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ACEP COVID-19 Field Guide

Table of Contents

Quarantine and Isolation for Patients

Risk Stratification and Evaluation

Quarantine

Who does not need to quarantine:

If you came into close contact with someone with COVID-19 and you are in one of the following groups, you do not need to quarantine.

Who should quarantine:

If you come into close contact with someone with COVID-19, you should quarantine if you are in one of the following groups:

    • You are ages 18 or older and completed the primary series of recommended vaccine, but have not received a recommended booster shot when eligible.
    • You received the single-dose Johnson & Johnson vaccine (completing the primary series) over 2 months ago and have not received a recommended booster shot.

What to do for quarantine:

  • Stay home and away from other people for at least 5 days (day 0 through day 5) after your last contact with a person who has COVID-19. The date of your exposure is considered day 0. Wear a well-fitting mask when around others at home, if possible.
  • For 10 days after your last close contact with someone with COVID-19, watch for fever (100.4◦F or greater), cough, shortness of breath, or other COVID-19 symptoms .
  • If you develop symptoms, get tested immediately and isolate until you receive your test results. If you test positive, follow isolation recommendations.
  • If you do not develop symptoms, get tested at least 5 days after you last had close contact with someone with COVID-19.
    • If you test negative, you can leave your home, but continue to wear a well-fitting mask when around others at home and in public until 10 days after your last close contact with someone with COVID-19.
    • If you test positive, you should isolate for at least 5 days from the date of your positive test (if you do not have symptoms). If you do develop COVID-19 symptoms, isolate for at least 5 days from the date your symptoms began (the date the symptoms started is day 0). Follow recommendations in the isolation section below.
    • If you are unable to get a test 5 days after last close contact with someone with COVID-19, you can leave your home after day 5 if you have been without COVID-19 symptoms throughout the 5-day period. Wear a well-fitting mask for 10 days after your date of last close contact when around others at home and in public.
    • Avoid people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days.
  • If possible, stay away from people you live with, especially people who are at higher risk for getting very sick from COVID-19, as well as others outside your home throughout the full 10 days after your last close contact with someone with COVID-19.
  • If you are unable to quarantine, you should wear a well-fitting mask for 10 days when around others at home and in public.
  • If you are unable to wear a mask when around others, you should continue to quarantine for 10 days. Avoid people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days.
  • Do not travel during your 5-day quarantine period. Get tested at least 5 days after your last close contact and make sure your test result is negative and you remain without symptoms before traveling. If you don’t get tested, delay travel until 10 days after your last close contact with a person with COVID-19. If you must travel before the 10 days are completed, wear a well-fitting mask when you are around others for the entire duration of travel during the 10 days. If you are unable to wear a mask, you should not travel during the 10 days.
  • Do not go to places where you are unable to wear a mask, such as restaurants and some gyms, and avoid eating around others at home and at work until after 10 days after your last close contact with someone with COVID-19.

After quarantine

  • Watch for symptoms until 10 days after your last close contact with someone with COVID-19.
  • If you have symptoms, isolate immediately and get tested.

Isolation

Everyone who has presumed or confirmed COVID-19 should stay home and isolate from other people for at least 5 full days (day 0 is the first day of symptoms or the date of the day of the positive viral test for asymptomatic persons). They should wear a mask when around others at home and in public for an additional 5 days. People who are confirmed to have COVID-19 or are showing symptoms of COVID-19 need to isolate regardless of their vaccination status. This includes:

  • People who have a positive viral test for COVID-19, regardless of whether or not they have symptoms.
  • People with symptoms of COVID-19, including people who are awaiting test results or have not been tested. People with symptoms should isolate even if they do not know if they have been in close contact with someone with COVID-19.

What to do for isolation

  • Monitor your symptoms. If you have an emergency warning sign (including trouble breathing), seek emergency medical care immediately.
  • Stay in a separate room from other household members, if possible.
  • Use a separate bathroom, if possible.
  • Take steps to improve ventilation at home, if possible.
  • Avoid contact with other members of the household and pets.
  • Don’t share personal household items, like cups, towels, and utensils.
  • Wear a well-fitting mask when you need to be around other people.

