Coronavirus exposure - help us do all the right things.
November 5, 2020 6:50 AM Subscribe
On 10/31 we were exposed to someone who has just tested positive for coronavirus. We have read all the guidelines but still want to be sure we’re doing the right things.
My wife and I are essential workers so our kids (both under 5) are in daycare.
The good news is the contact was outdoors, masked, and mostly distanced, but with kids of course they ran around and gave the person in question leg-hugs that should not be given, so I think per the CDC the hugs count as close contact. Plus we don’t want to play “was it really close contact” roulette, we want to do the right thing. None of us has symptoms currently.
Things we are doing:
* Quarantining our whole household for 14 days after exposure (so through end of day 11/13).
* Pulled the kids out of daycare as soon as a we learned about the test result.
* Told the daycare all the details.
* If anyone develops symptoms, get tested.
Our questions:
* If we remain symptom-free, should we still get tested? If so, when do we defy tested?
* The day care says they’ll inform the families in our kids’ rooms, but since none of of have a positive test they don’t have to close any of the rooms and no one has to quarantine. Maybe it’s my anxiety talking but is that really best practice? It feels... lax.
Anything else we’re not thinking of?
My wife and I are essential workers so our kids (both under 5) are in daycare.
The good news is the contact was outdoors, masked, and mostly distanced, but with kids of course they ran around and gave the person in question leg-hugs that should not be given, so I think per the CDC the hugs count as close contact. Plus we don’t want to play “was it really close contact” roulette, we want to do the right thing. None of us has symptoms currently.
Things we are doing:
* Quarantining our whole household for 14 days after exposure (so through end of day 11/13).
* Pulled the kids out of daycare as soon as a we learned about the test result.
* Told the daycare all the details.
* If anyone develops symptoms, get tested.
Our questions:
* If we remain symptom-free, should we still get tested? If so, when do we defy tested?
* The day care says they’ll inform the families in our kids’ rooms, but since none of of have a positive test they don’t have to close any of the rooms and no one has to quarantine. Maybe it’s my anxiety talking but is that really best practice? It feels... lax.
Anything else we’re not thinking of?
I don't have anything to add to your to-do list.
Re: testing, call your doctor about whether and when you should be tested. Around here, they are not recommending testing unless symptoms develop. It doesn't negate the 14 day quarantine, it may not give you actionable info, and it's taking away testing capacity for more urgent symptomatic cases.
Re: daycare, that is how our daycare is handling things, as is my workplace, based on guidance from the state and our county health department. Direct contact with a known positive case = quarantine. But the kids at daycare are one step removed from the positive case, and so don't need to make any changes (although informing the families is a great idea).
If one of your family tests positive, you then become "case zero" and the other kids are now in your position, quarantining because they have been directly exposed to a known positive.
posted by Knicke at 7:04 AM on November 5, 2020 [4 favorites]
Re: testing, call your doctor about whether and when you should be tested. Around here, they are not recommending testing unless symptoms develop. It doesn't negate the 14 day quarantine, it may not give you actionable info, and it's taking away testing capacity for more urgent symptomatic cases.
Re: daycare, that is how our daycare is handling things, as is my workplace, based on guidance from the state and our county health department. Direct contact with a known positive case = quarantine. But the kids at daycare are one step removed from the positive case, and so don't need to make any changes (although informing the families is a great idea).
If one of your family tests positive, you then become "case zero" and the other kids are now in your position, quarantining because they have been directly exposed to a known positive.
posted by Knicke at 7:04 AM on November 5, 2020 [4 favorites]
I've been through the guidelines in detail with a public health unit in the greater Toronto area and all of that, including the daycare's response, sounds well within tolerance to me.
posted by warriorqueen at 7:04 AM on November 5, 2020
posted by warriorqueen at 7:04 AM on November 5, 2020
Here in Santa Rosa, anyone can get free testing. One of the questions they ask is whether you were exposed. The whole process takes like 5 minutes at most, they just check you in, and stick a q-tip up your nose. It takes 4-6 days to get the results. Maybe there's something like that where you are?
posted by aniola at 7:04 AM on November 5, 2020 [2 favorites]
posted by aniola at 7:04 AM on November 5, 2020 [2 favorites]
I'd take a normal dose of Vitamin C, maybe as part of a multivitamin, as a 'might help'/ no downside strategy.
