Help with this covid risk scenario (confirmed positive case)

December 22, 2021 12:12 PM

Two of my 4 stepdaughters came with us to our house on Sunday after spending a few hours at my extended family's house fully masked and isolating from others while eating. Their mom texts us that she was exposed Friday, and initial test was negative but today's test was positive. My issue is that the other 2 stepdaughters were supposed to join us today. They have been in the home with mom since Sunday and I don't know how risky it is for them to come.

I am immunocompromised but already have been exposed to the 2 daughters currently in my house, and we drove in the car together unmasked for about three hours. All of them are vaccinated (all 2 doses not 3). All 4 stepdaughters currently test negative.

My question is how much does it increase my risk of getting COVID if the other 2 come join us? They report having had limited time around their mother. They are teens so disinclined to spend much time in close proximity to mom. Three of the four daughters ate with their mom Saturday night. Two that remained at home presumably ate with her Sunday. Monday mom felt unwell and basically started isolating then.

So what do we do? Say the other 2 can come now since we spent a few hours unmasked in the car with their sisters? Give it one more day and another negative test? Where can I find evidence-based information to make a sound decision?

posted by crunchy potato to Science & Nature (28 answers total)

If you're immunocompromised I really would not risk it - people have gotten Omicron from opposite hotel rooms! I don't have access to any special evidence (not a doctor), but it's clear that this new variant is very contagious. If they are teens they can take care of themselves - the onus shouldn't be on you - prioritize your health.
posted by coffeecat at 12:20 PM on December 22, 2021 [12 favorites]

There is no way I’d allow a confirmed exposure anywhere near me after such a short period of time.
posted by wnissen at 12:22 PM on December 22, 2021 [10 favorites]

Response by poster: Adding clarification: My question is do we bring the other 2 to my house since we already have some amount of exposure or is there significant difference between the exposure we have currently, and the one we invite if we tell them to join us? Two people who lived in the house with a positive COVID case are in my house now, after sharing one meal with that person, and I shared a three hour car ride with them unmasked. How much additional risk am I taking to say the other two people can come here too?
posted by crunchy potato at 12:23 PM on December 22, 2021

There is pretty much always a significant difference between some risk and that same risk + added risk. It does not cancel each other out, it adds up.

Saying that you might as well do [thing with some risk] because you already did [different thing with some risk] is like saying that since you are already riding your motorcycle while drunk, you might as well leave your helmet and protective suit at home.

It's impossible to say how much risk you took and how much the extra closeness would be adding, but one thing is sure: you'd be stacking one risk on top of another, and thus making a higher pile.
posted by Too-Ticky at 12:38 PM on December 22, 2021 [28 favorites]

When we were contacted by a contact tracer, we had to list all contacts made in the previous 48 hours. You don't mention when the first negative test was, but if it was yesterday, the children currently with you might not have been there while mom was shedding virus. If the girls currently in the house are not vaccinated, they need to quarantine in place. We were also given the number for the covid question hotline in our state--you may want to check and see if there is one in your area which can help.
posted by tchemgrrl at 12:40 PM on December 22, 2021 [2 favorites]

"How much additional risk am I taking to say the other two people can come here too?"
Yes, this is not the way to think about it. The first two daughters are less likely to have been exposed. Definitely start isolating yourself from them and don't have the other two in the house, if you can.
posted by melamakarona at 12:41 PM on December 22, 2021 [3 favorites]

I am immunocompromised

Stop there. You do not want any additional risk whatsoever. It is not personal; it is about protecting your own health. Please do not allow the other two to come and stay with you. Let them know it is not their fault and it is not personal, but you need to stay healthy. Good luck!
posted by Bella Donna at 12:45 PM on December 22, 2021 [35 favorites]

How much additional risk am I taking to say the other two people can come here too?

It would double your risk, at a minimum.

Think of it this way. Each stepdaughter is in effect rolling a die to see if she got COVID from her mother. If we assume the two stepdaughters with you now are truly COVID-negative, then you're fine and safe. Why would you want to roll more dice?

