What is the difference between quarantine and isolation?
Quarantine means the separation of a person or group of people reasonably believed to have been exposed to a communicable disease but not yet symptomatic, from others who have not been so exposed, to prevent the possible spread of the communicable disease.
Isolation means the separation of a person or group of people known or reasonably believed to be infected with a communicable disease, and potentially infectious, from those who are not infected, in order to prevent spread of the communicable disease.
What is meant by self-quarantine and self-isolation?
Self-quarantine (or self-isolation) means an exposed (or ill) person is asked to minimize their contact with others by staying in their apartment or home (or other location approved by the local health department). During this time, quarantined (or isolated) persons may not attend classes/labs/exams, go to work, be in public areas, use any public transportation (including ride-sharing services), or attend large gatherings or events. They should not go out to restaurants, coffee shops, or receive guests.
Persons in quarantine (but not isolation) may leave their home (in a private vehicle) for a limited time to take care of routine and necessary activities, such as grocery shopping or visiting the pharmacy.
Self-quarantine and isolation may be difficult to manage in communal living situations, especially for students. Students residing in university housing will need assistance. Other students should take appropriate steps to self-quarantine or isolate, including relocating, asking roommates to relocate, or taking measures to minimize contact with others. People with low risk exposures may only require self-observation rather than quarantine. Recommendations for who should be in quarantine vs. observation are in flux and depend on the risk of exposure. Consult with your local health department and the CDC COVID-19 website for additional guidance.
What is self-monitoring?
Persons with an elevated risk of exposure to COVID-19 may be asked to “self-monitor” for symptoms. This means they should measure (and record) their temperature twice daily and watch for fever, cough, or trouble breathing. In the event these symptoms develop, or they have a fever greater than 100.4°F, they should contact a health care provider.
How long should patients be isolated after they are tested for COVID-19?
Patients who are tested for COVID-19 because there is clinical suspicion, but who do not have known or suspected exposure to SARS-CoV-2 should be in appropriate isolation while the test is pending, but do not require prolonged isolation if the test for COVID-19 is negative. They can return to their normal activities, while remaining mindful of signs and symptoms, and continuing to practice good hand hygiene and respiratory etiquette.
Symptomatic patients who are tested and are medium or high risk contacts of a COVID-19 case, or have traveled from a country with a level 3 travel health notice or a U.S. state with community transmission, should remain in isolation for at least 14 days after their last exposure (or last date in the affected country/state), even if their COVID-19 test is negative (i.e, they remain in quarantine). Separation of individuals with exposure to COVID-19 for 14 days is recommended, regardless of if the individual is symptomatic, or if they have respiratory symptoms from any cause.
How long should patients be isolated after they are diagnosed with COVID-19?
In general, people should adhere to home isolation until the risk of secondary transmission is thought to be low. The decision to discontinue home isolation should be made in the context of local circumstances, so follow instructions from your local or state health department. For patients diagnosed with COVID-19 who are recovering in a home setting, isolation may usually be discontinued when both of the following have occurred: (1) The patient is free of fever without the use of fever reducing medications, productive cough and other acute symptoms of respiratory infection for 72 hours, AND (2) 7 days have elapsed from the day the patient first experienced symptoms. See CDC Guidance.
What about contacts of contacts?
Persons who are contacts of exposed but asymptomatic persons are not considered to be at increased risk, and no special guidance applies. For example, the roommate of an exposed person who is in self-quarantine is not restricted in their activities. For more information, consult the CDC COVID-19 website for the definition of what constitutes an exposure.
How should we advise a student via phone or telehealth who may have symptoms or needs testing?
If the student needs emergency medical attention, they should call 911 and let them know they may have COVID-19 (based on travel history, exposure, quarantine status, or symptoms).
If the student is being referred to another health care facility, contact the facility in advance and follow their instructions.
Students should be encouraged to call the student health center before going to the center for a visit or entering the waiting room. This information with a phone number should be posted to websites and on the entrance to the health center. If after telephone triage, it appears that the student should be seen for an in-person visit, consider referral to an appropriate community provider. If they are to be seen by the college health service arrange for them to enter via an alternate entrance if possible and meet them at the door. Immediately provide a mask to the ill person on arrival at your facility.
Any ill person seeking health care should be advised:
- Call your health care provider for advice.
- If you have fever and are experiencing difficulty breathing, call 911.
- Do not use public transportation, ridesharing, or taxis.
- Wear a facemask if possible.
- Cover your mouth and nose with a tissue when you cough or sneeze and dispose of that tissue in an enclosed receptacle.
Students with no symptoms should be provided with self-care instructions, including hygiene within the home, how to disinfect the home, and signs and symptoms which should trigger a health care visit. When possible, try to ensure access to a thermometer. While there is some emerging evidence that patients who use non-steroidal anti-inflammatory drugs (NSAIDs) may be at higher risk of complications, there has been no official guidance to providers about avoiding the use of these drugs.