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San Francisco Health Network

Isolation and Quarantine

Staying home to prevent spread of infection when you have or might have COVID-19

Last updated on January 11, 2022

 

Summary of changes on December 31, 2021

  • Updated recommendations for isolation and quarantine duration
  • Updated recommendations for who needs to quarantine
  • Adds a definition for what Up-to-Date on COVID-19 vaccination means

Change log:
January 5, 2022: clarifications, including new footnote re test types in the Summary Chart.
January 6, 2022: new section What type of test; error correction in summary table.
January 10, 2022: new section clarifying in what settings this guidance applies, update on quarantine exemption for those with prior infection in the last 90 days
January 11, 2022: revised section on settings at higher risk for COVID-19.

On this page:

What are isolation and quarantine?

In what settings does this guidance apply?

Who must stay home to prevent spread of COVID‑19?

Caring for yourself and protecting your loved ones while you must stay at home

How long to stay home

Summary Chart

What are isolation and quarantine?

Both isolation and quarantine refer to staying at home and away from other people, when you have or might have COVID‑19. Isolation and quarantine are used to keep people who have or might have COVID‑19 away from others, to keep the infection from spreading.

You isolate when you have been infected with the virus, even if you don't have symptoms. If you have symptoms that could be from COVID‑19, you also must isolate until you know you are not infected, usually after you have a negative COVID‑19 test.

You quarantine when you have had Close Contact with someone with COVID‑19 and might be infected.

Close contact is being within 6 feet of an infected person for a total of 15 minutes or more in 24 hours, even if both people were wearing masks.

An infected person can spread COVID‑19 starting 2 days before they have symptoms or test positive for COVID‑19. The individual may be contagious for the duration that they are in isolation—at least 5 days, but may be longer if symptoms persist past 5 days or the patient tests positive after day 5.

In what settings does this guidance apply?

This guidance is intended for members of the general public over the age of 18 years old, most workplaces, childcare, and non-TK-12 programs.

This guidance does NOT apply in health care settings including long-term care facilities, jails and shelters and schools. These settings have their own specific guidance for isolation and quarantine.

Additionally, a specific employer or institution may have more restrictive policies in place than those described below so it is best to check with your specific organization for their isolation and quarantine rules.

Who must stay at home to prevent the spread of COVID‑19?

  • People with COVID‑19
  • People with symptoms of COVID‑19 who haven't been tested or are waiting for their test results
  • People who had Close Contact to someone with COVID‑19 and are not Up-to-Date on their COVID-19 vaccination (see definition below) if over the age of 18 years old.

Up-to-Date on Vaccination means you are either (a) two weeks past completing the full initial course of vaccines—either two doses of Moderna or Pfizer or one dose of a Johnson & Johnson vaccine AND (b) one week after receiving a Booster of any type once a person is eligible for a Booster. Until a person is eligible for a Booster, they are considered Up-to-Date on Vaccination two weeks after completing their initial vaccines.

Caring for yourself and protecting your loved ones while you must stay at home

See the following links for steps to keep infection from spreading and how to take care of yourself:

   If you have symptoms of COVID‑19

   If you were around someone diagnosed with COVID‑19

   If you tested positive for COVID‑19 or were diagnosed with COVID‑19

   CDPH Isolation and Quarantine guidance

How long do I have to stay at home? (Ending Isolation and Quarantine)

If you tested positive or were diagnosed with COVID‑19

If you had a positive COVID‑19 test or were diagnosed with COVID‑19, you must stay home, except to get needed medical care. Everyone must stay home who tests positive for COVID-19, even if you are vaccinated, have no symptoms or were recently (within the last 90 days) infected and recovered. You must stay home until all of the following are true:

  • At least five (5) days have passed since your symptom(s) started AND
  • You no longer have fevers, AND
  • Your other symptoms are getting better, AND
  • You have a negative test* collected on day 5 or later

Wear a well-fitting mask around others, indoors and outdoors, for a total of 10 days.

If you never had any symptoms, you must stay home for five (5) days after your positive test. If you are unable to test or choose not to test, you can end isolation after day ten (10).

These guidelines apply to kids who test positive for COVID-19. Kids may return to school when they meet the rules above.

*Either an antigen or PCR test is fine, but an antigen test is preferred to leave isolation or in people who have had a recent COVID-19 infection. Over the counter tests are acceptable to end isolation or quarantine.

If you have symptoms of COVID‑19

If you have symptoms of COVID‑19, you must stay home except to get tested or get needed medical care, even if you are Up-to-Date on COVID-19 vaccination or have recently had COVID-19. You must stay home, away from other people, while waiting for your test result.

You can leave home after one of the following:

  • You have a negative COVID‑19 test result, collected after your symptoms started, AND you have had no recent Close Contact to someone with COVID-19.
    You are encouraged to stay home until you feel better, so that you don't spread other illnesses.
  • You get a doctor's note or clinic note that you do not need to isolate.
    A healthcare provider can give you a note that allows you to end isolation and leave home in two situations:
    • They decide that your symptoms are caused by a medical condition that you already have, like allergies or asthma.
    • They determine that your symptoms are caused by another disease, like strep throat, which is less likely to infect others.
  • Or, if you don't get tested or cleared by a healthcare provider, after all of the following are true:
    • Ten (10) days have passed since your symptom(s) started AND
    • You no longer have fevers AND
    • Your symptoms are getting better.

