Note: See the updated
Guidance on Isolation and Quarantine for COVID-19 Contact Tracing. This guidance is out of date and for historical purposes only.
Related Materials: Quarantine Guidance | Self Quarantine Instructions (PDF) | Self-Quarantine Instructions Flyer (PDF) | More Home & Community Guidance | All Guidance
After initial Stay At Home orders in mid-March, over the course of a few months, physical distancing and stay-at-home interventions helped flatten the curve in the State of California. As we gradually reopen sectors of our economy, and move outside of our homes and mix with others outside of our household we have noted a concerning increase in cases and hospitalizations, and the risk for exposure and infection has increased.
An important component to containing the spread of COVID-19 is timely case identification and contact tracing. While intense work is focused on COVID-19 vaccine and effective therapeutics, we do not expect that these will be available for many months or longer. To continue to loosen restrictions, we must take a multi-pronged approach, which includes continuing to scale-up a robust contact tracing plan and effective isolation or quarantine of those that are infected and exposed to COVID-19.
California Connected, the state’s contact tracing public awareness campaign, has been designed to raise awareness about contact tracing and our collective social responsibility to respond to this call to action. Additionally, the contact tracing program looks to build a contact tracing workforce that will augment local staffing resources. These public health workers from communities across the state will connect with individuals who test positive for COVID-19 and work with them, and people they have been in close contact with, to ensure they have access to confidential testing, as well as medical care and other services to help prevent the spread of the virus.
This guidance provides a framework for local public health departments and the contact tracing workforce related to both the isolation and quarantine.
Isolation: separates those infected with a contagious disease from people who are not infected.
Quarantine: restricts the movement of persons who were exposed to a contagious disease in case they become infected.
Isolation and quarantine are proven public health interventions fundamental to reducing COVID-19 transmission. Adequate isolation and quarantine processes must be in place to respond to the increasing number of cases we see with modification of local and statewide physical distancing and stay-at-home orders.
Isolation and quarantine can create substantial hardships. Those under isolation or quarantine must be treated with respect, fairness and compassion; and their dignity and privacy must be protected. Federal resources made available to local public health departments should be considered to support people who are not able to isolate or quarantine in accordance with this guidance.
All instructions provided by the local public health jurisdiction to individuals who are being asked to isolate or quarantine should be provided in their primary language and be culturally appropriate. Additionally, local public health departments should ensure that instructions for individuals with disabilities, including those with access and functional needs, are provided.
California has a diverse population with no single race or ethnic group constituting a majority of the population. These populations include different racial and ethnic groups, members of tribal nations, immigrants and refugees. They may be at higher risk for COVID-19 or worse health outcomes due to a number of reasons including living conditions, work circumstances, underlying health conditions, and limited access to care. It is important that case investigations and contact tracing are conducted in a culturally appropriate manner, which includes meaningfully engaging community representatives from affected communities, collaborating with community-serving organizations, respecting the cultural practices in the community, and taking into consideration the social, economic and immigration contexts in which these communities live and work. Local public health departments should be mindful of discrimination not only based on race, but also based on disability.
To help build trust, jurisdictions should employ public health staff who are of the same racial and ethnic background as the affected community and are fluent in their preferred language. When that is not possible, interpreters and translations must be provided for individuals who have limited English proficiency. Core demographic variables should be included in case investigation and contact tracing forms, including detailed race and ethnicity, as well as preferred language.
Finally, given that diverse populations experience discrimination and stigma, it is important to ensure the privacy and confidentiality of data collected and to ensure that the participant is aware of these safeguards. Every person in California, regardless of immigration status, is protected from discrimination and harassment in employment, housing, business establishments, and state-funded programs because of their race, national origin, and ancestry, among other protected characteristics.
The California Department of Public Health (CDPH) recommends a symptom-based strategy to determine the duration of isolation for people with COVID-19 who are symptomatic, meaning they have symptoms. Persons with COVID-19 who have symptoms and were instructed to care for themselves at home may discontinue self-isolation under the following conditions:
The symptoms-based strategy will prevent most, but not all, instances of secondary transmission. Increasing evidence suggests people with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset. However, a very limited number of persons with severe illness or who are severely immunocompromised may warrant extending duration of isolation for up to 20 days after symptom onset. Consider consulting with local infectious disease experts when making decisions about discontinuing isolation of persons who are likely to remain infectious longer than 10 days.
