Listen to Austin 360 Radio

What's the difference between quarantining and isolating for COVID-19? Understanding updated CDC recommendations

Nicole Villalpando
Austin American-Statesman

Last week, the federal Centers for Disease Control and Prevention updated its guidance for when to quarantine and when to isolate because of COVID-19. A lot of folks have been confused about the new recommendations, which changed the number of days and who needs to quarantine. We asked local doctors to help us understand these guidelines and the difference between quarantining and isolating. 

According to the CDC, the guidelines changed because of new information that indicated people tend to be infectious two to three days after being exposed before symptoms set in and up to eight days after the symptoms set in, with infectiousness waning with each day. 

What is the difference between quarantine and isolation?

You are in quarantine when you have been in close contact with someone who has tested positive for COVID-19, but you have not tested positive yet. If you test positive, you enter isolation and the counting of days starts again.  

You are in isolation if you have tested positive for COVID-19. It does not matter if you have symptoms. 

Hospitalizations and COVID:Amid omicron COVID spike, Texas hospitals see staffing shortages accelerating

Registered nurse Yolanda Harper works at a free COVID-19 testing site Thursday at the Toney Burger Activity Center. Getting tested can help you know whether to quarantine or isolate.

How are the days counted for quarantine or isolation?

For quarantining, Day 0 is the day you have had close contact with someone with COVID-19. Day 1 is the first full day after you've had contact.

If you are isolating, Day 0 is the day you first test positive. Day 1 is the first full day after your positive test.

Do I need to quarantine?

People who are up to date in their vaccinations do not need to quarantine. Being up to date means that you have had both shots of the Pfizer or Moderna vaccines, or one shot of the Johnson & Johnson vaccine, and you have been boosted if it's been more than five months since being fully vaccinated with Pfizer or Moderna and two months for Johnson & Johnson. You should try to get tested five days after you were in close contact with someone with COVID-19.

Explaining boosters:What do FDA's changes in COVID-19 boosters mean for you?

"That's the good news," said Dr. Stanley Spinner, vice president and chief medical officer at Texas Children's Pediatrics and Texas Children's Urgent Care. If you are boosted or it's not time yet to be boosted but you've completed the first series, "you're presumed to have good protection."

If you are not up to date in vaccinations, you need to quarantine for five days if you have been in close contact with someone who tests positive. 

What does close contact with COVID-19 mean? 

Close contact is being within 6 feet of someone, for at least 15 minutes, who has tested positive regardless of whether they wore a mask or where you were. It's also cumulative. If you were within 6 feet of three people who tested positive for five minutes, that equals the 15 minutes and the need to quarantine.

The CDC has different guidelines for school settings.

For students in schools, close contact means you've been within 3 feet of someone with COVID-19 in an indoor setting, such as a classroom, or a structured outdoor setting for 15 minutes or more over the course of 24 hours. For students, close contact also can mean within 6 feet of someone indoors for 15 minutes or more in 24 hours if both people were not wearing masks or not wearing masks properly.

For adults, close contact means within 6 feet of someone for more than 15 minutes regardless of the setting or mask use.

Each school district has its own policies as well in guidance with the Texas Education Agency and the CDC. When in doubt, follow the stricter rules.

"We acknowledge that there is confusion right now," said Dr. Suneet Singh, medical director for CareHive Health. "This is still being pieced together." 

Things are evolving, he said. Schools are no longer being shut down and cleaned after one positive case.

What does it mean to quarantine for COVID-19?

Quarantine means that for five full days you are not going anywhere outside your home — not to the grocery store, not to school, not to work. Inside your home, wear a mask to prevent other people in your home from becoming exposed. 

How do I get out of quarantine?

If you are negative and have no symptoms, you can leave quarantine on Day 6, but watch for symptoms through Day 10 and wear a mask everywhere you go through Day 10. Remember, during Stage 5 safety guidelines, which is the level Austin is in, you should wear a mask everywhere regardless of quarantine or vaccination status. You should not travel and avoid being around people who are at high risk. 

Here's what Stage 5 means:Austin returns to Stage 5 of COVID guidelines. What will change for you?

If you develop symptoms, isolate until you test negative.

What's tricky about ending quarantine at Day 5 instead of Day 10 with kids in schools, Spinner said, is it's impossible for them to wear a mask the entire time at school. They have to eat lunch and when they do, they are not wearing masks.

The Texas Education Agency updated its guidance to 10 days for students instead of 14, following the CDC's recommendations. Staff members can get out of quarantine five days after close contact.

James Hensley eats breakfast before school begins at Cedar Park's Faubion Elementary School in December. Because kids have to eat lunch and cannot wear their mask during lunch or breakfast, they need to stay out for 10 days if they are quarantining.

What does it mean to isolate?

If you have tested positive or have symptoms regardless of vaccination status, you need to stay home and isolate for five days. That means you are wearing a mask around others in your home and trying to separate yourself as much as possible from other family members.

You are not going anywhere outside your home during the isolation period. 

When can I end my isolation?

If you had symptoms, you must wait five full days after your positive test and be fever free for 24 hours without the use of medications, and your symptoms have to be improving. If you were severely ill, you should wait at least 10 full days after your positive test and call your doctor.

If you've had no symptoms, the isolation period is five days after your positive test or Day 6.

Once you get out of isolation, wear a mask at least until Day 10 and avoid travel or being around people with high risks for severe disease.

The Texas Education Agency's guidelines are that staff members can get out of isolation five days after a positive test if they don't have symptoms or five days plus being fever free for 24 hours if they had symptoms that have improved. For students to get out of isolation, it's 10 days past the onset of symptoms or a positive test and being fever free for 24 hours.

Spreading COVID-19:Fact-check: Can vaccinated people spread COVID-19?

Do I need to quarantine if someone in my family is quarantining?

If you were not the person who was in close contact with someone with COVID-19, you do not need to quarantine. That means if a child has been sent home from school and is told to quarantine, but has no symptoms and has not tested positive, parents, siblings or others in the household do not need to quarantine.

Everything changes once the child tests positive or has symptoms. Then everyone in the family who has been in close contact with the child needs to quarantine and that child is in isolation. 

COVID-19 in schools:Austin-area schools see rising teacher and student absences

Why are quarantining and isolation different for COVID-19 than for the flu or other illnesses?

"COVID has been a lot more contagious even in the original strain than the common cold or flu and has been significantly more contagious as we've gone to delta and omicron," Spinner said. 

We know that people can spread COVID-19 for several days after they test positive even if they feel fine, he said. We also know that people who are not symptomatic can spread it. 

The good news is that COVID-19 has not yet reached the contagiousness of measles, Spinner said, though it is approaching that level. If it does, anyone in the room with someone who tested positive would have to quarantine, he said. 

Why is it important to follow the quarantine and isolation guidance for COVID-19?

Singh explains that it's like the butterfly effect. When one person doesn't quarantine or isolate, they infect many more people, who then have to quarantine and isolate. 

"When so many people have the disease, it takes away so many people in the workforce. Grocery stores, restaurants and companies have to shut down," he said.

While the omicron variant is not thought to cause as much severe illness, especially in people who are vaccinated, it still can cause hospitalization and death in unvaccinated people, including children 4 and younger who can't be vaccinated, and people who have underlying conditions. 

"It's so important to work together to keep one another safe," Singh said.

More:Austin concerts postponed or canceled as omicron surges: Erasure, Best Coast, and more