NEW ROCHELLE, N.Y. - Eli Epstein had a low-grade fever for a day or two in early March and tested positive for coronavirus as it spread through his neighborhood in New Rochelle.
He has felt fine since. His wife tested positive, too, but never got sick.
Now, about 20 days later, they are still under a state-ordered quarantine - along with about 100 other congregations from Young Israel of New Rochelle, which was one of the initial hot spots for the virus in the country.
The problem is he and others are still testing positive for the virus, even though they have had no symptoms for weeks.
"We're waiting for some rule that tells us how we can resume our lives," Epstein said. "We're completely asymptomatic."
US coronavirus map: Tracking the outbreak
The state Department of Health is requiring anyone in the New Rochelle epicenter, in particular, to stay quarantined until their test results come back negative.
But with a growing dearth of tests and unknowns about how long the virus might linger in a person's body - even if it appears they are not contagious - the Young Israel community is left wondering when the state or Westchester County will lift the mandatory quarantine that started March 3 and continues for those who are still testing positive.
Initially, about 1,000 Young Israel congregants were ordered to self-quarantine, while those who tested positive were in a mandatory quarantine.
"The person who tested positive, based on time, should be OK now but based on test results is not. So now what?" said Richard Wolff, another congregant who had family members test positive and are still quarantined.
Conflicting criteria causes confusion for New Rochelle congregants
The confusion in New Rochelle, about 20 miles north of midtown Manhattan, is that there is differing guidance on when a person who tested positive for coronavirus can be let out of a mandatory quarantine.
The Centers for Disease Control gives two options for people who tested positive with the virus and are under home isolation.
One is the "non-test based strategy." First, they have to wait at least seven days since their symptoms first appeared.
And they have to wait at least three days after they no longer have a fever without having to use medicine and have improvement in their respiratory systems before they should end their quarantine.
The other option to end a quarantine is to get back a negative test, the "test-based strategy."
So far, New York state has stuck with the testing plan for New Rochelle patients, local officials said, leaving the residents uncertain when they can either get another test as they become increasingly scarce or wait until a negative one comes back.
Assemblywoman Amy Paulin, D-Scarsdale, said the state needs to develop a plan to help the residents get out of quarantine and have a system consistent across the state as the number of positive cases swelled to nearly 26,000 on Tuesday.
"The dilemma is they are wasting tests if they retest these people," she said. "But they are trapped."
Finding a path forward for coronavirus patients in New Rochelle
Paulin said the state should consider the policies of New York City as the number of positive cases grow and as it becomes more untenable to retest every person who becomes infected. New York by far has the most confirmed cases in the nation.
In the city, where the number of coronavirus cases hit nearly 15,000 on Tuesday, it is using the "non-test based strategy" to allow infected residents to end their quarantine.
"If you had or may have had COVID-19," the city's guidance says, "stay home for seven days after your symptoms started, and for three days after your fever has stopped without the use of fever-reducing drugs, such as Tylenol and ibuprofen, and your cough or sore throat symptoms have improved."
'Vital and urgent': Inside New York City's difficult quest to obtain coronavirus testing kits
So far, Westchester County nor the state has adopted that plan with the New Rochelle patients.
Westchester County Health Commissioner Dr. Sherlita Amler said the current policy is under review by the state Health Department, but has not been rescinded. The policy only affects people who have tested positive for the disease, she noted.
It was originally put in place because health officials were unclear how long a person can spread the disease once they become infectious, Amler said.
Amler said it's difficult for people to receive another two tests "because it's difficult to get tested."
Jill Montag, a spokeswoman for the state Health Department, said the state is working under its most current guidance.
"However, policies are constantly changing and under review given the nature of this constantly evolving public health emergency," she said.
What happens next in the New Rochelle quarantine
The situation is clearly evolving, particularly on how long a person may be a risk to others.
And New Rochelle was among the first sizable outbreaks in the nation, putting them a week or two ahead of other communities now being hit with the virus - complicating the state's decision on how to move forward.
In fact, some of the positive patients in New Rochelle are now volunteering to help the state find ways to fight the virus.
Gov. Andrew Cuomo said Tuesday the state is trying to take plasma from people who are infected and have the antibodies to fight to virus "and will try putting that plasma into a person who is still struggling with the disease hoping that the antibodies make a difference."
'Deeply disruptive': Orthodox synagogue copes with coronavirus quarantine
The state is also testing the blood of infected patients who got better on their own and now may have an immunity.
"That would be very important for us to know because then health care workers that could go back to work; there are workers that could return back to the private sector," Cuomo said.
Dr. Aaron Glatt, the chief of infectious diseases and epidemiologist at Mount Sinai South Nassau Hospital, said public health experts are still studying how long a person infected with COVID-19 remains contagious.
"If somebody is still known to have COVID-19, then there is a concern even if they are asymptomatic that they could transfer it," he said.
Glatt, who also heads the hospital's department of medicine, supported the state Health Department approach requiring a second negative test, citing the ongoing effort to gather more information amid a surging outbreak.
Trump reopens battle with Cuomo: After easing tensions, Trump returns to attacking New York Gov. Cuomo over coronavirus response
"Often we would rather err on the side of being more careful and cautious, rather than allowing somebody to go back who is capable of transmitting the disease," he said.
Yet the debate around lifting quarantine orders seems to be rapidly evolving as scientists race to unlock the virus' secrets.
A containment area of a one-mile radius in New Rochelle was put in place March 12 and expires Wednesday. The area was aimed at limiting gatherings in the community, but the state has since closed most businesses in New York and shuttered all schools and houses of worship.
"We learn more about this every day, but at this point in time this is the best estimate by some very bright people," Glatt said.
Meanwhile, New Rochelle residents are either trying to get new tests, mainly at a drive-up, state-run site in the city, or hoping the state will change its approach.
In the meantime, they said they will continue to follow the state's orders.
"We are the most compliant community," Epstein said.
"We followed this to a T, and now there's no way out of this."
Follow Joseph Spector on Twitter: @GannettAlbany
Contributing: David Robinson, USA TODAY
This article originally appeared on New York State Team: Coronavirus NY: New Rochelle patients quarantined even after improving