Taking Off the Gloves: Toward a Less Dogmatic Approach to the Use of Contact Isolation

Strongly held beliefs about the need for contact isolation to prevent the spread of infections in the hospital have contributed to increased costs and decreased flexibility and, more recently, have driven aggressive diagnostic testing for colonization in asymptomatic patients. Examination of the evidence cited in support of the benefits of isolation and growing evidence of its unintended harms offer an opportunity to think differently about how contact isolation might best be applied. This review considers what we do and do not know about the potential benefits and harms of isolation as a public health measure and proposes a framework for considering under what circumstances it might optimally be used.