posted by theora55 at 7:05 AM on November 5, 2020 [1 favorite]
posted by theora55 at 7:05 AM on November 5, 2020 [1 favorite]
What your daycare is saying is in accordance with my kid's school's policy. If you feel it's lax, get everyone tested now, and use that information according to their policy. At our school, a family positive would shut down the kid's/kids' classroom(s) for 14 days after that kid was last present. If your tests are all negative, you still have to quarantine, but unless you become symptomatic or have a positive test, it's reasonable for the school to assume they don't have to shut anything down over second-order contact. If everyone were doing that, all of this would grind to a halt pretty promptly, but those of us who are trying to do the in-person thing have already passed the "shut it all down" decision point. It's okay if you want to reconsider your position in light of this personal experience and move to some other family arrangement (I mean that genuinely: no snark), but this is exactly what the whole "essential workers are essential" model calls for. As a hypothetical parent in your kids' class, them staying out of school for 14 days is entirely sufficient, assuming you're all asymptomatic the whole time (our school also requires a negative test at 12 days, but I'm not convinced that's meaningful on top of the quarantine).
posted by teremala at 7:21 AM on November 5, 2020 [1 favorite]
posted by teremala at 7:21 AM on November 5, 2020 [1 favorite]
I can confirm that by the guidelines in my area, no one at daycare would need to quarantine unless the child in that class tests positive (maybe if the child develops symptoms after known exposure? Not sure about the guidance there.)
A parent from my child’s class tested positive and the daycare notified us but didn’t need to close down the classroom or anything. I’m not sure that notification was even required (the classmate was asymptomatic and tested negative), but I appreciated it.
posted by songs about trains at 7:24 AM on November 5, 2020
A parent from my child’s class tested positive and the daycare notified us but didn’t need to close down the classroom or anything. I’m not sure that notification was even required (the classmate was asymptomatic and tested negative), but I appreciated it.
posted by songs about trains at 7:24 AM on November 5, 2020
(Ah, correction: I reviewed the document and a family positive wouldn't trigger the closure, only extend the family's quarantine. Only a positive from a child/teacher actually present shuts down a pod. Public Health has raved about this policy and indeed it's contained at least two community-based infections to only the affected person/family despite high overall numbers in the county.)
posted by teremala at 7:37 AM on November 5, 2020
posted by teremala at 7:37 AM on November 5, 2020
It sounds like you are doing all the right things. We are a similarly situated family, with two kids in daycare, who went through a COVID exposure and illness last month. Our exposure was a longer, indoor one, and 3 out of 4 in our family ended up testing positive. It seems less likely that you guys will get it given the outdoor setting, but here's a run down of how things unfolded for my family:
Testing: We decided to get the whole family tested, even though we knew that a negative test would not negate the 14 day quarantine requirement. Our doctors advised waiting 4-5 days from the exposure to test to reduce the chance of a false negative. By the time we got tested, two out of four of us were exhibiting symptoms. The two adults had mild symptoms and tested positive, the four-year-old tested positive but never had symptoms, and the one-year-old tested negative (and no symptoms). Whether you do the test is up to you. A negative test won't change your course of action, but it might give you some peace of mind.
Precautions at home after exposure: As soon as we knew we had been exposed, the adults started wearing masks at home, wiping things down much more frequently, and generally trying to give each other more space in case one of us came down with symptoms. My husband and I slept in separate beds and used separate bathrooms. Of course this kind of isolation is almost impossible from the toddlers in the house, and that's probably why it spread quickly through our family.
Being sick: I was really worried when my husband and I started having symptoms that we would become severely ill at the same time and wouldn't be able to ask anyone to help us take care of our kids because they were under quarantine. It turned out that our symptoms were as mild as a common cold and this wasn't a problem, but it wouldn't hurt for parents of young kids to think through a plan in case of this scenario. This is especially true for single parents. Older grandparents were out of the question, but maybe a young, healthy aunt or uncle who was willing to step in and risk exposure if the parents really were sick enough that they really couldn't care for the kids?
