Updated January 13, 2022.
As health authorities look to contain the spread of COVID-19, testing, quarantine and isolation remain central tools to controlling and ending the pandemic. And if you're a parent or caretaker of elderly parents, you might find yourself feeling overwhelmed just at the thought of these measures. While these words may trigger sci-fi images of hazmat suits or cushioned solitary cells, the reality is far less terrifying. Here’s what you need to know if you or someone you know has been told to quarantine.
What’s the difference between quarantine and isolation?
Quarantines are meant to prevent people without symptoms who have been exposed to SARS-CoV-2 from infecting others. These individuals are asymptomatic but have either traveled from an area with an active outbreak, or have had close contact with a laboratory-confirmed case. Quarantining allows close monitoring for the development of symptoms, if any, while preventing further transmission of the virus. If you haven’t been fully vaccinated, the safest way to quarantine is to stay home and avoid contact with others for five days, followed by five days of strict mask usage. Alternatively, if a five-day quarantine is not possible, an exposed person should wear a well-fitting mask at all times when around others for 10 days after exposure. If you do develop symptoms, you should immediately isolate yourself and contact your healthcare provider.
If you are fully vaccinated including a booster, or you completed your two-shot vaccination series with Moderna or Pfizer within the last six months or J&J vaccine within the last two months, you do not need to quarantine if you are exposed to someone with COVID-19. You should, however, wear a mask when indoors around others for 10 days following your exposure, and if possible, be tested five days after the exposure. Be sure to monitor for symptoms and isolate as below if you develop any symptoms of COVID-19.
Isolation, meanwhile, refers to separating those who are already sick from those around them that they might infect. Isolation provides individuals the opportunity to recover from the virus without spreading it to others.
Note: If you were tested through a program affiliated with your employer, school, or other organization, please continue to follow any isolation guidance communicated by your team as some areas are continuing to follow the CDC’s previous guidance of 10 days of isolation. Please also continue to follow any local, state or tribal guidance that is different from the CDC guidance below.
Patients who have symptoms and a positive test for COVID-19 should isolate until the following per the CDC:
- At least 5 days have passed since their symptoms first appeared. The first day of symptoms counts as “day 0”.
- They have had no fever for at least 24 hours without the use of fever-reducing medication
- They have no other symptoms, or their symptoms are mostly resolved. This should be followed by five days of wearing a mask when around others.
Patients who have symptoms and have not yet been tested
- should isolate as above until a negative test confirms symptoms are not attributable to COVID-19. Home antigen tests should be used according to the package instructions, including repeating the test if recommended by the manufacturer. It’s also recommended for symptomatic individuals to confirm a negative antigen test with a nucleic acid amplification test (NAAT) like PCR or LAMP before ending their isolation. With a negative test, we still recommend considering avoiding others and wearing a mask until your symptoms have improved.
Patients without symptoms who test positive for COVID-19 should isolate until the following:
- At least five days have passed since they first tested positive assuming they have not developed symptoms within that time. This should be followed by five days of wearing a mask when around others.
Finally, anyone with severe illness due to COVID, those with moderate to severe immunocompromise, or those who unable to wear a mask are recommended to isolate for the full 10 days. Isolation may be discontinued after 10 days once symptoms have improved and it’s been at least 24 hours since fever went away (without fever reducers).
Testing to end isolation
Antigen testing to end isolation between 5 and 10 days is a good way to find out if you are likely to infect others, especially if you have regular contact with someone who is at increased risk for severe disease if they develop COVID-19. In fact, many state and local health agencies require testing to end isolation after five days.
On the other hand, testing isn’t required by the CDC because most people who are feeling better aren’t contagious after 5 days, and masking is an effective tool that reduces transmission while giving you the ability to be around others sooner.
Recommendations for those who opt to test after the isolation period is over:
- If you have access to a COVID antigen test and prefer to end isolation based on a negative test, the CDC guidance is:
- Take an antigen test after 5 days.
- If it’s positive, continue isolation for another 5 days, or at least until 10 days have passed from your first day of symptoms.
- If it’s negative, you can end isolation and wear a well-fitting mask for an additional 5 days when around other people.
Using a PCR or other NAAT test to end isolation or to recheck COVID status after a recent positive test is not recommended, as these tests can detect small genetic fragments from the virus for weeks to months after an infection that don’t represent infectious virus.
How are these different from social distancing?
Social distancing refers to maintaining a safe physical distance between yourself and other people outside your household. The CDC defines this safe space as at least six feet. Unlike with social distancing, those who are quarantined or isolated should stay home and separate themselves from others, even those within their household to the best they can.
What should I do if I’ve been told to quarantine or isolate?
While it may be scary being told to quarantine or isolate, it’s important to keep in mind that the vast majority of people who have contracted COVID-19 thus far have experienced mild symptoms similar to the common cold or flu, and have recovered fully. That being said, the virus can sometimes cause severe disease and even death. That’s why it’s very important we take the necessary steps to prevent the virus from spreading. Here’s how you can protect yourself and others during your quarantine or isolation:
Limit your out-of-home activity to medical care and do not go into school or work. You should also avoid public transportation, ride-sharing, and taxis. If you need groceries, try using a meal or grocery delivery service where your food can be dropped off right outside your door.
Keep to one room as much as possible if you live with roommates or family members. You should also use a separate bathroom if possible.
Wear a mask
If you are sick and must go in public or be around other people, it’s important to wear a face mask to prevent spreading the virus. Remember to also put a facemask on before entering the doctor’s office or when traveling to and from your doctor’s appointments. If you don’t have one upon arriving, your provider should provide one for you that you can keep on-hand for transportation home and future use.
Stay away from pets
In April 2020, two cats in New York became the first household pets in the U.S. to test positive for COVID-19. This is believed to be the result of close contact with infected humans. While there have not been any confirmed reports of pets transmitting COVID-19 to humans, it appears the virus can pass from people to animals. It is recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus. If you must care for a pet while you are sick, make sure to wear a face mask and wash your hands before and after interacting with your pet.
Do not share personal items
To avoid spreading germs, do not share dishes, utensils, towels, or other personal items with other people in your household. Any shared items should be washed thoroughly with soap and water.
Wash your hands
Wash your hands often with soap and water for at least 20 seconds, and if soap and water aren’t available, use an alcohol-based hand sanitizer.
Staying active will keep you both mentally and physically healthy during your quarantine. Exercise can help reduce elevated cortisol levels, as well as trigger the release of endorphins, boosting both your mood and immune function. If you are feeling well enough and don’t have active symptoms, try an at-home workout to avoid physical contact with others. Even walking up a few flights of stairs, or having a dance party in your room can be helpful.
Stay in contact with friends and family
Research shows that quality time with people you care about can boost your happiness level. If you are quarantined, try to still connect with your friends and family through video chat or phone calls.
Monitor your symptoms
If you find your symptoms worsening, contact your primary care provider or reach out to our 24/7 virtual care team. If you are experiencing a medical emergency, please call 911.
If you are not sure whether you are recommended to quarantine or isolate, or when to discontinue your quarantine or isolation, please contact your healthcare provider.
The One Medical blog is published by One Medical, an innovative primary care practice with offices in Atlanta, Boston, Chicago, Los Angeles, New York, Orange County,Phoenix, Portland, San Diego, the San Francisco Bay Area, Seattle, and Washington, DC.
Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. The One Medical Group entities and 1Life Healthcare, Inc. make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.