Current Covid Isolation Guidelines
February 15, 2024 7:57 AM Subscribe
After being incredibly lucky for years, Covid has entered our household. I seem to have avoided catching it in the pre-symptom window and I'd like to keep avoiding it. What's the current best practice for determining when the ill person is no longer contagious?
Searching this is hard because it's coming up with government recommendations that seem focused on getting people back to work. I also am aware that I tend towards anxiety and I don't want to make my partner isolate in the bedroom and wear a mask anytime he leaves it for the whole 2 weeks if that's not necessary.
(Also we have an Event schedule 15 days from his exposure, which feels pretty reasonable for him being over it, but I could still cause scheduling problems if I catch it now.)
Searching this is hard because it's coming up with government recommendations that seem focused on getting people back to work. I also am aware that I tend towards anxiety and I don't want to make my partner isolate in the bedroom and wear a mask anytime he leaves it for the whole 2 weeks if that's not necessary.
(Also we have an Event schedule 15 days from his exposure, which feels pretty reasonable for him being over it, but I could still cause scheduling problems if I catch it now.)
Best answer: I'd be completely satisfied to spend unmasked time with someone once they've had two clean antigen tests, 48 hours apart.
posted by mskyle at 8:05 AM on February 15 [22 favorites]
posted by mskyle at 8:05 AM on February 15 [22 favorites]
It's more important for them to mask than for you, although best if you both do. Cracking windows in addition to whatever air purifiers helps. Use separate bathrooms to the extent you can.
I kept myself and kiddo from catching it when spouse had it this way. I borrowed a second air purifier too.
If they are on paxlovid (and even if not), be aware of rebound cases, wherein the person tests negative for a day or so but then positive again. They can still transmit during the second phase, though it is less likely, and they will probably feel not as sick as the first wave. So yes you'd want at least a second negative test a few days after the first to be on the safe side.
Good luck! It's annoying and challenging but you can do it.
posted by SaltySalticid at 8:26 AM on February 15 [1 favorite]
I kept myself and kiddo from catching it when spouse had it this way. I borrowed a second air purifier too.
If they are on paxlovid (and even if not), be aware of rebound cases, wherein the person tests negative for a day or so but then positive again. They can still transmit during the second phase, though it is less likely, and they will probably feel not as sick as the first wave. So yes you'd want at least a second negative test a few days after the first to be on the safe side.
Good luck! It's annoying and challenging but you can do it.
posted by SaltySalticid at 8:26 AM on February 15 [1 favorite]
Best answer: They are no longer contagious when they have had two negative tests, 48 hours apart.
posted by twelve cent archie at 8:30 AM on February 15 [2 favorites]
posted by twelve cent archie at 8:30 AM on February 15 [2 favorites]
Best answer: As far as I know there isn't an update to the basic picture, in terms of how to protect each other and how to make educated guesses about "am I contagious right now?". The basic picture remains:
- Rapid antigen test results are the best indication we have about possible contagiousness, as average people making realtime decisions. The strength of the color of the test line is roughly an indication of how much virus is in the nose right now, and that's probably correlated with how contagious the person is right now... but we don't know where the exact "faint enough line to not be contagious" cutoff is, so we need to assume that any faint line on the test is a positive result and means the person is potentially contagious. So - get a bunch of tests, after a few days start testing every other day or so (or whatever interval makes sense with the number of tests you can afford and the "progress" in terms of symptoms and the color of the line). You're looking for a fully negative test and then another fully negative 24-48 hours later.
- Wearing an N-95 mask is the gold standard of protection. Be sure to put the mask on correctly (see the instructions for where the straps go, how to shape the nosepiece to your nose, and test whether you have a good fit) and keep it on the whole time when you're in the shared airspace. (If it's just you and your partner, maybe you can be the one who wears the mask all the time, scrupulously, since it kind of sucks to wear a mask if you're sick.) Just being super consistent with the mask is the key even though it is a drag.
3M Aura masks are a good choice, they are comfortable and well-fitting for a variety of face shapes and sizes and are widely available at home improvement stores or for delivery online. They can be re-used for a couple days or until they become soiled/harder to breathe in. (Anecdata: I spent over a month taking care of a loved one with covid who couldn't wear a mask; I wore an Aura N95 mask the whole time, no exceptions, and I didn't catch it.)
- Ventilation and filtration of indoor air helps a lot. If you can open windows even a couple inches, and get air exchange going that can yield a surprisingly big reduction in buildup of virus in the air. HEPA air purifiers are great and you should run them if you have them; if you don't already have one, it could be worth getting/building your own since it may have reusability for e.g. wildfire smoke. And choose your airspace - have the sick person stay in another room, have the other family members avoid spending a lot of time in the up-close-and-personal higher-risk air zone if possible (e.g. if you don't have to be nursing the person).
posted by LobsterMitten at 8:44 AM on February 15 [8 favorites]
- Rapid antigen test results are the best indication we have about possible contagiousness, as average people making realtime decisions. The strength of the color of the test line is roughly an indication of how much virus is in the nose right now, and that's probably correlated with how contagious the person is right now... but we don't know where the exact "faint enough line to not be contagious" cutoff is, so we need to assume that any faint line on the test is a positive result and means the person is potentially contagious. So - get a bunch of tests, after a few days start testing every other day or so (or whatever interval makes sense with the number of tests you can afford and the "progress" in terms of symptoms and the color of the line). You're looking for a fully negative test and then another fully negative 24-48 hours later.
