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Guidelines to discontinue isolation after being diagnosed with COVID-19 either clinically (by symptoms only) or by RNA nasopharyngeal testing (with and without symptoms) for patients who are not healthcare providers:

For Symptomatic Persons with COVID-19 Under Isolation:

1). Symptom-based strategy

May discontinue isolation under the following conditions:

• At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and
• Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
• At least 10 days have passed since symptoms first appeared.

2). Test-based strategy (if available)

May discontinue isolation under the following conditions:

• Resolution of fever without the use of fever-reducing medications and
• Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
• Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive respiratory specimens collected ≥24 hours apart (total of two negative specimens).

For Asymptomatic Persons Who have Tested Positive and are Under Isolation:

1). Time-based strategy*

May discontinue isolation under the following conditions:

• At least 10 days have passed since the date of their first positive COVID-19 diagnostic test assuming they have not subsequently developed symptoms since their positive test.
• If they develop symptoms, then the symptom-based or test-based strategy should be used.

2). Test-based strategy*

May discontinue isolation under the following conditions:

• Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive respiratory specimens collected ≥24 hours apart (total of two negative specimens)*.

*Note, because of the absence of symptoms, it is not possible to gauge where these individuals are in the course of their illness, and it is possible that the duration of viral shedding could be longer or shorter than 10 days after their first positive test. There have been reports of prolonged detection of RNA without direct correlation to viral culture.

For the full CDC recommendation: Discontinuation of Isolation for Persons with COVID -19 Not in Healthcare Settings, Recommendations from CDC

From WebMD*

“Since we know that the virus is transmitted through droplets when someone coughs or sneezes and contact with contaminated surfaces, there are steps we can take to stay safe. Here are some things to consider when creating an “isolation zone” in your home:

• Designate a separate room where you can close the door, if possible. If that’s not an option, find a space where there is at least 6 feet between the sick person and other people.
• Those who are not sick should use a different bathroom from those who are, if available. If a separate bathroom is not available, the sick person should clean the bathroom after each use. Others in the home should try to let the bathroom “air out” for at least 30 minutes before using it again. And make sure that everyone in the home – regardless of which bathroom they’re using – closes the toilet lid when flushing and runs the exhaust fan to limit viral particles in stool from hanging out in the air.
• Try to make sure that any shared spaces in the home have good air flow, with an air conditioner or an open window. Air filters and air purifiers can also be helpful in these situations — look for air filters that are designated MERV 13 or higher. Humidifying the air can also be helpful, because viruses live longer at lower humidity. Setting the humidity to between 40-60% is ideal.
• If possible, the sick family member should wear a face mask when they are around other people (a basic surgical mask is what’s recommended) . Caretakers can use one too when within 6 feet of a sick person. If a face mask is not available, limit time in close contact to less than 15 minutes and disinfect all surfaces that the sick person has come in contact with. If not having a face mask makes you feel anxious, you can make a DIY face mask at home, though be aware that we still don’t know how much protection a DIY mask truly offers. If you do make one, make sure it fits snugly around your mouth and nose. The University of Cambridge did some studies looking at the protection you may get from different materials: from vacuum cleaner bags to cotton t-shirts.
• Avoid sharing household items like dishes, cups, utensils, towels, bedding, or other items.
• Don’t allow the sick family member to interact with or care for any pets in the home.
• Clean all “high-touch” surfaces, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables, every day. Also, clean any surfaces that may have blood, stool, or body fluids on them.
• Wash laundry thoroughly. If you can, wear disposable gloves while handling soiled items and keep soiled items away from your body. Remember to clean your hands immediately after removing your gloves.
• Place all used disposable gloves, face masks, and other contaminated items in a bag before disposing of them with other household waste.

Make sure to monitor your loved one’s symptoms and call the healthcare team immediately if their symptoms worsen.”

If Someone in Your Home Has COVID-19: How to Keep Others Safe

“Take immediate action to prevent further spread of COVID-19.

Have you received notification that you tested positive for the virus that causes COVID-19? There is no reason to panic. Most individuals who are not at increased risk for severe COVID-19 illness typically experience a flu-like episode and fully recover.

If you test positive for COVID-19, you should:

• Isolate yourself at home and do not leave the house unless you have been instructed to visit a health care facility.
• Wear a disposable face mask OR cloth face cover to protect others from contaminated respiratory droplets that enter the air when you cough or sneeze.
• Stay in a separate room with a separate bathroom, if possible.
• Maintain at least 6 feet distance from others.
• Keep all ‘high-touch’ surfaces clean. This includes doorknobs, tabletops, telephones, and even your computer and keyboard.
• Limit contact with housemates, especially those who are at increased risk of severe COVID-19 illness (elderly or immunocompromised individuals and those with respiratory problems).
• Among the most effective practices that limit the spread of COVID-19 is practicing good ‘respiratory etiquette’ and hand hygiene:

1. Avoid touching your eyes and mouth.
2. Dispose of tissues after coughing or sneezing.
3. Wash your hands regularly and thoroughly with warm, soapy water for 20 seconds. Use alcohol-based hand sanitizer in a pinch, if soap and water are not available.

If you are older than 65 and/or you are immunocompromised or have an underlying chronic health condition, you have a higher risk of developing more severe COVID-19 illness. Follow the same practices as everyone else, closely monitor your symptoms, and seek medical care if your symptoms worsen.

Notify close contacts.
As a courtesy and as an important step in controlling the pandemic, try to notify the people with whom you have been in contact over the past 7 to 10 days.

Contact your healthcare provider if symptoms worsen.
The same type of home care you would use for cold or flu symptoms also works for most patients infected by SARS-CoV-2. [For pain relief and fever reduction with coronavirus, there are some reports to avoid ibuprofen (Advil, Motrin) and use acetaminophen (Tylenol) instead, but there is no scientific evidence to support the claim.]

But, severe COVID-19 illness extends beyond cough, fever and congestion. Immediately notify your healthcare provider for any of the following symptoms:

• Chest pain
• Chest tightness
• Difficulty breathing (having a hard time “catching” your breath)
• Altered mental status
• Bluish lips/skin (cyanosis)

Keep track of your symptoms and the calendar.
Start a journal to record your temperature readings. Measure your temperature more frequently if fever occurs. Note the dates when symptoms emerge, their severity, and their resolution. This is powerful information to share with your healthcare team as they track your progress or in case complications ensue. You can expect to remain in isolation until any fever has resolved for three days with steady improvement in your other symptoms.

Give yourself the time and space to completely recover, which takes a few days to a week in most cases of COVID-19. Reach out to friends and family and other support groups.”

From Healthgrades: What to do if you test positive for COVID-19, Healthgrades

PLEASE QUARANTINE YOURSELF FOR 14 DAYS FROM START OF SYMPTOMS TO FULLY RECOVER. YOU SHOULD NOT GO OUT IN PUBLIC UNLESS YOU HAVE BEEN WITHOUT A FEVER WHILE OFF FEVER-REDUCING MEDICINES FOR AT LEAST 3 DAYS.

For those interested in donating convalescent plasma: How to Donate Convalescent Plasma