Having worked in Urgent Care throughout 2020 and the COVID pandemic, I’ve seen the same questions and concerns come up time and time again. We’ve been at this for a year now, but there is still plenty of confusion surrounding this disease and what we should do about it. So I wanted to get some information out there to provide easy guidance on some of the most common topics that still confound us in 2021. Hence, The COVID Series.
In the first article, we’re going to talk about quarantine. Guidelines have changed, employers are making up their own rules, and there are different recommendations for every situation. But if you break it down, it’s actually pretty easy to figure out who should quarantine and for how long. We’ll use the CDC’s return to work guidelines on this one, and if you want to take a peek at those for yourself, it’s all publicly available here.
I’ve been exposed!
First, let’s talk about exposure. The CDC gives us a very clear definition of what a “close exposure” is. If you meet any of these criteria, you’ve had a close exposure:
- You were within 6 feet of someone with COVID for at least 15 minutes.
- You ate or drank after someone with COVID.
- You had direct contact with someone with COVID (like a hug or kiss).
- You provided care for someone with COVID in their home.
- Someone with COVID coughed or sneezed right on you (Ew!).
Now, if you’ve had a close exposure, what should you do? The answer is pretty simple. Quarantine yourself in your home for 14 days! You can show up positive for COVID even 12 or 13 days after exposure. I’ve seen it happen too many times. That’s why the CDC recommends a full 14 day quarantine after any close exposure.
If you need to get back to work quicker, the CDC does allow for a couple of ways to do that. These newer guidelines were released to allow folks to get back to work sooner if their need is URGENT. You can get back to work sooner than 14 days in the two following ways:
- You’ve gone 10 days after the exposure and have developed ZERO symptoms.
- You get a negative COVID test at least FIVE days after the exposure, AND you haven’t developed any symptoms by day SEVEN. Then you can return on day eight.
Remember, this is not ideal. We always want to go the full 14 whenever possible!
What if I live with someone who has COVID?
If someone in your house tests positive for COVID, you might be in for a long quarantine. If you can separate ENTIRELY from that person for the remainder of their quarantine, then you only need to quarantine for 14 days from the last time you had close exposure to them (see the guidance above). However, if you have repeated exposure to that person (like caring for a child who has COVID), then your quarantine goes for 14 days AFTER THE END of their quarantine. That’s right, because every day counts as a new exposure, you may have to quarantine for up to 24 days. That’s why it’s best to completely separate from a COVID patient if at all possible.
I’m infected!
If you test positive for COVID, how long you need to quarantine depends on one thing- Do you have symptoms? If you have symptoms, you should quarantine for 10 days from the START of those symptoms. If you never had any symptoms, you should quarantine for 10 days from the date you tested positive. After your ten days are up, as long as you haven’t had a fever in 24 hours, and you feel at least a little better, you’re all done!
Bonus: Should I be retested?
Easy answer- Almost certainly not! The CDC specifically states you should ONLY get retested if you have recovered from COVID and then develop new symptoms. COVID tests are so sensitive that they will detect dead viral particles in your nostrils for up to 90 days after you have cleared the infection. A positive test within 60 days of COVID infection likely means absolutely nothing. Yes, I know that many employers are demanding a negative test before they will allow you to come back to work. But I’ve seen dozens of patients who have needlessly missed weeks of work because their employer continued to force them to retest after they had been cleared by CDC criteria. If you’ve got a boss who’s asking for this, point them to the CDC website. It’s all right there for the public! Now, if you’ve got an elderly or unwell relative or friend you want to visit, and you’re terrified of infecting them, there’s nothing wrong with waiting until you get a negative test to be absolutely, without a doubt, 100% sure you’ve cleared the virus. Also, if your doctor recommends retesting for a specific reason (make sure they can give you one!), then you should probably go ahead and do it. Otherwise, there’s really no good reason to retest after infection.
Well that’s it for article 1 of the COVID series! Hopefully this clears up some confusion and helps to demystify the current recommendations. Of course, all New Leaf Online patients are welcome to call or text me any time with any questions they might have about this or any other health topic. If you’d like to enroll as a patient at Auburn Direct Primary Care, just click on our Enrollment button. We’d love to have you join the New Leaf Online family!
All best,
Kyle Adams, MD
