What it Means to Isolate, Quarantine, or Shelter in Place

The next steps if you are told to stay at home.

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.

Coronavirus: Check your symptoms

Use Buoy Assistant to figure out if you should seek care for COVID-19.

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Self-quarantine

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.

Self-isolation

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.

Hear what 5 others are saying
COVID positive 3 timesPosted May 3, 2020 by V.

I am 34-year-olds and possibly contracted the virus from a coworker who had symptoms and tested positive. I felt fine, just dealing with allergies, but I went to test as a precautionary measure. While I waited for my results, I lost my sense of smell and knew then that the test would come back positive and it did. I regained my sense of smell 3 days later and waited my quarantine time to retest... having no symptoms I was sure I would test negative... but it came back positive a second time... I quarantined an additional 14 days and went to test again... still asymptomatic.... I said third time is a charm.... 4 days later I get my results and tested positive again.... I have been self-isolating for 39 days and counting. I have tested positive three times for COVID-19. I spiraled emotionally. Everyone says I should be happy I have no symptoms but I may not be physically hurting... but it does take a big emotional toll. I don't know what the next steps are...

What am I supposed to do?Posted April 28, 2020 by A.

Female, age 41. I'm a type 1 diabetic for 35 yrs now. I also have a history of cardiomyopathy & CHF. I don't feel that well most of the time. The CHF left my lungs a bit weak, I have an inhaler, no asthma. I also have seasonal allergies. I've had a painful headache, different from any I've had before. I take Tylenol, but it doesn't really help. For the past week, I've had cramps & lower back pain—I'm not due for my cycle & there's no way possible I could be pregnant. 3 days ago I became nauseous & vomit every time I eat. I understand none of these recent symptoms fall under the C19 virus. It's close to impossible that I'm able to get through to my pc. I'm also too scared to go to the hospital. I wish there were a few more options on Buoy to add my other conditions, ie: I sometimes have a hard time breathing, not due to asthma, heart issues. What do I do? Again, I'm only 41, I feel people like myself, & me, have been forgotten about or have slipped through the cracks.

Spouse with compromised immune systemPosted April 21, 2020 by C.

4/21/2019: Male, age 53. Generally healthy. Have been working from home since March 16—so it has been over a month. My wife has a compromised immune system due to her medication for MS. So I am careful when and if I need to go out. Since being home, I average about 1 to 3 trips a week—going to either the pharmacy, grocery store, or to pick up take-out food. (I try to complete all my chores in a single trip.) I live in a suburb and have access to sidewalks for exercise—the sidewalks are not very crowded. I do my best to maintain social distances in all public areas. For the last 2 to 3 weeks, when in public, I have been wearing a folded bandana with balaclava for added protection—plus rubber gloves when in the supermarket. (We also have used curbside pickup the last time we did take-out.) However, it is impossible to maintain social distances in the supermarket under all circumstances—even if the owners meters the number of customers. While most customers do wear face masks, about 15% do not. My last trip was 2 days ago. Today, my throat is a bit scratchy and I am developing a cough. Plus, my nose is a bit moist. I took the "quiz" and the result was that testing is not required, but self-isolation is recommended. I'll do my best for the next 14 days, but we have a small house. I wish the quiz has a question asking whether you live with people who are high risk.

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