What Do I Do if I’ve Been Exposed to COVID-19?

One of the more frequent questions people have is:  what do I do if I’ve been exposed to COVID-19?

Much of the guidance that is out there isn’t always easy to sort through. It may be intimidatingly long, it may have multiple versions/updates (which is most current?), or one source may contradict another.

So… to help you out, here is an easy-to-read reference that covers the most important steps and tips after a COVID exposure.

Mitigation Step One: Identify Close Contacts

If you become sick, your close contacts should be identified to try to slow the spread of disease.  Close contacts are individuals who spent time with the sick person while they were contagious. People who test positive for COVID-19 are considered contagious up to 48 hours before they show symptoms (and some never show symptoms).

While medical privacy laws prevent names from being shared without permission, you can let your friends and family know generically that they have been exposed. A person who was a close contact may also be contacted by the local Health Department and informed that they were exposed. However, if you know you spent time around someone who is sick, you should not wait to hear from health officials before taking appropriate action — due to extremely heavy case loads, not all close contacts are receiving calls. Also, the COVID positive person may not have shared the names of all of their close contacts with health officials (state law allows them to decline to share this information). Individuals who believe they have been exposed do have the right to call the Health Department themselves to get clarification on whether they qualify as a close contact and to discuss the steps they need to take.

Mitigation Step Two: Quarantine Exposed Individuals

Individuals who are close contacts of a COVID positive person are at risk of developing the disease themselves. And because they can become contagious before they realize they are sick, they should stay away from others, which includes staying away from their workplace. On average, symptoms begin showing up between five and seven days after exposure. However, it can take up to 14 days for COVID-19 symptoms to develop, which is why contacts are told by public health officials to quarantine for 14 days from the date they were last exposed.

If the close contact lives in the same household as the sick person, their quarantine is longer. Since they are essentially being continually exposed the entire time the sick person is contagious, they must remain in quarantine for 14-days after the sick person is released from isolation by the Health Department.

For employees who perform critical functions, a modified quarantine may be allowed, but this must be worked out with the local Health Department.

Mitigation Step Three: Conduct COVID-19 Testing at the Appropriate Time

Many peoples’ first reaction after hearing of an exposure is to request a COVID-19 test. However, the timing of the test greatly impacts the accuracy of the results. It takes a number of days after exposure to have enough of the virus in someone’s system to begin showing symptoms of the disease. This also means it takes several days for enough virus to be present for the test to detect it. The longer an individual waits, the more accurate the results will be. Public health officials recommend that, if a close contact is not showing symptoms yet, they should wait at least 5-7 days after exposure to get tested (preferably at least 7 days).

Be aware of the limitations of testing. Covid-19 testing using real-time reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab can result in a false positive or false negative result. In other words, a positive test doesn’t guarantee that the SARS-CoV-2 virus is causing infection at all, and maybe the SARS-CoV-2 virus might not be in the patient’s body at all.

Nonetheless, getting a negative test result does not release a confirmed close contact from quarantine. People who have not been formally placed in quarantine by health officials, but know they were exposed, should also continue to quarantine, even after a negative test result. Even though a large number of people develop symptoms within that 5-7 day window after exposure, there are some who do not show signs of being sick until the very end of their quarantine period. If someone tests negative on day 5, they may still test positive (and be contagious) later in their quarantine period as more virus builds up in their system. Employees who attempt to return to work before their quarantine period is over risk infecting more co-workers during that “pre-symptomatic” period, if they do end up getting sick.

Individuals who test positive during their quarantine period should attempt to separate themselves completely from everyone, including members of their own household (if possible). Additionally, the members of their household should immediately begin to quarantine.

Final Thoughts: Return to Work

Individuals who have been quarantined as close contacts and do not develop symptoms during their quarantine period do not have to obtain a COVID-19 test prior to being released back to work. Additionally, those individuals who do end up contracting the virus are not asked to obtain a follow-up negative COVID-19 test result prior to being released from isolation by the Health Department. Because
fragments of the virus can remain in the body for some time after COVID patients recover, some individuals will continue to test positive, even though they are no longer contagious or ill. Requiring a negative test result would keep those people in isolation much longer than is medically necessary.

Additionally, individuals who have been isolated or quarantined due to COVID-19 are not required to obtain a release letter from the Health Department before returning to work at the end of their isolation or quarantine period. If an employer’s policy requires a release letter, though, the employee can call the Health Department to request one.