Plus it seems to me that the two stepdaughters NOT with you have more exposure (and are therefore more likely to have COVID) compared with the ones who are at your place. The two currently with their mother have been with her for twice as long (Sunday Monday Tuesday Wednesday, versus Saturday Sunday), and during a period in which her viral load was higher, which means a higher likelihood of transmissibility.

(I think the mother's self-isolating doesn't really bring down the risk, unless you are super-confident they all did it perfectly, e.g., separate bathrooms, no common-area visits by Mom, open windows for ventilation, etc. And even then, there's Omicron. So upshot, I wouldn't count on the self-isolation changing anything.)

So yeah. Don't let the two additional step-daughters come to your place: it's not safe for you.
posted by Susan PG at 12:47 PM on December 22, 2021 [21 favorites]

Can the other two stepdaughters isolate in a third place (hotel / friend who has recently recovered / friend's empty home) for a couple of days until they get a confirmed-negative test? That way they can minimize exposure on their end and potentially come home to you if they haven't been exposed long enough to be infected? (Assuming they're old enough and there's someone who can take care of their care and feeding needs in a safe way if they're underage)
posted by Mchelly at 12:49 PM on December 22, 2021

Please correct me if I have missed any details. Person A, the mom, was exposed to COVID-19 on Friday, and had a positive test result today, exactly five days later. This lines up with how long the US CDC thinks the virus generally takes to incubate in a person enough for them to test positive.

Person B, one of your stepdaughters, was only in the same house as A for a few hours on Sunday, including eating with A at one meal. Your three other stepdaughters, C, D, and E, visited A's house on Saturday night for dinner, and also on Sunday.

Since then, B and C have been at your house. D and E have been at A's house since Sunday, having had "limited time" with A - but possibly sharing several meals and presumably sharing a ventilation system. (I'm assuming they're not masking for eating/sleeping/showering and A doesn't have positive air pressure set up or anything.) All four daughters are currently negative.

Based on my understanding of the US CDC recommendations, A's isolation period begins from when she first experienced symptoms, and continues for ten days if symptoms improve. If her symptoms began on Sunday, December 19th, then she can stop isolating on December 29th, if symptoms other than the loss of smell/taste have improved, as that's about when she most likely won't be shedding virus anymore.

This means B and C's last exposure to a person with COVID was Sunday, December 19th. They cannot get "good" (conclusive/useful) test results until Friday, December 24th, which is five days later.

If D and E are still in A's house, my understanding is that they are currently being exposed to a person with COVID, right now. I don't think they can get "good" test results until five days after they leave. If they stay at A's house tomorrow, their test results won't be conclusive until the 25th, for instance.

I would minimize your contact and shared ventilation with B and C as much as you can in your own home. If your residence will allow for all the recently-exposed/isolating stepdaughters to cloister themselves away from you much more effectively than they can at A's house, because there are window-unit heaters/separate floors/things like that, it might not be an entirely terrible idea to let the four of them spend the next few days together, rather than two there and two here, if the daughters can do things like drive themselves to your home. They should be getting groceries and other things like that in as socially-distanced a manner as possible, too, though, which makes something like booking a motel room very risky for the motel operators/food delivery people/etc.

You should not eat meals with any of the stepdaughters or get in an automobile with any of them until they have conclusive negative results, even though you've been doing so already. It is possible their bodies will shed more virus as the illness incubates in them. It is also extremely possible that they will not have any symptoms because they are teenagers - and that they will still be carrying a disease that can kill you.

I'm really sorry.
posted by All Might Be Well at 12:52 PM on December 22, 2021 [16 favorites]

Minor arithmetic update: 23 + 5 is not 25, it's 28. If D and E stop being exposed to a person with COVID tomorrow, December 23rd, then their test results won't be conclusive until the 28th.
posted by All Might Be Well at 1:10 PM on December 22, 2021 [3 favorites]

I'm immunocompromised and my doctors would not be ok with the level of risk you describe. Have you talked with your doctors about this?
posted by twelve cent archie at 1:10 PM on December 22, 2021 [1 favorite]

So the daughters have been spending time with/in the home of someone with known Covid since Saturday. How much cumulative time they spent in direct proximity to their mom feels irrelevant at this point, we know it is very difficult to isolate absolutely perfectly in a shared home.