- Wearing an N-95 mask is the gold standard of protection. Be sure to put the mask on correctly (see the instructions for where the straps go, how to shape the nosepiece to your nose, and test whether you have a good fit) and keep it on the whole time when you're in the shared airspace. (If it's just you and your partner, maybe you can be the one who wears the mask all the time, scrupulously, since it kind of sucks to wear a mask if you're sick.) Just being super consistent with the mask is the key even though it is a drag.
3M Aura masks are a good choice, they are comfortable and well-fitting for a variety of face shapes and sizes and are widely available at home improvement stores or for delivery online. They can be re-used for a couple days or until they become soiled/harder to breathe in. (Anecdata: I spent over a month taking care of a loved one with covid who couldn't wear a mask; I wore an Aura N95 mask the whole time, no exceptions, and I didn't catch it.)
- Ventilation and filtration of indoor air helps a lot. If you can open windows even a couple inches, and get air exchange going that can yield a surprisingly big reduction in buildup of virus in the air. HEPA air purifiers are great and you should run them if you have them; if you don't already have one, it could be worth getting/building your own since it may have reusability for e.g. wildfire smoke. And choose your airspace - have the sick person stay in another room, have the other family members avoid spending a lot of time in the up-close-and-personal higher-risk air zone if possible (e.g. if you don't have to be nursing the person).
posted by LobsterMitten at 8:44 AM on February 15 [8 favorites]
FWIW, the CDC website has a handy calculator in addition to their guidance, which is reasonably nuanced and reflects what people have said here. You can obviously choose to be more conservative if you wish. We're currently in the midst of this and the one thing the website doesn't answer is when do I, the currently non-infected person, stop counting myself as having been exposed (i.e. the date of my last exposure is unclear)? Presumably two negative test 48hrs apart or 10 days.
posted by hoyland at 8:47 AM on February 15 [3 favorites]
posted by hoyland at 8:47 AM on February 15 [3 favorites]
Nasal rinses don’t yet have a super huge body of peer reviewed evidence behind them, BUT the risk to using them is so low it’s basically a “can’t hurt to try it.”
I’ve used them pretty consistently after evenings out where I didn’t wear a mask (bar, restaurant) and found they’ve helped put my mind at ease, if nothing else. And whether from allergies or being sick, I’ve also found them to be very helpful with symptoms.
posted by raccoon409 at 9:09 AM on February 15 [4 favorites]
I’ve used them pretty consistently after evenings out where I didn’t wear a mask (bar, restaurant) and found they’ve helped put my mind at ease, if nothing else. And whether from allergies or being sick, I’ve also found them to be very helpful with symptoms.
posted by raccoon409 at 9:09 AM on February 15 [4 favorites]
My link wasn’t working above so here it is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10312243/
posted by raccoon409 at 9:11 AM on February 15 [1 favorite]
posted by raccoon409 at 9:11 AM on February 15 [1 favorite]
Mask. Maintain social distancing and be mindful of household airflow in every way possible.
Both of you use one of the nose sprays. I could only get my hands on the Xylitol one right away (it has helped with nose comfort) but I'm going to start carrying an Iota Carrageenan spray going forward. We did not know about CPC mouthwash until just yesterday but that too is going in our arsenal for future exposure risks and if we're stuck in the house with one of us sick again.
My husband and I just had a surprising chain of events - we went away for a higher-risk weekend starting on a Friday morning, we both had mild sinus complaints Saturday evening (this happens every time we change pollen/pollutant profiles), mine escalated Sunday evening as we were coming home (but also going up 1000 feet in elevation), Monday I got suspicious it wasn't allergies, I didn't test until Tuesday but it was positive.
My husband was negative at that time, and didn't see the point in splitting up as we're living in a 700sf house with baseboard heaters (no filtered ventilation) in 20f weather, though we did crack windows. He tested negative all week and didn't have symptoms until Friday when he also tested positive, and proceeded to follow the exact same sickness arc I did.
As wild as it seems, I feel like I have to assume we both got exposed the first day but I'm the only one who got it then, and then I gave it to him.
Split the house up, if at all possible. I'd far rather only I had gotten sick.
posted by Lyn Never at 9:14 AM on February 15 [1 favorite]
Both of you use one of the nose sprays. I could only get my hands on the Xylitol one right away (it has helped with nose comfort) but I'm going to start carrying an Iota Carrageenan spray going forward. We did not know about CPC mouthwash until just yesterday but that too is going in our arsenal for future exposure risks and if we're stuck in the house with one of us sick again.
My husband and I just had a surprising chain of events - we went away for a higher-risk weekend starting on a Friday morning, we both had mild sinus complaints Saturday evening (this happens every time we change pollen/pollutant profiles), mine escalated Sunday evening as we were coming home (but also going up 1000 feet in elevation), Monday I got suspicious it wasn't allergies, I didn't test until Tuesday but it was positive.