Isolation and quarantine: One thing that surprised me about the isolation and quarantine periods was how there is a domino effect on the overall quarantine duration as additional household members test positive. Since our one-year-old tested negative, her quarantine period didn't start until after the END of the last isolation period of a sick individual -- so 5 days after exposure until the last positive test/start of symptoms, plus 10 days of isolation for the sick individual, plus 14 days of quarantine for the baby after isolation ended. All told it was about a month that we were isolated or quarantined and without childcare. It was like March/April all over again, but with the rest of the world going on in our new quasi-normal.
My family is totally fine now, and we feel very lucky, all things considered. But it was a stressful experience for us because no one in our community had been through family quarantine, and we hadn't thought through our backup care plans. And you'll almost certainly be fine -- but I do encourage you to think through a plan. Especially with daycare kids, exposures like this are our new normal.
posted by c lion at 7:56 AM on November 5, 2020 [12 favorites]
Testing: We decided to get the whole family tested, even though we knew that a negative test would not negate the 14 day quarantine requirement. Our doctors advised waiting 4-5 days from the exposure to test to reduce the chance of a false negative. By the time we got tested, two out of four of us were exhibiting symptoms. The two adults had mild symptoms and tested positive, the four-year-old tested positive but never had symptoms, and the one-year-old tested negative (and no symptoms). Whether you do the test is up to you. A negative test won't change your course of action, but it might give you some peace of mind.
Precautions at home after exposure: As soon as we knew we had been exposed, the adults started wearing masks at home, wiping things down much more frequently, and generally trying to give each other more space in case one of us came down with symptoms. My husband and I slept in separate beds and used separate bathrooms. Of course this kind of isolation is almost impossible from the toddlers in the house, and that's probably why it spread quickly through our family.
Being sick: I was really worried when my husband and I started having symptoms that we would become severely ill at the same time and wouldn't be able to ask anyone to help us take care of our kids because they were under quarantine. It turned out that our symptoms were as mild as a common cold and this wasn't a problem, but it wouldn't hurt for parents of young kids to think through a plan in case of this scenario. This is especially true for single parents. Older grandparents were out of the question, but maybe a young, healthy aunt or uncle who was willing to step in and risk exposure if the parents really were sick enough that they really couldn't care for the kids?
Isolation and quarantine: One thing that surprised me about the isolation and quarantine periods was how there is a domino effect on the overall quarantine duration as additional household members test positive. Since our one-year-old tested negative, her quarantine period didn't start until after the END of the last isolation period of a sick individual -- so 5 days after exposure until the last positive test/start of symptoms, plus 10 days of isolation for the sick individual, plus 14 days of quarantine for the baby after isolation ended. All told it was about a month that we were isolated or quarantined and without childcare. It was like March/April all over again, but with the rest of the world going on in our new quasi-normal.
My family is totally fine now, and we feel very lucky, all things considered. But it was a stressful experience for us because no one in our community had been through family quarantine, and we hadn't thought through our backup care plans. And you'll almost certainly be fine -- but I do encourage you to think through a plan. Especially with daycare kids, exposures like this are our new normal.
posted by c lion at 7:56 AM on November 5, 2020 [12 favorites]
Your plans are in line with CDC guidelines and also make sense logically given what we know about the virus. Guidelines say that testing 5-7 days after known exposure is best; you're more likely to pull a false negative if you test earlier. But given that you know you were exposed to someone with it (yes, even masked, even outdoors) it is best to quarantine for 14 days as you've planned. Quarantining for 14 days after exposure is not akin to pandemic safety theatre. We are in the place that we are in in the United States because far too many people aren't/weren't cautious enough. Thank you for being cautious.
posted by k8lin at 8:31 AM on November 5, 2020 [5 favorites]
posted by k8lin at 8:31 AM on November 5, 2020 [5 favorites]
Your closest hospital probably has a covid-19 hotline that will tell you exactly what to do.
If either of you are healthcare workers the guidelines for return to work are different. In my ER we are tested if close contact with known positive. If negative and no sx, back to work with respirator.
posted by pintapicasso at 8:41 AM on November 5, 2020 [1 favorite]
If either of you are healthcare workers the guidelines for return to work are different. In my ER we are tested if close contact with known positive. If negative and no sx, back to work with respirator.
posted by pintapicasso at 8:41 AM on November 5, 2020 [1 favorite]
Epidemiologist here. All sounds good but, yes, get tested before breaking quarantine.
posted by late afternoon dreaming hotel at 9:53 AM on November 5, 2020
posted by late afternoon dreaming hotel at 9:53 AM on November 5, 2020
You should all get tested, regardless of symptoms. If you want you could get tested now, and again in a few days. That addresses the incubation period of the virus.