So last known point of exposure for SDs #1 and #2 was on Sunday, they're already with you. Per the CDC, they can't know for certain they're negative until Friday the 24th at the very earliest (5 days out). Same for you at this point.

Last exposure for SDs #3 and #4 we can consider today, so the first day they can test with any degree of certainty is Monday the 27th. They have also had a far higher degree of exposure throughout this time. A negative test from them tomorrow, one day after their mom tested positive, is essentially worthless at this stage.

I am really sorry but I absolutely wouldn't knowingly extend my own exposure timeline by letting them come, and especially not as an immunocompromised person. I am missing out on Christmas with my partner and his children this year because they are in a situation exactly like the one you're describing. It really sucks.
posted by anderjen at 1:19 PM on December 22, 2021 [3 favorites]

Response by poster: To answer twelve cent archie, I am waiting on my doctor to call me back. I did call the nurse line and they basically just gave me CDC guidelines without an actual recommendation. She noted that routine exposure (being around someone repeatedly) is higher risk. Mom is a nurse so I bet she self-isolates better than most people BUT she did not know she could even possibly have it until 3 days after she was exposed.

I am just overcome with guilt at the idea that my health status is what will keep my stepdaughters from time with their father at Christmas. I am hoping my doctor will magically say "eh, since you are around the other two, go ahead" but I am pretty confident that's not the case.
posted by crunchy potato at 1:28 PM on December 22, 2021

Please, please don't feel guilty about your health status! It's very unfortunate but it is what it is; you are not being immunocompromised at your stepdaughters, after all. Be kind to yourself if you can manage it.
If you need to lay blame, lay it at the spikey feet of the virus.
posted by Too-Ticky at 1:40 PM on December 22, 2021 [26 favorites]

I am just overcome with guilt at the idea that my health status is what will keep my stepdaughters from time with their father at Christmas.

Don't be. He can go do something outside your home with them or you can all just blame the virus since it's the virus's fault. Your health is your health and it's not your fault it's just true, just like this virus. I am sorry this is a hassle but additional risk that is avoidable should be avoided.
posted by jessamyn at 1:49 PM on December 22, 2021 [13 favorites]

Here is a good checklist of what to do after testing positive or finding out someone tested positive.
https://www.nbcnews.com/news/us-news/just-tested-positive-covid-s-rcna9540

And there is no blame for the health conditions that exist-- They are just the facts!
And you are trying to be responsible about those facts and what they mean...just like any other adult should.
posted by calgirl at 1:57 PM on December 22, 2021 [4 favorites]

I am just overcome with guilt at the idea that my health status is what will keep my stepdaughters from time with their father at Christmas.

It's not - there's no way they should be around their father or anyone else either! (You can also see this as their mother's "fault", if that's any more helpful, though I wouldn't advise going that way.)

Do Christmas later. You can make any weekend special.
posted by trig at 2:00 PM on December 22, 2021 [6 favorites]

They shouldn't be seeing anyone right now, especially not anyone in your household. They have a confirmed exposure and should be isolating during the incubation period and have tests to confirm that they're not positive after they've waited the number of days necessary. So that means no visit with you and no visits with anyone. Omicron is extremely contagious and so isolation needs to be extra strict.
posted by quince at 2:08 PM on December 22, 2021 [8 favorites]

They should absolutely stay with their mom and not come to you. It sucks, it’s not what anyone wants, but it’s the least bad option.
posted by Stacey at 2:50 PM on December 22, 2021 [1 favorite]

I am just overcome with guilt at the idea that my health status is what will keep my stepdaughters from time with their father at Christmas.

