Isolation
Isolation: separates those infected with a contagious disease from people who are not infected.
Quarantine
Quarantine: restricts the movement of persons who were exposed to a contagious disease in case they become infected.
Isolation and quarantine are proven public health interventions fundamental to reducing COVID-19 transmission. Adequate isolation and quarantine processes must be in place to respond to the increasing number of cases we see with modification of local and statewide physical distancing and stay-at-home orders.
This presentation will focus on isolation at home based of information from the California Department of Public Health.
DURATION OF ISOLATION
The California Department of Public Health (CDPH) recommends a symptom-based strategy to determine the duration of isolation for people with COVID-19 who are symptomatic, meaning they have symptoms. Persons with COVID-19 who have symptoms and were instructed to care for themselves at home may discontinue isolation under the following conditions:
- At least 10 days have passed since symptom onset; AND
- At least 24 hours have passed since resolution of fever without the use of fever-reducing medications; AND
- Other symptoms have improved
The symptoms-based strategy will prevent most, but not all, instances of secondary transmission. Increasing evidence suggests people with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset. However, a very limited number of persons with severe illness or who are severely immunocompromised may warrant extending duration of isolation for up to 20 days after symptom onset. Consider consulting with local infectious disease experts when making decisions about discontinuing isolation of persons who are likely to remain infectious longer than 10 days.
For persons with COVID-19 who are asymptomatic, meaning that they have NOT had any symptoms, CDPH recommends that these individuals be instructed to care for themselves at home. They may discontinue isolation under the following conditions:
- At least 10 days have passed since the date of the first positive COVID-19 diagnostic (federally approved Emergency Use Authorized molecular assay) test. If they develop symptoms, then the strategies for discontinuing isolation for symptomatic persons (see above) should be used.
ISOLATION AT HOME
The majority of people with COVID-19 have mild to moderate symptoms, do not require hospitalization, and can be isolated at home. However, the ability to prevent transmission in a residential setting is an important consideration. The federal Centers for Disease Control and Prevention (CDC) has guidance for both patients and their caregivers to help protect themselves and others in their home and community.
Considerations for the suitability of care at home include whether:
- The person is stable enough to be home.
- If needed, appropriate and competent caregivers are available at home.
- There is a separate bedroom where the person can recover without sharing immediate space with others.
- There is a separate bathroom or one that can be disinfected after use.
- Resources for access to food and other necessities are available.
- The person and other household members have access to appropriate, recommended personal protective equipment (PPE; at a minimum, gloves and facemask/cloth face covering) and can adhere to precautions recommended as part of home care or isolation (e.g., respiratory hygiene and cough etiquette, hand hygiene).
Home Isolation
Isolation of persons who are infectious or individuals who have tested positive for COVID-19 can be at home provided the following conditions are in place.
What setup is needed:
A separate bedroom. If a bedroom must be shared with someone who is sick, consider advising the following:
- Make sure the room has good air flow by opening the window and turning on a fan to bring in and circulate fresh air if possible.
- Maintain at least 6 feet between beds if possible.
- Sleep head to toe.
- Put a curtain around or place other physical divider (e.g., shower curtain, room screen divider, large cardboard poster board, quilt, or large bedspread) to separate the ill person’s bed.
A separate bathroom or one that can be disinfected after use.
Access to necessary services:
- Clinical care and clinical advice by telephone or telehealth.
- Plan for transportation for care if needed.
- Food, medications, laundry, and garbage removal.
When to seek care:
If new symptoms develop or their symptoms worsen.
If the infected person is going to a medical office, emergency room, or urgent care center, the facility should be notified ahead of time that the person has COVID-19; the person should wear a facemask (or if unavailable, a cloth face covering) for the clinical visit.
Any one of the following emergency warning signs signal a need to call 911 and get medical attention immediately:
- Trouble breathing.
- Bluish lips or face.
- Persistent pain or pressure in the chest.
- New confusion or inability to arouse.
- New numbness or tingling in the extremities.
Resources
- County of Tulare HHSA- Daily COVID- 19 Updates for Tulare County
- City of Porterville
- Sierra View Medical Center- Local COVID-19 Resources
- Centers for Disease Control- COVID-19 Disease Information
- State of CA- COVID-19 State Response
- State of CA- COVID-19 FAQs
- Porterville College COVID-19 Information
Works Cited
Articles:
- https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Guidance-on-Isolation-and-Quarantine-for-COVID-19-Contact-Tracing.aspx
- https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.html
Images:
- https://www.ca.gov/agency/?item=california-department-of-public-health
- https://www.chrichmond.org/blog/fever-congestion-fatigue-what-might-your-symptoms-mean
- https://www.clickorlando.com/news/local/2020/08/11/coronavirus-when-can-you-end-home-isolation/
YouTube:
- https://www.youtube.com/watch?v=qPoptbtBjkg
- https://www.youtube.com/watch?v=czUd4W2wrdQ
Credits:
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