My husband was negative at that time, and didn't see the point in splitting up as we're living in a 700sf house with baseboard heaters (no filtered ventilation) in 20f weather, though we did crack windows. He tested negative all week and didn't have symptoms until Friday when he also tested positive, and proceeded to follow the exact same sickness arc I did.
As wild as it seems, I feel like I have to assume we both got exposed the first day but I'm the only one who got it then, and then I gave it to him.
Split the house up, if at all possible. I'd far rather only I had gotten sick.
posted by Lyn Never at 9:14 AM on February 15 [1 favorite]
I managed to avoid catching it from my mom while sharing a smallish NYC one-bedroom with her over the holidays this year, so there is hope. She started paxlovid the day after testing positive and stayed in my bedroom with the doors shut and the windows cracked (climate change useful for once). We had air purifiers running in both the bedroom and the living room where I was sleeping. Whenever she came out of the bedroom for a quick bathroom visit, she had an N95 on; similarly, whenever I had to go into the bedroom to bring her food or pills or whatever, we both wore one. (I also spent a fair amount of time out of the apartment, but nearby in case she needed me.) I never had any seriously suspicious symptoms but tested twice a day anyway. She went home nine (I think) days after testing positive and one day after testing negative (we had already moved her initial return flight). She wore an N95 the entire way home.
There are more extensive mitigation procedures we could've adopted, but since the person at much higher risk of serious illness already had it, this seemed like the best balance between caution and everyone losing their damn minds.
posted by praemunire at 10:00 AM on February 15
There are more extensive mitigation procedures we could've adopted, but since the person at much higher risk of serious illness already had it, this seemed like the best balance between caution and everyone losing their damn minds.
posted by praemunire at 10:00 AM on February 15
Response by poster: Thanks all! I'll take 2 negative test 48 hours apart as the standard.
We've been masking and staying in separate rooms, but there's only one bathroom so we can't keep perfect isolation. But I've cracked a couple windows. The air filtration comments made me check the one I have been running, which was bought for allergies before covid, which turns out to be 'hepa like', so I've ordered two actual hepa filters. A small one for the bedroom will be here tomorrow and a larger one for the main room will be delivered today.
I figure I'll start testing once he gets his second negative test. The possibly bright side is that the version seems to hit fast, both he and the person he got it from went from exposure to brief fever to sick within 48 hours, so I'm hoping that it'll be obvious if I get it (though will still test before the Event . I'd rather not reschedule, but also don't want to infect anyone else).
posted by platypus of the universe at 10:26 AM on February 15 [1 favorite]
We've been masking and staying in separate rooms, but there's only one bathroom so we can't keep perfect isolation. But I've cracked a couple windows. The air filtration comments made me check the one I have been running, which was bought for allergies before covid, which turns out to be 'hepa like', so I've ordered two actual hepa filters. A small one for the bedroom will be here tomorrow and a larger one for the main room will be delivered today.
I figure I'll start testing once he gets his second negative test. The possibly bright side is that the version seems to hit fast, both he and the person he got it from went from exposure to brief fever to sick within 48 hours, so I'm hoping that it'll be obvious if I get it (though will still test before the Event . I'd rather not reschedule, but also don't want to infect anyone else).
posted by platypus of the universe at 10:26 AM on February 15 [1 favorite]
have the sick person stay in another room
and run that room at negative pressure with respect to the rest of the house by putting a box fan in there that blows outward through the window.
Siting the fan about a metre inside the window will shift more air out through it than having it mounted in the window frame, because the fan blades pull air in from around the sides of the fan as well as from behind it, and it's better if they're not uselessly recirculating outside air when they do that. Having the fan inside the room a little bit also gives the outgoing stream coming off the front of it an opportunity to entrain some additional room air as it leaves.
posted by flabdablet at 10:53 AM on February 15
and run that room at negative pressure with respect to the rest of the house by putting a box fan in there that blows outward through the window.
Siting the fan about a metre inside the window will shift more air out through it than having it mounted in the window frame, because the fan blades pull air in from around the sides of the fan as well as from behind it, and it's better if they're not uselessly recirculating outside air when they do that. Having the fan inside the room a little bit also gives the outgoing stream coming off the front of it an opportunity to entrain some additional room air as it leaves.
posted by flabdablet at 10:53 AM on February 15
there's only one bathroom so we can't keep perfect isolation
When my partner had covid again in December, he brought our camping toilet (along with either cat litter or wood chips to cover odors) into his room to minimize time spent outside of the room, and minimize the number of times he had to mask up.
posted by metonym at 5:53 PM on February 15
When my partner had covid again in December, he brought our camping toilet (along with either cat litter or wood chips to cover odors) into his room to minimize time spent outside of the room, and minimize the number of times he had to mask up.
posted by metonym at 5:53 PM on February 15
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Wear a mask.
Get one of those air filter machines.
My son got it, I did not. Ms. Windo got it, I did not.
And the current guidelines seem to be getting thrown out the window, so, shrugs...
Stay clear, stay safe.
posted by Windopaene at 8:02 AM on February 15 [7 favorites]