Did you or someone in your household test positive for COVID? Here’s what to do.

COVID-19 case numbers and hospitalizations are soaring in North Carolina as the omicron variant of the virus continues to spread.

In response to the nature of transmission of the omicron variant, the Centers for Disease Control last week issued new guidance for isolation for those infected with the virus and quarantine protocol for those exposed to the virus.

In a statement announcing the changes, CDC Director Dr. Rochelle Walensky said the updated recommendations “balance what we know about the spread of the virus and the protection provided by vaccination and booster doses” and that the updates “ensure people can safely continue their daily lives.”

So, what do the new recommendations say? What should you do if you or someone in your household is diagnosed with COVID? How can you stay safe?

Here are some answers.

What’s the difference between isolation and quarantine?

Throughout the pandemic, you might have used the words “isolation” and “quarantine” interchangeably.

But there is a difference, and it could impact the recommended response you should take if you or someone in your house has COVID.

Isolation applies to people who have tested positive or are showing symptoms for COVID-19.

▪ Isolation “is used to separate people with confirmed or suspected COVID-19 from those without COVID-19,” the CDC says.

You should follow the CDC’s guidance for isolation if:

• You have tested positive for COVID, regardless of whether you are showing symptoms.

• You have symptoms of COVID, even if you do not know whether you have been exposed to the virus or are a close contact of someone infected with the virus.

Quarantine applies to people who have been exposed to COVID-19 through a close contact, even if you may not have been infected.

▪ Quarantine is a strategy used to prevent further transmission of the virus by keeping possibly infected people away from others.

▪ An exposure to COVID is defined by the CDC as “contact with someone infected with SARS-CoV-2, the virus that causes COVID-19, in a way that increases the likelihood of getting infected with the virus.”

▪ The “way that increases the likelihood of getting infected with the virus” is generally through a close contact. To be considered a close contact, you generally must have been within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period.

That means if, for example, you were within 6 feet of an infected person for three 5-minute increments in 24 hours, you are considered a close contact, and should follow the CDC’s guidance for quarantine.

Some groups of people may be exempt from quarantine under the CDC’s guidance.

I tested positive for COVID. How long do I isolate?

Under the CDC’s new guidance, everyone who has presumed or confirmed COVID-19 should stay home and isolate from other people for at least five full days.

▪ Treat “Day Zero” as the first day you experienced symptoms. If you received a positive test but are asymptomatic, treat “Day Zero” as the day you tested positive.

▪ “Day One” of isolation is the first full day after you exhibited symptoms, or the first full day after you tested positive for asymptomatic people.

▪ You can leave isolation after five full days.

For example: If you have tested positive for COVID and experienced symptoms for the first time on a Sunday, Sunday is your Day Zero. Monday would be your Day One. Friday would be your fifth full day of isolation, and you could leave isolation after completing the fifth day.

The CDC says you should not travel during your 5-day isolation, regardless of whether you have symptoms.

What should I do during isolation for COVID?

If you have tested positive for COVID and are isolating, there are steps you can take to keep yourself and others safe, and prevent the virus from spreading within your household.

The CDC says you should:

▪ Monitor your symptoms. If you begin to show any emergency warning signs, seek emergency care immediately by calling 911 or another local emergency service.

Emergency warning signs include:

• Trouble breathing

• Persistent pain or pressure in your chest

• Confusion

• Inability to wake up or stay awake

• Pale, gray or blue-colored skin, lips or nail beds (depending on your skin tone)

▪ Take care of yourself. Get rest and stay hydrated. Over-the-counter medicines, such as acetaminophen, may help you manage your symptoms and feel better.

▪ Stay in a separate room from other members of your household, if possible.

▪ Use a separate bathroom from other members of your household, if possible.

▪ Clean your hands often. Wash your hands with soap and water, or use hand sanitizer if soap and water aren’t available.

▪ Try to improve the ventilation, or air flow, of your home.

You can improve air flow by:

• Bringing as much fresh air into your home as possible. Open doors and windows and use fans to to move virus particles in the air from inside your home to outside.
  
  

• Filtering the air in your home. Set your HVAC fan to “on” instead of “auto” so that the fan runs continuously, even when the air conditioning is not on.

• If you don’t have an HVAC system, consider getting a high-efficiency particulate air (HEPA) cleaner.

• Turn on the exhaust fan in your kitchen and bathroom.

• Use fans, including ceiling fans, to improve air flow. Place fans near open windows and point them so that they push air out of the window. Point fans away from people.

▪ Avoid contact with other members of your household, including pets.

▪ Don’t share personal household items, such as towels, bedding, cups and utensils.

▪ Wear a well-fitting mask, especially when you need to be around other people in your house.

When can I leave isolation if I had COVID symptoms?

If you tested positive for COVID and had symptoms, you can leave isolation after five full days.

Use the following additional CDC guidance for deciding when it is safe to end your isolation:

▪ If you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved, you can end isolation after your fifth full day. The loss of taste and smell may last for months after your diagnosis, so you do not need to wait for those symptoms to subside before ending your 5-day isolation.

▪ If you continue to have a fever or your other symptoms have not improved after five full days of isolation, you should wait to end your isolation until you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved.

▪ If you have access to a COVID antigen test and want to do so, you can test yourself towards the end of your 5-day isolation and if you have been fever-free for 24 hours. If your test result is positive, you should continue to isolate for five more full days. If your test result is negative, you can end isolation.

▪ After ending your isolation, you should still wear a well-fitting mask around others in your home and in public. If you cannot wear a mask around others or in public, you should isolate for a full 10 days.

