Close Encounters of the (Cumulative) 15 Minute Kind
Thursday, October 22, 2020

Just when you thought you had your contact tracing protocol down for dealing with COVID-19 exposures, CDC guidance has changed again.

The CDC has now expanded the definition of close contact to be  “Someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.”  Under the new definition, three five-minute encounters, five three-minute encounters, or fifteen one-minute encounters over a 24 hour period (which could overlap on two workdays) could all be considered “close contacts.”  The CDC states that  “Data are limited, making it difficult to precisely define ‘close contact;’ however, 15 cumulative minutes of exposure at a distance of 6 feet or less can be used as an operational definition for contact investigation.”   But then the CDC appears to add some flexibility into the definition, stating that factors to consider when defining close contact include:

  • proximity (closer distance likely increases exposure risk),

  • the duration of exposure (longer exposure time likely increases exposure risk),

  • whether the infected individual has symptoms (the period around onset of symptoms is associated with the highest levels of viral shedding),

  • if the infected person was likely to generate respiratory aerosols (e.g., was coughing, singing, shouting), and

  • other environmental factors (crowding, adequacy of ventilation, whether exposure was indoors or outdoors).

According to the CDC, “the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE.  At this time, differential determination of close contact for those using fabric face coverings is not recommended.”

This change will make contact tracing more difficult to be sure.  But it is a good time to remind employees of the importance of maintaining social distance at all times.

 

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