Maintain your quarantine regardless of the test results.
More people should be getting tested, period. We need to get our test rates up for the general population if we are ever going to beat this thing. The fact that you had close contact with someone who tested positive makes it all the more important for you to get tested. You should not have to pay for these tests, though the details of payment will vary with your location and your insurance.
Thank you for taking COVID-19 seriously and acting responsibly. If everyone in our country behaved the way your family is behaving we'd have this thing beat!
posted by Winnie the Proust at 10:17 AM on November 5, 2020 [2 favorites]
Maintain your quarantine regardless of the test results.
More people should be getting tested, period. We need to get our test rates up for the general population if we are ever going to beat this thing. The fact that you had close contact with someone who tested positive makes it all the more important for you to get tested. You should not have to pay for these tests, though the details of payment will vary with your location and your insurance.
Thank you for taking COVID-19 seriously and acting responsibly. If everyone in our country behaved the way your family is behaving we'd have this thing beat!
posted by Winnie the Proust at 10:17 AM on November 5, 2020 [2 favorites]
Most the research I've seen indicates the average incubation period is 5 days but can be anywhere between 2 and 14 days. In my part of the country, tests take about 2 to 6 days to come back, so pragmatically, I would probably get tests 8 days after exposure to give the best possible chance of an accurate test and also the best possible chance of being done with quarantine on Day 14. Obviously if you start to get symptoms (even after a negative test) I'd retest.
posted by Happydaz at 10:21 AM on November 5, 2020
posted by Happydaz at 10:21 AM on November 5, 2020
My employer had a physician in Italy when COVID started ramping up. Italy did contact tracing and testing, and (according to our physician there) found half of the infected people had no symptoms. Please get tested.
Closer to home, my spouse's grandboss's kid returned home in March when colleges closed. Both the kid's roommates had COVID with symptoms, the kid didn't. The kid's mother did get COVID. My spouse lost their sense of taste for a few days, but no other symptoms.
posted by JawnBigboote at 2:26 PM on November 5, 2020
Closer to home, my spouse's grandboss's kid returned home in March when colleges closed. Both the kid's roommates had COVID with symptoms, the kid didn't. The kid's mother did get COVID. My spouse lost their sense of taste for a few days, but no other symptoms.
posted by JawnBigboote at 2:26 PM on November 5, 2020
I am an epidemiologist but not your epidemiologist.
- Daycare actions are consistent with my local guidance.
- We recommend people with a known exposure get tested 5-9 days after exposure (7 days target +/- 2 days).
- You cannot test your way out of quarantine; a negative test does not mean you are safe. You do need to wait the 14 days in hard quarantine.
If you have other questions, you can memail me.
posted by quadrilaterals at 2:28 PM on November 5, 2020 [5 favorites]
- Daycare actions are consistent with my local guidance.
- We recommend people with a known exposure get tested 5-9 days after exposure (7 days target +/- 2 days).
- You cannot test your way out of quarantine; a negative test does not mean you are safe. You do need to wait the 14 days in hard quarantine.
If you have other questions, you can memail me.
posted by quadrilaterals at 2:28 PM on November 5, 2020 [5 favorites]
Hi, I have an MPH and I’m a contact tracer for NC.
1. You’re doing all the right things! YAY!
2. Please stay home through 11/14. Halloween counts/your exposure day counts as day zero and November 1 would be your first day of quarantine.
3. I would get tested on 11/6 or after (which works out since that’s tomorrow!) get the PCR test (nasal swab) rather than another one. This will be the most accurate test for you
4. I’ve seen a lot of day care outbreaks lately and this is anecdotal but kids generally don’t have symptoms or they are mild. Your kids will not like the PCR swab. You can consider the rapid test but those have high false negatives
5. Our health department has been really backlogged. I would expect to be contacted tomorrow or Monday if the case (the positive person) has listed you as contacts.
6. I don’t know if anywhere that is tracing contacts of contacts. Your day care is acting in accordance to guidelines. I know it’s frustrating though and feels like a monster on the doorstep.