When can I leave isolation if I was asymptomatic?

If you tested positive for COVID but were asymptomatic, you can leave isolation five full days after your positive test.

Use the following CDC guidance for deciding when it is safe to end your isolation:

▪ If you continue to have no symptoms of the virus, you can end your isolation after your fifth full day of isolation.

▪ If you develop symptoms after testing positive, your 5-day isolation period will start over. “Day Zero” will become your first day that you showed symptoms. “Day One” will be the first full day after you started showing symptoms. You can end isolation after your fifth full day of isolation. You will then follow the guidance for ending isolation for symptomatic people.

▪ If you have access to a COVID antigen test and want to do so, you can test yourself towards the end of your 5-day isolation and if you have been fever-free for 24 hours. If your test result is positive, you should continue to isolate for five more full days. If your test result is negative, you can end isolation.

▪ After ending your isolation, you should still wear a well-fitting mask. If you cannot wear a mask around others or in public, you should isolate for a full 10 days.

What to do after you end isolation

If it is safe for you to end your isolation based on CDC guidance, you should continue to follow these recommendations:

▪ Continue to wear a well-fitting mask around others in your home and in public for five additional days.

▪ Avoid contact with immunocompromised people, including those at nursing homes, for at least five more days.

▪ Avoid travel for at least five more days. If you must travel after your five day isolation, wear a well-fitting mask for the duration of your travel. If you are unable to wear a mask, you should not travel before 10 full days of isolation.

▪ Do not go to places where you are unable to wear a mask for at least five more days. Such places include restaurants and gyms.

▪ Avoid eating around others, including at home or at work, for at least five more days.

What if I was severely ill with COVID?

If you were severely ill with COVID, including if you were hospitalized or required intensive care or ventilation support, or are immunocompromised, you may need to isolate longer than five days.

The CDC recommends an isolation period of 10 to 20 days for these groups.

▪ Consult with your health care provider about when you can end isolation and resume being around other people.

I was exposed to COVID. Do I need to quarantine?

If you are exposed to COVID through a close contact, you will need to quarantine if:

▪ You are 18 years or older and have have received the primary series of a recommended COVID vaccine, but have not received a booster shot when eligible.

• The primary series of COVID vaccines are two shots of either Pfizer or Moderna.

• Pfizer booster shots are available five months after your second dose.

• Moderna booster shots are available six months after your second dose.

▪ You received the single-dose Johnson & Johnson vaccine more than two months ago, but have not received your booster shot.

• Johnson & Johnson booster shots are available two months after your initial, single dose.

▪ You have not completed the two-dose, primary series of either Pfizer or Moderna vaccinations.

▪ You are completely unvaccinated.

If you are exposed to COVID through a close contact, you do not need to quarantine if:

▪ You are 18 years or older and have received all recommended vaccine doses, including boosters and additional primary shots for some immunocompromised people.

▪ You between the ages of 5 to 17 years and have completed the primary series of COVID-19 vaccines.

• The primary series of the Pfizer vaccine, the only vaccine currently availavle for 5- to 17-year-olds, is two doses.

▪ You had a confirmed case of COVID-19 within the last 90 days.

I need to quarantine. What should I do?

If you meet the CDC’s criteria for needing to quarantine due to a close contact to COVID-19, you should follow these guidelines:

▪ You will need to quarantine for at least five full days. Stay at home and away from other people. Wear a mask if you must be around other people in your home.

• Count the day of your exposure as Day Zero.

• Day One is the first full day after your exposure.

• Continue quarantining through at least Day Five.

▪ Watch for symptoms. For at least 10 days after your exposure, monitor yourself for fever (100.4 degrees Fahrenheit or higher), cough, shortness of breath and other COVID symptoms.

• If you develop symptoms, get tested immediately and isolate until you receive your results. If you test positive, you will need to follow the guidelines for isolation.

▪ If you do not develop symptoms, you will need to get tested a minimum of five days after your exposure.

• If you test negative, you may leave your home, but continue to wear a well-fitting mask when around others and in public until at least 10 full days have passed since your exposure.

• If you test positive, you should isolate at least five days from the date of your test.

• If you test positive, then develop symptoms, you should isolate for at least five days from when your symptoms begin.

▪ Regardless of whether you test positive or negative, or develop symptoms or don’t, you should avoid immunocompromised and high-risk people, including those at nursing homes, for at least 10 days following your exposure.

▪ Throughout your quarantine, try to stay away from people in your household.

▪ Even after you end quarantine, you will need to wear a mask around others in your household and in public. If you cannot wear a mask around others or in public, you should isolate for a full 10 days.

▪ The CDC says you should not travel during your 5-day quarantine, regardless of whether you have symptoms.

• If you need to travel after your 5-day quarantine, get tested at least five days after your exposure.

• If your result is negative, you may travel with precautions, including wearing a mask throughout the duration of your travel.

• If you are unable to get tested, you should wait to travel until 10 full days after your exposure. Continue to wear a mask.

• If you are unable to wear a mask, continue to quarantine for 10 full days after your exposure and do not travel until then.

What to do after quarantine

▪ You should continue to monitor yourself for any symptoms for at least 10 days after your exposure to COVID.

▪ Continue to wear a mask around your home and in public until the 10 days have passed.

▪ If you develop symptoms at any point during the 10 days, get tested immediately and follow isolation protocol until you receive your test results.

How to get tested for COVID in North Carolina

You can find out more information about how to get tested for COVID-19 in North Carolina at covid19.ncdhhs.gov/about-covid-19/testing/find-my-testing-place.