The perplexing problem of persistently PCR-positive personnel

[...]of using the test-based strategy, many institutions now have significant numbers of staff whose nasopharyngeal swabs remain RT-PCR positive for COVID-19, despite the fact that they have recovered from their episodes of illnesses and have been asymptomatic for weeks or, in some instances, months. [...]regarding the standardization of testing, if the clinical laboratory community developed universal standards for SARS-CoV-2 similar to the World Health Organization’s standards for hepatitis B and C, a multicenter study of all currently manufactured SARS-CoV-2 nucleic acid amplification tests could be designed to correlate the cycle threshold values on each platform for patients who have positive and negative viral cultures. Fewer data are available on viral viability duration in this latter population, and the need for further research on this topic is urgent. [...]based on these data, one approach to managing recovered HCP who work primarily with patient populations at high risk of complications would be to use the “time from symptom development” strategy plus “sustained improvement in respiratory symptoms” and add a safety factor (eg, adding an additional week or 2) to the time from symptom onset, or perhaps adding 2 weeks from test positivity for asymptomatic staff detected as positive. Conflicts of interest All authors report no conflicts of interest relevant to this article. *After this manuscript was submitted and accepted, the Centers for Disease Control and Prevention modified their recommended “return to work” criteria to state that a test-based strategy is no longer recommended and to advocate strategies basically consistent with the suggestions outlined in this paper (See https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html).References 1.