7. Make plans for/consider dividing your household into care taker half and worker half now. If anyone in your household tests positive, they have 10 days of isolation from symptom onset or positive test (which ever is earlier). However, if they keep exposing the rest of the family then those family members’ 14 day quarantine will only begin once the sick family members 10 days end. So if they have symptoms on Nov 4th, then their isolation is through Nov 14, and everyone else’s quarantine starts on the 15th and ends on the 29th. Add in additional family members who get sick and this can reaaaalllly get long.
Feel free to PM me if you have additional questions of any kind!
posted by raccoon409 at 3:30 PM on November 5, 2020 [6 favorites]
1. You’re doing all the right things! YAY!
2. Please stay home through 11/14. Halloween counts/your exposure day counts as day zero and November 1 would be your first day of quarantine.
3. I would get tested on 11/6 or after (which works out since that’s tomorrow!) get the PCR test (nasal swab) rather than another one. This will be the most accurate test for you
4. I’ve seen a lot of day care outbreaks lately and this is anecdotal but kids generally don’t have symptoms or they are mild. Your kids will not like the PCR swab. You can consider the rapid test but those have high false negatives
5. Our health department has been really backlogged. I would expect to be contacted tomorrow or Monday if the case (the positive person) has listed you as contacts.
6. I don’t know if anywhere that is tracing contacts of contacts. Your day care is acting in accordance to guidelines. I know it’s frustrating though and feels like a monster on the doorstep.
7. Make plans for/consider dividing your household into care taker half and worker half now. If anyone in your household tests positive, they have 10 days of isolation from symptom onset or positive test (which ever is earlier). However, if they keep exposing the rest of the family then those family members’ 14 day quarantine will only begin once the sick family members 10 days end. So if they have symptoms on Nov 4th, then their isolation is through Nov 14, and everyone else’s quarantine starts on the 15th and ends on the 29th. Add in additional family members who get sick and this can reaaaalllly get long.
Feel free to PM me if you have additional questions of any kind!
posted by raccoon409 at 3:30 PM on November 5, 2020 [6 favorites]
Oh, and what kind of essential worker are you? The term hasn’t really been defined yet but those in health care may still report to work but have to quarantine outside of work and self monitor symptoms (does not apply for those who work in nursing homes). I don’t know if this is just in NC or National. I believe this is done to help ease staffing shortages. I’d hope a health care facility would already have guidance in place on this. I don’t know what this might look like if you’re a grocery store essential employee.
Also don’t beat yourself up about this. It sounds like you were doing a lot to try and mitigate risk and some under five kiddos have a few understandable hugs. You’ve acted swiftly and with great prudence to help protect other community members from becoming sick. When we attach a lot of shame to people’s actions it makes it that much harder to get others to disclose information. Thank you for being a leading example to other in the day care on how to act
posted by raccoon409 at 3:35 PM on November 5, 2020
Also don’t beat yourself up about this. It sounds like you were doing a lot to try and mitigate risk and some under five kiddos have a few understandable hugs. You’ve acted swiftly and with great prudence to help protect other community members from becoming sick. When we attach a lot of shame to people’s actions it makes it that much harder to get others to disclose information. Thank you for being a leading example to other in the day care on how to act
posted by raccoon409 at 3:35 PM on November 5, 2020
I got tested recently because I had traveled- by car and very carefully. I got tested after I'd been back for 6 days and had self-quarantined to reassure my family. I did not have any symptoms. I got my negative test result in 24 hours. A lot of testing places have improved and are giving results much faster. If I were you I would find out about local testing places and get the whole family tested in a couple of days.
posted by mareli at 4:16 PM on November 5, 2020
posted by mareli at 4:16 PM on November 5, 2020
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There are no public health organizations suggesting day care providers (or any business) should close due to a "second-party" exposure notification. There are no public health organizations that suggest testing when you have no symptoms for more than 14 days.
Your plan is more cautious than the vast majority of the population would do and is in line with even the most conservative government guidance. You're fine.
Consider getting tested twice during your quarantine and ending it sooner upon negative results. Outdoor masked mostly distanced contact is very low risk. There's no reason to put your family through unnecessary quarantine; it's something akin to pandemic safety theater.
posted by saeculorum at 7:02 AM on November 5, 2020 [11 favorites]