Think of it in terms of what your stepdaughters would feel if they were the reason for you getting covid, if it turns out they do have it and pass it to you. Would you want to give them that guilt? That sort of (potentially life-long) guilt can affect them for years to come - and (especially if you contract covid and are severely affected) they would also be reminded of it more acutely every holiday season.
posted by aielen at 5:15 PM on December 22, 2021 [7 favorites]

It’s not just your health status, though, it’s now equally theirs, also through no fault of their own. Even if everyone in your household was completely, robustly healthy with immune systems of steel, it still wouldn’t remotely make sense for them to leave their mother’s house smack in the middle of an exposure period and come to yours only to start over. It’s awful timing but absolutely no one carries blame or reasons for guilt here. So far it sounds like everyone is doing everything right to resolve this as swiftly as possible. Keep it that way.

I think you’re going to notice a lot of people needing to delay their Christmas celebrations well into January. You’re definitely not alone.
posted by anderjen at 8:07 PM on December 22, 2021 [4 favorites]

Family dynamics always make this stuff so tricky to see clearly. This Internet stranger says, absolutely not, do not invite your other stepdaughters to join you. As household members of a case, they are each at high risk of developing COVID themselves. You can all celebrate together later. Don’t make your stepdaughters and husband risk needing to mourn you instead.
posted by eirias at 5:30 AM on December 23, 2021

my health status is what will keep my stepdaughters

For what it's worth, the UK is recommending everyone in a household with a positive test "to limit close contact with other people outside your household", regardless of their health status. So really it would be best practices for them to stay home even if you weren't immunocompromised- coming to visit would definitely count as close contact.

You're not keeping them away, it's the virus that's keeping them home.
posted by BungaDunga at 5:31 AM on December 23, 2021 [2 favorites]

Ditto what everybody said. Your stepdaughters are at high risk of testing positive themselves. And if you are immunocompromised I would NOT take that risk. I'm not your doctor, I'm not a doctor period. But if you explain this to your PCP s/he will confirm what we suggested. Omicron is scary. They are showing 3X times household transmissions for Omicron.

Some latest stats show that Omicron may be the MOST infectious disease EVER recorded, while not quite infectious as measles, it has MUCH SHORTER incubation time.
posted by kschang at 7:23 AM on December 23, 2021

If you were in the UK, then the other stepdaughters would need to self-isolate (and so not visit you) for 10 days starting on the day their mother experienced symptoms or had a positive test, whichever came first. So through to about New Year's Eve or New Year's Day? And hard agree with everyone who says that this is neither your fault nor their mother's fault, it's the fault of the virus. Christmas is delayed/messed up/less than ideal because we are still living through a pandemic.
posted by plonkee at 7:51 AM on December 23, 2021

And please do NOT believe "omicron is mild" myth until there are a LOT MORE studies confirming it. South Africa has a much younger population (median age is... 27? Compared to 40 in UK) so their general health cannot be compared to US or UK directly. Also, most of the data are from one doctor (albeit, head of South African Medical Association) and one health insurance company, Discovery Health, and it's a press release based on only 3 weeks of data, NOT a study with raw data other scientists can review. A LOT of antivaxxers are using the South African data to push for rolling back any sort of lockdown measures.
posted by kschang at 8:08 AM on December 23, 2021 [1 favorite]

I am just overcome with guilt at the idea that my health status is what will keep my stepdaughters from time with their father at Christmas.

Consider reframing the situation in a way that is true and, perhaps, comforting. By asking the stepdaughters to stay with their mom and explaining why, you and your partner are modelling responsible parenting and advanced adulting chops to the entire family.

Being responsible is a snap in low-stress, low-stakes situations. The challenge is being responsible in high-stress, high-stakes situations. Making the right decision for your health is also the right decision for your entire family. Even if some of them do not agree, it's true. Please don't blame yourself for a situation that is completely out of your control.
posted by Bella Donna at 12:11 PM on December 23, 2021 [4 favorites]