For persons with COVID-19 who are asymptomatic, meaning that they have NOT had any symptoms, CDPH recommends that these individuals be instructed to care for themselves at home. They may discontinue isolation under the following conditions:
For most individuals who have had close contact (less than 6 feet for at least 15 minutes) with a person who is COVID-19 positive, CDPH recommends the exposed person self-quarantine and stay home for a period of 10 days from the last day of exposure. Household members and intimate partners of COVID-19 positive persons should also self-quarantine for this period, as well as anyone who has had unprotected contact with an infected person's body fluids and/or secretions, such as being coughed or sneezed on, sharing cups or utensils, or providing care without wearing appropriate protective equipment (facemask and gloves). If they have not developed any symptoms, exposed individuals may leave their homes after 10 days, but they must self-monitor for COVID-19 symptoms and strictly adhere to all recommended non-pharmaceutical interventions, (e.g., consistent use of face coverings, maintaining a distance of at least 6 feet from others, frequent hand washing) for 14 days following exposure. If an exposed person develops any symptoms during this 14-day period, regardless of testing or earlier quarantine release, that individual must immediately self-isolate and contact their local public health department or healthcare provider to seek testing.
Health care workers and critical infrastructure workers, including first responders, should follow guidance that includes special consideration for these groups and addresses strategies to mitigate staffing shortages. If they have never developed symptoms, healthcare personnel and certain essential infrastructure workers may be allowed, during critical staffing shortages, to discontinue self-quarantine after 7 days with specific testing; these employees should consult with their local health departments and employers regarding when to return to work. Local health departments may be more restrictive when determining quarantine periods and may recommend that those who are in contact with persons at high risk for severe disease or persons working in high risk settings such as skilled nursing facilities maintain a 10-day or 14-day quarantine period.
The majority of people with COVID-19 have mild to moderate symptoms, do not require hospitalization, and can be isolated at home. However, the ability to prevent transmission in a residential setting is an important consideration. The federal Centers for Disease Control and Prevention (CDC) has guidance for both patients and their caregivers to help protect themselves and others in their home and community.
Considerations for the suitability of care at home include whether:
In addition, both the person and caregiver should be educated and understand the clear indications for when they must seek clinical care. Although mild illness typically can be self-managed or managed with outpatient or telemedicine visits, illness may worsen quickly days after the initial onset of symptoms.
Individuals in quarantine at home or in an alternate site that is shared with other people (e.g., household members) should maintain physical distance (at least 6 feet) from others at all times, wear a face covering around others, self-monitor for symptoms (check temperature twice a day and watch for fever, cough, shortness of breath, or any other symptoms that can be attributed to COVID-19), and avoid contact with people at higher risk for severe illness. If symptoms develop, individuals in quarantine should immediately contact their healthcare provider and/or local health department to determine where they can get testing.
The following are general steps for people suspected or confirmed to have COVID-19 to prevent spread to others in homes and communities. There are also specific steps for Home Isolation and Home Quarantine listed below. These steps should be conveyed via simple verbal and written instructions in the person’s primary language.
Isolation of persons who are infectious or individuals who have tested positive for COVID-19 can be at home provided the following conditions are in place.
Quarantine of persons who have been exposed to an individual who has tested positive for COVID-19 can be provided at home if the following conditions are in place.
NOTE: When everyone living in a household has been exposed, there is no requirement for a separate bedroom or bathroom if all persons remain without symptoms and without a positive COVID-19 test. However, facemasks (or if unavailable, a cloth face covering) for those quarantined are needed for any possible encounter with persons entering from outside the household.
When just one person is quarantined in a household with other household members who have not been exposed, a separate bedroom and separate bathroom (or one that can be disinfected after use) are needed. Additionally, facemasks (or if unavailable, cloth face coverings) for the quarantined individual and disinfectants to clean surfaces are needed for any possible encounter with persons entering from outside the household.