If your COVID‑19 test is positive, see If you tested positive or were diagnosed with COVID‑19.

If you were exposed to COVID‑19.

If you had Close Contact to someone with COVID‑19, you may need to stay home based on how many vaccine doses you have received.

  • If you are Up-to-Date on all COVID-19 vaccines, or you have had confirmed COVID-19 in the last 90 days (e.g. you tested positive on a viral test for COVID-19), you do not need to quarantine. However, you should:
    • Test on day 5.
    • Wear a well-fitting mask around others for 10 days, especially in indoor settings.
    • Monitor symptoms for 10 days since last date of Close Contact. If symptoms develop at any point, test immediately and stay home.
  • If you are NOT Up-to-Date on all COVID-19 vaccines, you must:
    • Stay at home for at least 5 days since your last contact with a person with COVID-19
    • Test on day 5
    • You may only leave your house after day 5 if symptoms are not present and you have a negative test on day 5 or after.
    • If you leave your home after day 5, wear a well-fitting mask around others indoors or outdoors, until day 10.
    • If you are unable to get tested or choose not to get a test and you do not develop symptoms, you can end quarantine after day 10.
    • Monitor symptoms for 10 days since last date of Close Contact. If symptoms develop at any point, test immediately and stay home.

You may consider also testing immediately after learning of a Close Contact. Testing early allows you to have earlier access to treatment options, especially if you are immunocompromised, and to let people around you know that they might have been exposed. If you cannot stay away from the infected person (for example, someone you take care of), you must continue to quarantine for at least 5 days after the infected person’s period of isolation has ended.

What kind of testing should I get?

Either nuclear acid amplification tests (NAAT) like a PCR, or antigen tests are acceptable to end isolation or quarantine. However, antigen testing is preferred in two situations, 1) to end isolation or 2) when you have a close contact but have had a recent infection with COVID-19 in the last 90 days. This is because antigen testing is better at picking up virus that is still infectious, while PCR tests can stay positive for some time and do not correlate as well with risk of infecting others. Over the counter tests are acceptable to end isolation or quarantine. See our additional guidance on at home testing.

Special settings at higher-risk for the spread of COVID-19

Shelters

Shelters includes general homeless shelters, residential rehabilitation, behavioral health residential programs, family shelters, youth shelters and domestic violence shelters.

If you live in a shelter you should follow isolation and quarantine rules for the general populations. See How long do I have to stay at home? (Ending Isolation and Quarantine). The SFDPH Isolation and Quarantine directives no longer require longer quarantine for residents of a shelter.

If you work in a shelter, you should follow isolation and quarantine rules for the general populations. See How long do I have to stay at home? (Ending Isolation and Quarantine). However staff at behavioral health sites who are considered healthcare workers should follow separate CDPH guidance on isolation and quarantine for healthcare providers.

Jails

If you work in a jail setting as a correctional staff member or a healthcare provider, you should follow the isolation and quarantine rules from your institution. Your facility may choose to be more strict that the rules found in the SFDPH Isolation and Quarantine directives.

Hospitals, Long Term Care Facilities and Nursing Homes

If you live in a long term care facility or a nursing home, or are admitted to an acute care or psychiatric hospital, you should follow the rules of your facility. If you work in a hospital, long term care facility or nursing home, you should follow the CDPH guidance on isolation and quarantine for healthcare providers.

Summary chart (for non-health care personnel): How long do I have to stay home and away from other people?

A. COVID‑19
(positive test or clinical diagnosis)

Regardless of vaccination

B. Symptoms of COVID‑19
(AND no Close Contact)

Regardless of vaccination

C. Close Contact to COVID‑19
(no COVID‑19 symptoms)

If you had symptoms, you must stay home until

  • 5 days have passed since your symptoms started and
  • You do not have a fever, and
  • Your symptoms are getting better, and
  • You have a negative test collected on day 5 or later.*

If you never had symptoms, you must stay home for 5 days after your positive test. If you do not get re-tested on day 5, you must stay at home for 10 days after your positive test.

You must stay home until one of the following happens:

  • You have a negative COVID‑19 test result,* collected after your symptoms started.
  • You get a doctor's note or clinic note that you do not need to isolate.
  • If you don't get tested or cleared by a healthcare provider, you must stay home until all of the following are true:
    • 10 days have passed since your symptoms started and
    • You don’t have a fever, and
    • Your symptoms are getting better.

Up-to-Date on for COVID‑19 Vaccines (or confirmed COVID-19 infection in the last 90 days)

You do not have to quarantine.

  • You should get tested on day 5 after Close Contact.*
  • You should wear a well-fitting mask around others until day 10, indoors and outdoors.

If symptoms develop, test, stay home and follow directions in Column B

Not Up-to-Date on COVID-19 Vaccines

You must stay home for at least 5 days since your last Close Contact.

  • You should test on day 5.*
  • In order to leave your house you must have a negative test collected on day 5 or later.

After you leave your house, wear a well-fitting mask around others for an additional 5 days, especially in indoor settings.

If symptoms develop, test, stay home and follow directions in Column B.

 

† Special rules apply to health care settings including long-term care facilities, jails and shelters and schools.

* Either nuclear acid amplification tests (NAAT) like PCR, or antigen tests are acceptable for all scenarios. However, antigen testing is preferred either 1) to end isolation or 2) when you have an exposure but have had a recent infection with COVID-19 in the last 90 days.