MILWAUKEE — COVID-19 is spreading fast as the year gets underway. And with omicron sending cases to record highs, more and more people are navigating what to do after a positive test.
The CDC recently updated its guidance on quarantine and isolation. The new timelines can get complicated, but taking the right steps is important to help stop the spread.
Here, we break down what you need to know about the latest quarantine and isolation guidance for COVID-19.
What’s the difference between quarantine and isolation?
The basic ingredients are the same for both: You’re avoiding contact with other people to make sure you’re not getting people sick. But the reasons are different.
Quarantine happens when you’ve been exposed to COVID-19. You might not be sure if you are infected yet, but you’re still staying away from others in case you end up testing positive, too.
Isolation is when you do have COVID-19 and are trying to avoid spreading it to other people. The CDC guidelines for isolation are stricter than for quarantine, because you already know that you’re infected and could infect others.
What should I be doing during quarantine or isolation?
The key goal is to avoid contact with other people who could catch the virus.
For both quarantine and isolation, you should be staying home and keeping your distance from others, the CDC recommends. If you have to be around other people, including at home, you should wear a well-fitting mask.
If you’re isolating, the CDC recommends some extra precautions. You should stay in a separate room and use a separate bathroom if you can. Plus, you can take steps to improve ventilation — like by opening windows, turning on fans or using an air filter.
“You should take yourself out of society,” infectious disease expert Peter Chin-Hong told The New York Times. “Wall yourself up in a cocoon.”
And, of course, you should keep up basic hygiene steps you might take for a simple cold — like washing your hands often, not sharing utensils and covering your coughs and sneezes.
I’ve been exposed to someone with COVID-19. How long do I have to quarantine?
That depends on a key question: Are you “up to date” on your COVID-19 vaccinations, including booster shots?
If you are fully vaccinated and boosted, the CDC says you don’t need to go into a full quarantine. The same goes if you were vaccinated recently and aren’t due for a booster dose yet.
But you should wear a mask around other people for 10 days, and try to get tested five days after your exposure, per CDC guidance. (A high-quality mask, like an N95 or KN95, will be more effective at stopping the spread.)
If you’re unvaccinated or due for a booster shot, you’re more likely to catch COVID-19 — and the CDC has stricter quarantine rules for you to follow.
You should stay home and quarantine for five days after your exposure, the CDC recommends. After that, you should keep taking precautions until Day 10: Wear a mask, avoid travel and don’t spend time with high-risk people.
In either case, if you start noticing any symptoms of COVID-19, you should start isolating right away and get a test as soon as possible, per CDC guidance. That includes mild symptoms that might feel like a cold — like a runny nose, cough or headache.
Especially since we’re seeing such high disease spread right now, “if you have these symptoms, chances are pretty good that you might have COVID,” Ben Weston, chief health policy advisor for Milwaukee County, said at a briefing this week.
I tested positive for COVID-19. How long do I isolate?
The CDC recently changed its guidance on this — cutting down the minimum isolation time from 10 days to five. Let’s break down what those timelines look like now.
First off: When do you start counting?
If your COVID-19 infection comes with symptoms, “Day 0” for your isolation time is the day you start to feel sick. If you don’t have symptoms but test positive, you should start the clock from when you get your positive test, per the CDC.
From there, the bare minimum for your isolation time is five days, according to the new rules. So, regardless of how you’re feeling, you should be staying home and staying away from others for those five days.
After Day 5, things get a little more complicated.
If you were ever severely ill with COVID-19, the CDC still recommends going through with a full 10 days of isolation.
If you never had symptoms, the CDC says you’re allowed to leave your isolation after those five days. And if you did feel sick, but your symptoms are improving — including no fever for a full 24 hours — you’re also OK to stop isolating.
There’s still a bit of a limbo period before you can get all the way back to normal, though.
Until Day 10 after your symptoms or positive test, the CDC advises some extra precautions: You should wear a good mask any time you’re around others — including in your own home — and avoid traveling or spending time with high-risk people. You shouldn’t go places where you won’t be able to wear a mask, like dining in at a restaurant.
Should I get a test before leaving isolation?
Right now, the CDC doesn’t require a negative test to end your isolation. But some experts — including leaders from the American Medical Association — say that tests should be used as an extra precaution, to make sure you’re not leaving isolation while you’re still contagious.
The CDC guidelines say that if you have access to a test, the best time is near the end of your five-day isolation. If you get a positive result, you should keep isolating.
Make sure you’re using a rapid antigen test, not a PCR test, for this kind of post-infection checkup. A PCR test — the kind that gets sent off to the lab — is so sensitive that it can pick up on the virus for months after you recover. Antigen tests, including the at-home kits, are a better indicator of whether you’re contagious right now.
"If you have COVID, and your antigen [test] is still positive at five days, you're almost certainly still infectious," clinical microbiologist Susan Butler-Wu told NPR.
Why did the rules change?
In part, officials said it’s because we have learned more about how — and when — the virus spreads.
“Science shows that the majority of SARS-CoV-2 transmission happens early in the illness,” DHS Secretary-designee Karen Timberlake said in a statement.
If you get COVID-19, you’re most likely to spread it in the day or two before symptoms appear and the few days after your symptoms, CDC Director Rochelle Walensky told NPR — though “there is a bit of transmission that still can occur in those last five days,” which is why it’s key to keep wearing a mask. (Some research has suggested that the omicron variant is especially speedy.)
The vaccines also make a difference, Weston pointed out in a briefing. Shots, including booster shots, mean you’re less likely to catch COVID-19 from an exposure — and probably less likely to spread it to others.
Some health experts have still raised concerns about the science behind the shorter timeframes. Walensky said that with the high numbers of infections amid the country’s omicron surge, the isolation timeframe is a practical concern, too.
“We want to make sure there is a mechanism by which we can safely continue to keep society functioning while following the science,” she told the Associated Press.