By Deborah Netburn
Tribune News Service
You’re doing everything right to avoid getting the coronavirus — avoiding handshakes, eschewing large gatherings and, of course, washing your hands several times a day. And yet, you’re worried.
Maybe you sat next to someone who was coughing in a movie theater. Or your spouse just returned from a business trip in Europe. Perhaps someone in your office building was diagnosed with COVID-19.
Now you can’t help but wonder: Do I need to self-quarantine? It’s an important question. People who have a compelling reason to believe they may have contracted the virus should isolate themselves for 14 days to see if they develop symptoms of COVID-19 — dry cough, fever, shortness of breath.
But a fortnight is a long time to be holed up. It’s not an action that should be taken likely.
“We have to keep living our lives, and by and large we should be able to,” said Dr. Nancy Gin, medical director of quality and clinical analysis for Kaiser Permanente in Southern California. “We need to respect this coronavirus, but not fear it.”
FIRST, A QUICK DEFINITION AND A DISTINCTION
Self-quarantine is when you feel fine, but you separate yourself from others because there’s a high chance you’ve been exposed to the disease.
Isolation is when you avoid people because you have symptoms of a disease and you don’t want to get others sick. In practice however, they look pretty similar.
“They have the same end game, which is that you are sequestered from the rest of the public for a period of time,” said Dr. George Rutherford, an infectious disease specialist at the UC San Francisco School of Medicine.
WHEN SHOULD YOU SELF-QUARANTINE OR ISOLATE YOURSELF?
The Centers for Disease Control and Prevention recommends that you self-quarantine if you have a medium or high risk of having recently contracted the coronavirus.
As of March 12, the CDC has identified just two scenarios that it considers high risk for coronavirus exposure:
- If you recently traveled back from China’s Hubei Province.
- If you live with, or are intimate with, someone who has been diagnosed with coronavirus and you have taken no steps to protect yourself.
The health agency has also described a few medium-risk situations, including recent travel to Iran or another country with sustained community transmission, close contact with someone with a laboratory confirmed case of COVID-19, or living with someone with confirmed COVID-19 and taking some precautions.
In these cases, experts recommend that you stay away from others for 14 days to see if any symptoms of the virus develop. If you are feeling sick — sore throat, fever, even just a cold — you should stay home as well.
“In the setting of the global pandemic, I think it is important for individuals who experience cold or flu-like symptoms to self-isolate themselves,” said Dr. Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security.
WHEN IS SELF-QUARANTINE UNNECESSARY?
Healthy Americans who do not fall in the high- or medium-risk categories do not need to self-quarantine at this time.
“In general, you should stay home if you have symptoms and not if you don’t have symptoms,” Gin said. “Think about how you would monitor yourself for the flu” and do that, she said.
So even if you live with someone who has flu-like symptoms, it is not necessary to self-quarantine. Even if someone in your office has been diagnosed with COVID-19, you do not need to self-quarantine. Even if you went to a conference where someone was diagnosed with COVID-19, you do not have to self-quarantine. Even if you flew on a plane, you do not have to self-quarantine (unless someone within two seats of you was diagnosed with COVID-19).
In all these cases, the advice is the same: “Monitor yourself for symptoms and then self-isolate if they develop,” Adalja said.
HOW LONG SHOULD YOU SELF-QUARANTINE IF YOU DO NOT HAVE SYMPTOMS OF COVID-19?
Health officials advise that if you do need to self-quarantine, you should expect to do it for a full two weeks to be safe. In a study of 181 people who contracted the new coronavirus, most people developed symptoms within six days of becoming infected, and 98% of them had symptoms by day 12.
The authors of the study calculated that only 101 out of every 10,000 patients will take longer than that to begin showing symptoms.
HOW LONG SHOULD YOU REMAIN IN ISOLATION IF YOU DO HAVE COVID-19 SYMPTOMS?
If you have cold and flu-like symptoms, you should isolate yourself from others for the duration of your symptoms, which could be up to 14 days.
SHOULD YOU TELL YOUR HEALTH CARE PROVIDER IF YOU DECIDE TO SELF-QUARANTINE OR TO ISOLATE YOURSELF?
It’s a good idea to notify your health care provider before you begin either one. He or she can give you tips on how to stay safe and protect those around you, as well as what red flags to look for that would indicate you need to see a doctor or nurse in person, or be moved to the hospital.
HOW CAN YOU KEEP THE PEOPLE YOU LIVE WITH SAFE?
If you do have to self-quarantine or isolate yourself, you should have as little contact with others as possible. Ideally, you would stay in a private room that other members of the household do not enter. However, since that is not always realistic, you should wear a mask to protect others.
“It is not necessary for the family to wear a mask, only the sick person,” Gin said.
CAN YOU WALK YOUR DOG IF YOU ARE IN SELF-QUARANTINE?
Yes. You can also accept a food delivery or sign for a package. That also goes for people who are self-isolating. “It’s 15 minutes of close face-to-face time that puts people at risk or two hours or more of contact in a contained environment,” Gin said.
“If you walk your dog and pass your neighbor, that’s fine.”