What It Means to Isolate, Quarantine, or Shelter in Place
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There is a lot we don’t know about this pandemic, but one thing that seems clear is that we will all be isolating or quarantining at some point soon.
Social distancing is the least drastic. The Centers for Disease Control and Prevention (CDC) is recommending all seemingly healthy people practice social distancing. It helps minimize the potential spread of COVID-19.
This means no large gatherings, which are starting to be outlawed in many states. What determines a large gathering varies but can mean as few as 10 people.
Even when you are with other people, regardless of the number, stay at least six feet away. This is the contagion radius. The one exception is the people who you live with, assuming they are not sick with COVID-19 or have not had contact with someone who has tested positive for it.
Quarantine is for when you’ve been exposed to a contagious disease. Isolation is for people who have a contagious disease. But these words are often being used interchangeably. And they may even have slightly different meanings depending on where you live.
If you think or know you’ve been exposed to COVID-19, you should self-quarantine from everyone, including those you live with.
If you do not develop symptoms after two weeks, you may not need to stay away from other people who are healthy. Social distancing will most likely still be recommended depending on the status of COVID-19 in your community. This protects other people from getting the virus from someone who is asymptomatic—infected with COVID-19 but not showing symptoms.
If you test positive for COVID-19 and are high risk—over 60 years old, immunosuppressed, and/or have an underlying health condition like chronic obstructive pulmonary disease (COPD)—you will probably stay in the hospital in case you need additional care like a ventilator.
If you’re not high risk and have mild symptoms, it is likely you’ll self-isolate in your own home. You will need to stay away from all other people until signs of the infection are gone, for a minimum of 14 days.
You can still shed the virus for up to seven days after it leaves your system, so talk to your doctor about when it’s safe to stop isolating, says Laila Woc-Colburn, MD, associate professor of infectious diseases and director of medical education at the National School of Tropical Medicine at Baylor College of Medicine.
Self-isolation is for those with confirmed or suspected coronavirus. It essentially means not leaving your house except to seek medical care, and minimizing contact with all other people, including those you live with. (Check out the CDC’s full run-down of what to do if you're sick with COVID.)
You can have food delivered, but it should be left outside the door. Similarly, friends can leave food and supplies outside your door. This will not be easy, but it’s the most effective way to try to contain the spread of COVID-19.
If for some reason you must be in the same room as other people, stay at least six feet away from them. If you have a mask, wear it. And even though you will not have had any physical contact, they need to wash or sanitize their hands thoroughly as soon as you are no longer with them.
Even if you have not been around anyone with a known case of COVID-19 and do not have any symptoms such as a fever, cough, or difficulty breathing, you should still be practicing social distancing at all times.
Self-isolating when you do not live alone
If you live with others and need to home-isolate, physically distance yourself as much as possible, advises Cassie Majestic, MD, an emergency medicine physician in Orange County, CA. Stay in a separate room at all times.
Significant others and kids should sleep and remain in a different room at all times. And no hugging or touching. Don’t share personal household items (dishes, utensils, bedding, towels). Ideally, use a separate bathroom. If that is not possible, disinfect every time you use it.
“High touch” surfaces (countertops, doorknobs, keyboards, handles, etc) should be disinfected multiple times a day. Food, medication, and other items should be left outside your door and not physically handed to you. Disposable cutlery and plates can help minimize risk of germ transfer. Otherwise, someone should wash all exposed dishes, ideally in a dishwasher or for at least 20 seconds each by hand. Then hands should be washed with soap and water for at least 20 seconds.
Shelter in place vs. lockdown
There is no strict definition for what will be involved if your area is in lockdown or you are told to shelter in place. San Francisco is in lockdown, but currently, people are still allowed to go for a walk or run as long as they maintain a six-feet distance from anyone they do not live with. New York City is considering a shelter in place, which is similar to a lockdown but may have stricter restrictions.
How to prepare
More and more places are considering enforced isolation, lockdown, or shelter in place at home. It is better to be prepared for the possibility. And while it is likely you’ll be able to go out for groceries, medications, and other supplies, stock up now. This is different from hoarding—where you buy as much as you possibly can of an item—which you should not do. The CDC has a checklist but below are some essentials.
- 15- to 30-day supply of non-perishable food like pasta, beans, canned goods, peanut butter, and pet food.
- Disinfectants and other cleaning products, liquid soap and hand sanitizer, and basic household goods like toilet paper and paper towels.
- Pain relievers like ibuprofen and a 30-day supply of all prescription medications but ideally 60-days in case there is a delay in refilling.
Most important, if you forget something, don’t panic. Grocery stores will remain open and will be restocking. Even under the most severe restrictions, people should be allowed to go to the grocery store and pick up medications.
The goal of these restrictions is to help stop the spread of the disease. And to keep the healthcare system from being overwhelmed by a huge number of sick people at once.
We will know that these measures are working when the number of new COVID-19 cases is lower than the number from the day before. Then we will hopefully start being on the road to recovery.
The scientific understanding of COVID-19 as well as guidelines for its prevention and treatment are constantly changing. There may be new information since this article was published. It’s important to check with sources like the CDC for the most up-to-date information.