COVID-19: CDC Recommendations for Isolation and Quarantine

SUMMARY:

Recommendations for isolation cover everyone regardless of vaccination status. Quarantining is not necessary following COVID-19 exposure but rather a high quality mask should be used for 10 days. The FDA recommends repeat testing following a negative result regardless of whether or not an individual has COVID-19 symptoms.

Definitions

• Exposure (general)
  • Contact with infectious agents (bacteria or viruses) in a manner that promotes transmission and increases the likelihood of disease
• Close contact
  • Someone who was less than 6 feet away from an infected person (laboratory-confirmed or a clinical diagnosis)
  • Cumulative total of ≥15 minutes over a 24-hour period (e.g., 3 individual 5-minute exposures for a total of 15 minutes)
• Isolation
  • Separation of an infected individual following confirmed viral infection
  • Recommended even in the absence of symptoms
• Quarantine
  • In close contact with an infected individual

Current Understanding Regarding Transmission

• Majority of SARS-CoV-2 transmission occurs early in the course of illness
  • 1 to 2 days prior to onset of symptoms and then 2 to 3 days after

Isolation Recommendations following Positive COVID-19 Test

Isolate Regardless of Vaccination Status

• Stay home for minimum 5 days
• Asymptomatic or symptoms have improved after 5 days | Fever-free for 24 hours without the use of fever-reducing medication
  • May discontinue isolation
  • Continue to wear a mask around others for 5 additional days
• If fever is still present after 5 days
  • Remain in isolation until fever resolves

Role of Testing for Ending Isolation

• Testing is not required to discontinue isolation

When to Remove Mask

• Following isolation
  • Wear mask through day 10 or
  • Obtain 2 sequential negative antigen tests 48 hours apart
• If antigen test results are positive, continue wearing a mask and wait at least 48 hours before taking another test
  • Continue taking antigen tests at least 48 hours apart until there are 2 sequential negative results even if beyond day 10

Note: Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation​ | Patients with more severe-to-critical illness likely remain infectious no longer than 20 days after symptom onset and extending duration of isolation and precautions to at least 10 days and up to 20 days after symptom onset may be warranted

How to Count Days

• Symptomatic
  • Day 0: First day of symptoms
  • Day 1: First full day after symptoms develop
• Asymptomatic
  • Day 0: Day of positive viral test (based on testing date)
  • Day 1: First full day after your positive test
• If symptoms arise after testing positive, isolation period starts over
  • Day 0: First day of symptoms
  • Day 1: First full day after symptoms develop

Quarantine Recommendations

• CDC Recommends that following exposure to COVID-19
  • Quarantining is no longer required
  • Day 1 is the first full day after last exposure
  • Wear a high-quality mask for 10 days if around others (home or indoors in public)
  • Get tested on day 6 (5 full days after last exposure) even if no symptoms
    • Negative test: Continue masking through day 10
    • Positive test: Isolate immediately

Note: If symptoms occur, isolate immediately until a negative test confirms symptoms are not attributable to COVID-19 | If test is positive, follow full isolation protocol

If At Home Rapid Antigen Test is Negative

FDA Recommendations

• If symptomatic
  • Test again 48 hours after the first negative test, for a total of at least two tests
  • If second test is negative and there is still concern regarding COVID-19 infection, individual may
    • Choose to test again 48 hours after the second test with an antigen test
    • Get a laboratory molecular-based test
    • Call health care professional
• If asymptomatic but concerned regarding exposure
  • Test again 48 hours after the first negative test, then 48 hours after the second negative test, for a total of at least three tests
  • If third test is negative, but concern remains regarding COVID-19, individual may
    • Choose to test again using an antigen test
    • Consider getting a laboratory molecular-based test
    • Call your health care provider

Note: Any positive result repeat test with an at-home COVID-19 antigen test means that an individual most likely has COVID-19 and should follow the CDC guidance for people with COVID-19

CDC: Ending Isolation and Precautions for People with COVID-19

CDC: Isolation and Precautions for People with COVID-19

CDC: What to Do If You Were Exposed to COVID-19

CDC streamlines COVID-19 guidance to help the public better protect themselves and understand their risk

FDA Safety Communication: At-Home COVID-19 Antigen Tests-Take Steps to Reduce Your Risk of False Negative