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CDC’s updated COVID-19 self-isolation advice explained by an infection expert

CDC updated its COVID-19 self-isolation advice, so we asked an Infection Preventionist to explain
(Image credit: Getty)

If you have COVID-19, knowing when it’s safe to stop self-isolating so that you are no longer a risk to others can be confusing. The severity of your illness, and whether you have been presenting symptoms or not, both come into play, according to recently updated CDC guidelines

In order to help slow the spread, health officials have consistently advised us to stay away from others if we are displaying coronavirus symptoms. The most common of these are a new cough and a fever, the latter of which can be measured with a digital thermometer

When to stop self-isolating after having COVID-19
The updated CDC guidelines for self-isolation are quite detailed, so we asked Lauren Bryan, Infection Preventionist at UCHealth Yampa Valley Medical Center, to break them down for us. It’s important to note that we are focusing here on cases of COVID-19 that do not require hospitalization, as the advice for those may differ.

The more we learn about the coronavirus, knowing when to stop self-isolating after a COVID-19 diagnosis gets trickier. Bryan explains: “This has become a bit more complicated as the length of viral shedding differs based on the severity of illness and the immunocompetence of the individual. You should consult with public health prior to leaving home isolation.”

Here’s a break-down of the recommended minimum time frames for self-isolation, based on various factors: 

CDC’s updated COVID-19 self-isolation advice explained by an infection expert

(Image credit: CDC)

A 'symptom-based strategy'

If a person hasn’t displayed coronavirus symptoms but has tested positive, the CDC now says they can end self-isolation at least 10 days after testing positive as long as they continue to have no symptoms. Bryan explains: “An immunocompetent person who is asymptomatic or has mild to moderate illness will no longer transmit the virus to others after ten days.”

If you do develop mild to moderate symptoms, you can be around others after:

  • 10 days since symptoms first appeared and
  • You’ve gone 24 hours with no fever without the use of fever-reducing medications and
  • Your COVID-19 symptoms have improved 

“But remember, virus transmission has been documented from asymptomatic carriers and from pre-symptomatic persons 48 hours prior to symptom onset,” Bryan reminds us, “so everyone should be wearing a mask.”

Even though large swathes of America continue to be divided on the subject of face coverings, face masks do work at helping to slow the spread of the coronavirus. WHO recommends medical masks for over 60s in areas where virus transmission is active and for anyone living with a person who has COVID-19. Don’t own a mask? Take a look at our guide to homemade face masks, or learn where to buy reusable face masks.

CDC’s updated COVID-19 self-isolation advice explained by an infection expert: A woman self-isolates after a positive COVID-19 test result

(Image credit: Getty)

But there are caveats to that minimum time frame. “Persons with severe illness or those who are immunocompromised need to isolate for longer,” Bryan explains. “This is because severe illness or a compromised immune system indicates the virus may have a greater ability to replicate in that individual and thus take a bit longer for the immune system to clear it.”

The CDC says that, ‘Persons who are severely immunocompromised may require testing to determine when they can be around others.’ In that instance, you will need to speak with your healthcare provider for more guidance on when it’s safe for you to be around others, and whether you need to be retested.

Why lingering symptoms are so confusing

So we now know the minimum time frame for self-isolation based on various factors, but what should we do if we still have lingering symptoms once the recommended self-isolation period has passed? “Unfortunately, we have seen lingering side effects and symptoms in many people who had COVID-19. Note that the CDC used the term ‘improved’ rather than resolved for discontinuing isolation for this reason,” Bryan clarifies. 

“We don’t have enough longitudinal studies at this point to know if patients with lingering symptoms will be more likely to develop chronic sequela [secondary adverse health outcome] from their COVID-19 infection. If you do have lingering symptoms, it will be important to continue to follow up with your health care provider so they can monitor you.”

CDC’s updated COVID-19 self-isolation advice explained by an infection expert: Face mask used to help slow the spread of the coronavirus

(Image credit: Getty)

The updated list of coronavirus symptoms

When the coronavirus pandemic first erupted, there were less than a handful of symptoms indicative of infection. Now we have several symptoms and counting, so it’s helpful to stay updated on the tell-tale signs of coronavirus infection. 

As of August, the CDC’s updated list of the main coronavirus symptoms are as follows:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

To accurately take your body temperature at home, we’d recommend using one of the best digital thermometers for fever monitoring. When we spoke to Dr Gero Bairda for our common coronavirus questions feature, he explained that thermometers are more accurate than placing your hand on your back or chest to check if you’re warm. 

To help slow the spread, and to protect yourself as much as possible, wear a face mask when outside of your home, especially in areas where the virus is active, and in spaces where it’s difficult to maintain social distancing. Hand hygiene is still important. That means regularly washing your hands with soap and water for at least 20 seconds, or using a 60% or more alcohol based hand sanitizer when you can’t get to a sink. 

For more health content, take a look at our guide to the best health insurance, and the best Medicare Part D plans for ongoing prescription drugs costs coverage.