Quarantining and Isolation: When Do You Do It, and Why?

Elemental explains how to protect yourself — and others — from Covid-19

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FFor the vast majority of Americans, chances are still slim that you’ll be exposed to the new coronavirus. But as Covid-19 continues to spread through the U.S., particularly in major metropolitan areas like Seattle, New York, and the Bay Area, it’s good to know what the protocol is, just in case.

What happens if I’m potentially exposed to the virus? Do I need to be quarantined? What does that even mean?

First, some quick definitions: Quarantine is for people who have been exposed to the virus but haven’t gotten sick. Isolation is for people who are ill and infectious.

“If you are ill, you would go into isolation. If you’re exposed to someone who’s ill, you go into quarantine,” explains George Rutherford, a professor of epidemiology and biostatistics at the University of California, San Francisco.

The general rule of thumb seems to be that the quarantine lasts for 14 days, which is twice as long as the incubation period from exposure to the virus to onset of disease.

You should quarantine yourself if you’ve had close personal contact with someone who is symptomatic or tested positive for the virus. That doesn’t mean just being in the same grocery store, office building, or bus as someone who’s infected — it means being within three to six feet of them so that if they coughed viral particles, these could potentially land on and infect you.

With a quarantine, you shouldn’t go out in public or go near anybody else. Don’t go to work, don’t go to school, don’t go to the store, don’t use public transportation or a ride-share. Do call your doctor to let them know you’ve potentially been exposed. Your doctor can then inform the state health department to help keep track of the spread of Covid-19. The general rule of thumb seems to be that the quarantine lasts for 14 days, which is twice as long as the incubation period from exposure to the virus to the onset of disease. If you don’t become symptomatic during that time, you’re in the clear.

If you live with other people, try to stay isolated from family members or roommates by using a different room and bathroom, be vigilant with washing your hands and cleaning surfaces, and don’t share household items such as towels or dishes. If you become symptomatic, your family or roommates may end up needing to be quarantined too.

I think I’ve got symptoms of Covid-19. At what point should I ask for a test? Where do I go?

If you think you might have Covid-19, you need to be in isolation. Do not go out in public, and stay away from friends and family members as much as possible. Do not just show up at the emergency room; instead, call your doctor’s office, and a nurse or clinician will do a phone screen with you to let you know if you need to come in or if you qualify for testing.

“Call ahead whether it’s your doctor’s office, whether it’s the ER, whether it’s a clinic, whatever, but give them a chance to not spread this further,” Rutherford says. “Give them advance warning instead of just showing up so they’ll have a place to put you.”

Because there is still a shortage of tests, the CDC and state health departments are limiting them to people who both have symptoms and have either international travel or a potential direct exposure, but that may change in the coming days and weeks as more tests are made available. If you don’t meet both criteria, health care workers will likely tell you to stay home and isolate yourself. If you get worse or have difficulty breathing, call 911 and you can be admitted to a local hospital for more intensive care.

What is the test testing for, exactly?

If you’re eligible, doctors will give you a nose and throat swab, which they’ll then send to a state lab or the CDC to analyze using a technique called PCR (polymerase chain reaction) to look for a small fragment of viral RNA. If the test is positive — the virus RNA was found inside your cells — it means you were recently infected with the virus.

The test can’t tell if someone had Covid-19 several months ago because once the virus is fully cleared there will be no traces of its RNA left. In order to diagnose the virus retrospectively, you would need a blood test to look for antibodies — markers that the immune system changed in response to the specific infection — but scientists haven’t developed that yet.

“Call ahead whether it’s your doctor’s office, whether it’s the ER, whether it’s a clinic, whatever, but give them a chance to not spread this further.”

How does someone know if they’re cured?

If someone has tested positive for the virus, according to the CDC, they’ll need to have two consecutive negative tests at least 24 hours apart from both the nose and throat swabs. They should also have an improvement in their symptoms with no sign of a fever for at least 72 hours.

So how long is this going to last? Will the new coronavirus ever go away?

There has been some speculation that, like the flu, Covid-19 may be a seasonal virus, and rates will decline in the spring. Many viruses are more active and infectious in colder temperatures, but no one knows if the new coronavirus will act in the same way. There have been far fewer cases in the Southern Hemisphere, where it’s summer, than above the equator, but that’s likely because a much smaller percentage of the world’s population (just 10%–12%) live there. The virus has spread in warm climates like Singapore and Thailand. If the virus does wind down in the spring it would be a huge boon to scientists and public health officials who are hard at work testing a vaccine and a treatment for Covid-19, but right now it’s too soon to tell.

The coronavirus outbreak is rapidly evolving. To stay informed, check the U.S. Centers for Disease Control and Prevention as well as your local health department for updates. If you’re feeling emotionally overwhelmed, reach out to the Crisis Text Line.

Health and science writer • PhD in 🧠 • Words in Scientific American, STAT, The Atlantic, The Guardian • Award-winning Covid-19 coverage for Elemental

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