer. With a nucleic acid amplification test (like PCR), your results may be positive for up to 90 days. In contrast, less sensitive antigen and rapid tests may show a positive result for a few weeks. But knowing when to stop isolating and resume your normal activities isn't always so clear-cut. Contact your health care team to let them know you tested positive for COVID-19 so it can be documented in your health record. URL addresses listed in MMWR were current as of ANSWER:Generally, if you are positive for COVID-19 by either the antigen or PCR test, you will need to be in isolation for a minimum of five days from the onset of your symptoms and/or a positive test for COVID-19. Do You Need to Retest After a Positive COVID-19 Result? Antigen tests, available over the counter, detect proteins on the surface of the virus itself. They help reduce the chance of you catching the virus from someone else who has it or spreading it to another person if you have it. Day zero is the day the sample was collected for a positive test result. If you were exposed to someone who has COVID-19 and you do not have symptoms, wait at least 5 full days after your exposure before testing. ANSWER:Yes. Compared with no COVID-19 vaccination. Bei der Nutzung unserer Websites und Apps verwenden wir, unsere Websites und Apps fr Sie bereitzustellen, Nutzer zu authentifizieren, Sicherheitsmanahmen anzuwenden und Spam und Missbrauch zu verhindern, und, Ihre Nutzung unserer Websites und Apps zu messen, personalisierte Werbung und Inhalte auf der Grundlage von Interessenprofilen anzuzeigen, die Effektivitt von personalisierten Anzeigen und Inhalten zu messen, sowie, unsere Produkte und Dienstleistungen zu entwickeln und zu verbessern. MMWR Morb Mortal Wkly Rep 2022;71:293298. If symptoms return after you have recovered or worsen after the isolation period, the CDC recommends restarting isolation at day 0. Estimating infectiousness throughout SARS-CoV-2 infection course. Antigen test results and associated individual characteristics were analyzed among 3,502 infections reported to YKHC during January 1February 9, 2022. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. CDC is not responsible for the content After all, Baird points out that these tests were never designed to function as get-out-of-isolation cards. You want to test on day three and five or day four and day six after exposure, just to make sure you are negative, Wells said. We take your privacy seriously. Is Your Company's COVID Vaccine Mandate Illegal? If you're going to spend time with people who are high-risk, think twice, says Landon. The type of test used is not the only reason why someone would continue to keep testing positive for COVID-19 for a while. First, only one follow-up antigen test was included in the analysis for each person; data were cross-sectional rather than longitudinal. Fifth, behavioral bias associated with the threshold for testing initially or during follow-up could possibly affect comparisons between individual characteristics. Exactly how long you test positive for COVID-19 after your symptoms start improving depends on the test you take. When Is It Safe To Be Around Someone Who Has Recovered From COVID-19? What we know about quarantine and isolation. The antigen test may have missed an early infection. Safety, tolerability and viral kinetics during SARS-CoV-2 human challenge. For example, one study analyzing data from a testing site in San Francisco during the January omicron surge suggests that many people were still testing positive after five days. A positive test generally correlates with the presence of infectious virus. Excluded 21 persons with partial vaccination (14 symptomatic infections and seven asymptomatic infections). (Frederic J. Brown/AFP via Getty Images . Centers for Disease Control and Prevention. With a rapid test, you may test positive for six or seven days after your symptoms have cleared. Science 2021;373:eabi5273. And that's particularly true for people who keep testing positive late into their infections. DOI: http://dx.doi.org/10.15585/mmwr.mm7108a3external icon. Some research has aligned more closely with the CDC isolation guidance, which assumes most people will no longer be infectious after five days. You need to take two tests 48 hours apart to ensure an accurate result. Epub December, 21, 2021. A positive antigen test result is considered accurate when instructions are carefully followed. But if there's something essential you need to do, don't feel trapped in your house. Scientists can determine that by taking samples from someone who's been infected and trying to grow the virus in a lab what's known as a viral culture. The persistence of a positive result depends on which test was used, since the polymerase chain reaction (PCR) test is more sensitive than the rapid antigen tests that can be administered at home. He has been covering technology, software, finance, sports and video games since working for @Home Network and Excite in the 1990s. If you tested positive for COVID-19 within 90 days and were re-exposed to the virus, you may or may not need to be retested. You can remove your mask and continue life as normal. MMWR Morb Mortal Wkly Rep. 2022;71(33):1057-1064. doi:10.15585/mmwr.mm7133e1. Even after you're done masking, you may still need to test again within three months of a positive COVID-19 test, such as for travel. Have you recently taken a COVID-19 test? This requires two consecutive negative results 48 hours apart. In certain circumstances, one test type may be recommended over the other. The information in this article is current as of the date listed, which means newer information may be available when you read this. The New York Times: Can I Stop Isolating If Im Still Testing Positive for the Virus?, medRxiv: COVID-19 symptoms and duration of direct antigen test positivity at a community testing and surveillance site, January 2021-22, Duration of viable virus shedding in SARS-CoV-2 omicron variant infection, Viral dynamics of Omicron and Delta SARS-CoV-2 variants with implications for timing of release from isolation: a longitudinal cohort study..
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