New Guidance about COVID Isolation and Quarantine
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/ Categories: WELLNESS, 2021

New Guidance about COVID Isolation and Quarantine

Earlier this week, the Centers for Disease Control and Prevention (CDC) reduced the recommended duration of quarantine after exposure to someone with COVID-19 and isolation after testing positive for the virus. Extensive experience over time has shown that most transmission of the virus to other people occurs 1 - 2 days after an individual is exposed and up to 3 days after symptoms begin.

A large proportion of the population will be exposed to the omicron variant over the next several weeks. We should expect a progressively negative impact on some services, including public transportation, retail stores, sporting events, and school activities. Such disruptions were evident when thousands of flights were canceled over the Christmas holiday due to flight crews requiring isolation after testing positive for the virus. The CDC’s new guidance aims to preserve safety while decreasing unnecessary disruption to our daily lives.

Here’s what you need to know:

After Exposure

  • Those who are vaccinated and if eligible, boosted, do not need to quarantine after exposure. They should, however, wear a mask around others for 10 days.
  • People who are unvaccinated or vaccinated but have not received a booster when eligible should quarantine for 5 days after exposure to someone with COVID-19, followed by 5 days of mask use when around others, including in the home with family.
  • All individuals who are exposed should get a COVID-19 test 5 days after their exposure.

(Click image to download or print)

After Testing Positive

  • An infected person may end isolation after 5 days after the positive test if symptoms are resolving and they are not experiencing a fever.
  • If the symptoms persist after isolating for 5 days, the person should remain isolated until symptoms are resolving and they are not experiencing a fever.
  • The individual may then return to normal activities but should wear a mask around others for 5 more days.

(Click image to download or print. Note that the chart below is on page 2 of the PDF.)


Anyone with Symptoms

Individuals with symptoms, regardless of whether they have been exposed, should quarantine until a negative test confirms the symptoms are not due to COVID-19.

Nearly every one of us will encounter the virus at some point in the near future. We can take solace in knowing that those who are vaccinated and boosted are much more likely to be asymptomatic or experience or cold- and flu-type symptoms rather than severe illness requiring hospitalization.

Trey Dobson, MD, is the chief medical officer at Southwestern Vermont Medical Center in Bennington and an emergency medicine physician at Dartmouth-Hitchcock Health. 

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How to Maintain a Healthy Immune System

There are so many things that we have little control over. We can't control what genes we get, how old we are, or what viruses are circulating in our environment, but there is a lot we can do to prevent illness. Remarkably, many of the same habits that protect you from diseases like diabetes, cancer, and heart disease also help your immune system fight infections.

Most viruses can't hurt you until they get inside your body. So, we can help our immune system if we avoid viruses and cut off the ways they travel. Viruses can spread through the air, but not usually for very far. Keep your distance—at least 6 feet—from others, and be a good neighbor by wearing a mask in all public areas.

Viruses that cause the most common illnesses—respiratory infections, including the common cold, flu, and the new COVID-19—travel into the body through your mouth, nose, and eyes and make their way to the areas they infect, like the lungs. The best way to break this chain is to clean your hands frequently, and don't touch your face with hands that have touched anything else. In addition, you can reduce the number of viruses in your environment by cleaning frequently touched objects with a bleach- or alcohol-based cleaner.

Vaccinations are your next line of defense. Immunizations, like the flu shot, introduce a small and harmless part of a virus or bacteria. The vaccine gives your immune system an opportunity to make antibodies against the virus. A vaccinated immune system responds more quickly and effectively when illnesses are introduced. What's more, when we all get vaccinated, we decrease the likelihood that anyone will get sick. If you are unsure about whether you or your children are up to date on their vaccinations, call your primary care provider’s office.

Your third line of defense is living a healthy lifestyle. It is clear that the same things that help the rest of our bodies function also improve the strength of our immune response. Likewise, things that hinder our bodies' ability to function compromise the immune system.

Regular exercise might be the most powerful way to maintain a healthy immune system. By increasing heart rate and blood flow, we allow the cells and substances of the immune system to move through the body freely and do their job efficiently. Similarly, things that slow the movement of cells and substances, like smoking or drinking alcohol in excess, may decrease the body’s ability to function and decreases the immune response, as well.

Getting adequate sleep may also positively affect the immune response. Chronic sleep deprivation has been shown to decrease the beneficial boost in immunity from vaccinations.

Our emotional state, too—whether we are stressed, lonely, or depressed, for instance—affects our immune response so much that a relatively new specialty called psychoneuroimmunology now studies the connection. One pioneering study, conducted in the early 1980s, found that college students operating within a stressful 3-day exam period had fewer of the cells that fight tumors and viral infections. In simple terms, the students almost stopped producing immunity boosters and infection fighters.

Finally, physicians have concluded that eating a mostly plant-based diet—including fruits, vegetables, beans, nuts, whole grains, and lean protein—supports overall health and may also support immunity. Nutritious foods include important vitamins that the immune system needs to function, such as beta carotene, vitamin C, vitamin D, and zinc. Note, however, that supplements that claim to improve immune function have not yet been shown to do so to the extent necessary to protect against infection and disease. It is better to eat whole foods that are rich in vitamins rather than take supplements.

Always consult with your provider before making changes to your exercise plan or trying a new supplement and if you have any medical concerns. Physicians and the other professionals working in their offices also provide help for developing a plan for a healthier life. Call your primary care office or 802-447-5007 to find a primary care provider.

Healthy habits, like those that protect your body from disease and infection, are not always easy to adopt or maintain. Perhaps knowing just how important they are to maintaining a healthy immune response will provide the extra motivation necessary to make them a priority.

Kim Fodor, MD, is an internal medicine physician at SVMC Internal Medicine.

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