Medical Minute

As many of you are hopefully aware, Germany implemented increased restrictions nationwide due to the rising COVID-19 case counts. In the local area, the case count doubled in the past month compared to the previous seven months, and Ramstein Air Base is also experiencing an increase in cases. There is no doubt that COVID-19 is around us, and we need to maintain our prevention measures.

For Ramstein, I get a lot of questions about the different requirements for quarantine and isolation. Isolation is the term for those who have COVID-19, and quarantine is the term for those who had close contact with a positive member or who traveled from a high risk area.

In general, there is a 14-day quarantine requirement for all travel to or from a “risk” location, which today is essentially everywhere. However, if the travel was official (PCS, TDY), per modified General Order #2, you can test on the sixth day of quarantine and end the quarantine if the test is negative. If you were traveling on leave (including emergency leave), you can test after day 10. Unfortunately, we are only testing TRICARE beneficiaries, so others will have to wait the full 14 days. The modified General Order #2 is an Air Force (Ramstein) installation directive and does not apply on other installations.

These “clearance” tests after travel should not be confused with medically indicated tests. Individuals who test positive can be released from isolation after 10 days as long as they meet certain criteria including no fever for the previous 24 hours and improving symptoms. The Centers for Disease Control and Prevention stopped the recommendation for a test-based strategy for known positive cases as experience demonstrates follow-up tests can be positive for weeks after the person is well and no longer infectious.

If you are a close contact of a known positive, there is no release from quarantine earlier than 14 days. The quarantine for close contacts is longer than for those who have COVID-19 due to the time it takes for the virus to grow and because of how much of the virus is needed to produce a positive result. To be released, you also need a negative test, which is typically collected between days 11 and 14. If you have further questions, please see the CDC website for an in depth discussion about discontinuation of precautions: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html

Finally, no update on the influenza vaccine for the 4-65 year old population. Luckily, we have not seen any influenza in our population. I hope we will have our vaccine shipment within the next 10 days, and we will publish details as soon as possible. Remember: wash your hands, wear your face covering, and keep your distance!