Estimating the quarantine failure rate for COVID-19

Quarantine is a crucial control measure in reducing imported COVID-19 cases and community transmissions. However, some quarantined COVID-19 patients may show symptoms after finishing quarantine due to a long median incubation period, potentially causing community transmissions. To assess the recommended 14-day quarantine policy, we develop a formula to estimate the quarantine failure rate from the incubation period distribution and the epidemic curve. We found that the quarantine failure rate increases with the exponential growth rate of the epidemic curve. We apply our formula to United States, Canada, and Hubei Province, China. Before the lockdown of Wuhan City, the quarantine failure rate in Hubei Province is about 4.1%. If the epidemic curve flattens or slowly decreases, the failure rate is less than 2.8%. The failure rate in US may be as high as 8.3%-11.5% due to a shorter 10-day quarantine period, while the failure rate in Canada may be between 2.5% and 3.9%. A 21-day quarantine period may reduce the failure rate to 0.3%-0.5%.