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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Moving Forward Safely

One of the most frustrating and anxiety-producing traits of our COVID –19 pandemic is how much uncertainty is involved in all aspects of this disease. Symptoms caused by the Coronavirus, age groups affected, the usefulness of medications, anticipated death rate, and the timeline for development of a vaccine are examples of information that sometimes change on a weekly basis.

Vermonters have done a great job of limiting the spread of the virus and protecting our most vulnerable neighbors by following the Governor's "Stay Home, Stay Safe" order over the past few months. Now, we've all been directed to wear masks in public. Both Bennington and Wilmington's Select Boards have passed local mandates requiring masks in public places. Thanks to these efforts—along with distancing, handwashing, and other factors—Vermont is among the states with the fewest number of infections. Continuing each of these important infection-prevention strategies is crucial to returning to a more normal way of life.

As we open up and begin to re-connect, we fully expect to see a rise in COVID –19 cases in Vermont. Thankfully, we have had time to prepare for this increase. We also have adequate PPE, and increased testing will help us gather crucial information for stemming the spread with less disruption to our normal lives.

More than ever, I find it helpful to focus on what we have learned and how it can help us move forward safely. Here is some of what we have learned so far: Most large hospitals, often treating over 1000 COVID patients daily, effectively protected their workers by obsessively following the rules of screening, hygiene, distancing, and masking. Each of these components is designed to work together; Each alone has its inherent limits.

  • Absent quick testing at the workplace, the best screening is asking employees if they have COVID-like symptoms (fever, chills, new cough, shortness of breath, sore throat, loss of taste or smell) and to stay home if they do.
  • Washing our hands (or using sanitizer) after touching well-handled items or visiting populated areas. Washing your hands 10 times daily is not too often.
  • Though an uncovered sneeze or cough can travel farther, 6 feet distancing continues to be the sweet spot for safety.
  • Masks (double layer cotton and surgical) are effective to prevent spreading of large and some small droplets containing virus. They also seem to give some minimal protection to those wearing a mask. Since possibly 40 percent of transmission happens when we do not have symptoms, we wear our masks to protect others and to suppress overall infection rate. They also help many people (not all) to avoid touching their face. The downside is a warm chin; the upside is you may be protecting someone from a significant illness. Masks are not a symbol of government intrusion. Masks are simply a tool to protect others and show empathy.

It is difficult to predict how many COVID-19 infections will occur in our communities in the coming months. What I am certain of is that our choices, on where we go and what we do, often affect the safety of those around us. As we learn to live with this virus in our community, following the recommendation above will help us all.

Marie George, MD, is SVMC’s infectious disease specialist.

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