What Healthcare Providers Need to Know about “Isolation” and “Quarantine”

Blog post by Panna Lossy, MD

Many people, including doctors, don’t understand the public health terms “Isolation” and “Quarantine. ” Like many words, they have a very specific meaning to professionals in one area (in this case public health) but a different meaning to the general public.  It is important that all providers understand the public health meaning of these terms.

Isolation is for known COVID-positive patients OR people with symptoms who are awaiting test results or are suspected by a clinician of having the disease.   Such people are often referred to as People Under Investigation (PUI).

Quarantine is for the asymptomatic Close Contacts (household members, intimate partners, care givers) of a COVID-positive patient or PUI.

Known COVID-positive patients or PUI need to Isolate – this means:

• Stay alone in a room with a closed door
• Use a designated bathroom that no one else uses
• If they must leave the room they must wear a mask
• Cannot leave the house

For most people, Isolation will end 10 days after the onset of symptoms IF they have not had a fever (without antipyretics) AND improvement of symptoms for 3 days.

People in Isolation also must tell their Close Contacts to Quarantine.

Close Contacts (household members, intimate partners, and caregivers) of PUI (i.e. people with symptoms who have been tested or not) need to Quarantine.  This means they:

• Cannot leave the house
• Should physically distance from others in their household
• Open windows, frequently wash hands and sanitize high touch surfaces daily,
• Watch for symptoms for 14 days after last contact with the PUI

It is our job as doctors (and our legal responsibility) to make the difficult decisions about which patients we clinically suspect have Covid -19 and to then tell them to Isolate and tell them to ask their Close Contacts to Quarantine. We are also required to fill out a form for everyone we suspect has Covid-19 and submit that to PH.

The Emergency Isolation Order that the Sonoma County Public Health Officer put into effect on April 10 codifies all of this. It makes breaking isolation or quarantine a misdemeanor punishable by fine or imprisonment or both.

IsoCare is a volunteer community-based organization that helps patients understand and comply with these very difficult orders.  For more information, check out https://www.disastercrashcart.org/isocare.php.