So You Tested Positive for COVID-19. How Long Should You Isolate Yourself?

"Stay Home" flyer posted on doors around San Francisco.  (Polly Stryker/KQED)

Even before Candace Palmerlee tested positive for the coronavirus, she began isolating herself at home, not wanting to pass the infection on to others.

When her positive test result was confirmed on March 16, she says she and her family were given three different timelines for how long they would need to stay within the confines of their Walnut Creek home. One nurse instructed Palmerlee to wait two weeks from the date of her first symptom, another advised her to wait two weeks from the date her test was taken, and county literature said a minimum of seven days was required, plus an additional three after all symptoms subsided.

"If you look at all three of those different lines of advice, you come up with very different dates for when I’m released," says Palmerlee.

She decided to go with the most conservative instructions.

When her isolation is over, she plans to honor the shelter-at-home directives, but she wonders about when those lift, and if it will be okay to return to work as an orthopedic manual therapist, where she has human-to-human contact. "I work with a large geriatric population in my private practice and I cannot be shedding virus when I go back to work," she said. "We need to be really clear that I am no longer contagious. So how do I how do I find that out?"

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Dr. Sajan Patel of the University of California San Francisco says the guidelines for how long to isolate after testing positive for COVID-19 are changing rapidly, so it's important to seek out the most up-to-date information. When you do, he says, refer to the Centers for Disease Control and Prevention (CDC) guidelines.

There are two routes to take to discontinue home isolation: one requiring close monitoring of symptoms and the other involving retesting for COVID-19.

If you can’t get tested again, which is likely given the shortage of tests, the CDC instructs three criteria must be met:

  1. You have had no fever for at least 72 hours (that is three full days of no fever without the use of medicine that reduces fevers)
    AND
  2. other symptoms have improved (for example, when your cough or shortness of breath have improved)
    AND
  3. at least 7 days have passed since your symptoms first appeared

Dr. Patel emphasizes that "you need all three."

If you will be tested to establish whether you can discontinue home isolation, the CDC instructs that the following criteria be met:

  1. You no longer have a fever (without the use of medicine that reduces fevers)
    AND
  2. other symptoms have improved (for example, when your cough or shortness of breath have improved)
    AND
  3. you received two negative tests in a row, 24 hours apart. Your doctor will follow CDC guidelines.

When these conditions are met, Dr. Patel said, "It is not permission to jump back into society. It is, 'I don't have to be stuck in one room using one bathroom, wiping down every single thing, every moment.'" Social-distancing and sheltering-in-place still apply to people who are no longer contagious.