Ending isolation for people who had COVID-19 and had symptoms

If you had COVID-19 and had symptoms, isolate for at least 5 days. To calculate your 5-day isolation period, day 0 is your first day of symptoms. Day 1 is the first full day after your symptoms developed. You can leave isolation after 5 full days.

  • You can end isolation after 5 full days if you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved (Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation​).
  • You should continue to wear a well-fitting mask around others at home and in public for 5 additional days (day 6 through day 10) after the end of your 5-day isolation period. If you are unable to wear a mask when around others, you should continue to isolate for a full 10 days. Avoid people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days.
  • If you continue to have fever or your other symptoms have not improved after 5 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. Continue to wear a well-fitting mask. Contact your healthcare provider if you have questions.
  • Do not travel during your 5-day isolation period. After you end isolation, avoid travel until a full 10 days after your first day of symptoms. If you must travel on days 6-10, wear a well-fitting mask when you are around others for the entire duration of travel. If you are unable to wear a mask, you should not travel during the 10 days.
  • Do not go to places where you are unable to wear a mask, such as restaurants and some gyms, and avoid eating around others at home and at work until a full 10 days after your first day of symptoms.

If an individual has access to a test and wants to test, the best approach is to use an antigen test towards the end of the 5-day isolation period. Collect the test sample only if you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved (loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation). If your test result is positive, you should continue to isolate until day 10. If your test result is negative,  you can end isolation, but continue to wear a well-fitting mask around others at home and in public until day 10. Follow additional recommendations for masking and restricting travel as described above.

Ending isolation for people who tested positive for COVID-19 but had no symptoms

If you test positive for COVID-19 and never develop symptoms, isolate for at least 5 days. Day 0 is the day of your positive viral test (based on the date you were tested) and day 1 is the first full day after the specimen was collected for your positive test. You can leave isolation after 5 full days.

  • If you continue to have no symptoms, you can end isolation after at least 5 days.
  • You should continue to wear a well-fitting mask around others at home and in public until day 10 (day 6 through day 10). If you are unable to wear a mask when around others, you should continue to isolate for 10 days. Avoid people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days.
  • If you develop symptoms after testing positive, your 5-day isolation period should start over. Day 0 is your first day of symptoms. Follow the recommendations above for ending isolation for people who had COVID-19 and had symptoms.
  • Do not travel during your 5-day isolation period. After you end isolation, avoid travel until 10 days after the day of your positive test. If you must travel on days 6-10, wear a well-fitting mask when you are around others for the entire duration of travel. If you are unable to wear a mask, you should not travel during the 10 days after your positive test.
  • Do not go to places where you are unable to wear a mask, such as restaurants and some gyms, and avoid eating around others at home and at work until 10 days after the day of your positive test.

If an individual has access to a test and wants to test, the best approach is to use an antigen test towards the end of the 5-day isolation period. If your test result is positive, you should continue to isolate until day 10. If your test result is negative, you can end isolation, but continue to wear a well-fitting mask around others at home and in public until day 10. Follow additional recommendations for masking and restricting travel described above.

Ending isolation for people who were severely ill with COVID-19 or have a weakened immune system (immunocompromised)

People who are severely ill with COVID-19 (including those who were hospitalized or required intensive care or ventilation support) and people with compromised immune systems might need to isolate at home longer. They may also require testing with a viral test to determine when they can be around others. CDC recommends an isolation period of at least 10 and up to 20 days for people who were severely ill with COVID-19 and for people with weakened immune systems. Consult with your healthcare provider about when you can resume being around other people.

This CDC guidance is meant to supplement—not replace—any federal, state, local, territorial, or tribal health and safety laws, rules, and regulations with which homeless shelters must comply.

Recommendations for Specific Settings

These recommendations do not apply to healthcare professionals. For guidance specific to these settings, see

Patients, residents, and visitors to healthcare settings: Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic

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