A. Persons who test positive for COVID-19 are recommended to stay home until they are no longer infectious
If you test positive for COVID-19 and have symptoms, isolate for at least 5 days. Day 0 is your first day of symptoms.
- You can end isolation after 5 full days if you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved (Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation).
- You should continue to wear a well-fitting mask around others at home and in public for 5 additional days (day 6 through day 10) after the end of your 5-day isolation period. If you are unable to wear a mask when around others, you should continue to isolate for a full 10 days. Avoid people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days.
- If you continue to have fever or your other symptoms have not improved after 5 days of isolation, you should wait to end your isolation until you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved. Continue to wear a well-fitting mask.
- Do not travel during your 5-day isolation period. After you end isolation, avoid travel until a full 10 days after your first day of symptoms. If you must travel on days 6-10, wear a well-fitting mask when you are around others for the entire duration of travel. If you are unable to wear a mask, you should not travel during the 10 days.
- Do not go to places where you are unable to wear a mask, such as restaurants and some gyms, and avoid eating around others at home and at work until a full 10 days after your first day of symptoms.
After you have ended your isolation, you can consider antigen testing. With two sequential negative tests 48 hours apart, you may remove your mask sooner than day 10. If your antigen test results are positive, you may still be infectious. You should continue wearing a mask and wait at least 48 hours before taking another test. Continue taking antigen tests at least 48 hours apart until you have two sequential negative results. This may mean you need to continue wearing a mask and testing beyond day 10.
People who are severely ill with COVID-19 (including those who were hospitalized or required intensive care or ventilation support) and people with compromised immune systems might need to isolate at home longer. They may also require testing with a viral test to determine when they can be around others. CDC recommends an isolation period of at least 10 and up to 20 days for people who were severely ill with COVID-19 and for people with weakened immune systems. Consult with your healthcare provider about when you can resume being around other people.
Reminder: All persons who are experiencing an illness should stay home while they are ill, even if they test negative for COVID-19 or receive an alternative diagnosis.
If you test positive for COVID-19 and never develop symptoms, isolate for at least 5 days. Day 0 is the day of your positive viral test (based on the date your specimen was collected).
- If you continue to have no symptoms, you can end isolation after at least 5 days.
- You should continue to wear a well-fitting mask around others at home and in public until day 10 (day 6 through day 10). If you are unable to wear a mask when around others, you should continue to isolate for 10 days. Avoid people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days.
- If you develop symptoms after testing positive, your 5-day isolation period should start over. Day 0 is your first day of symptoms. Follow the recommendations above for ending isolation for people who test positive for COVID-19 and have symptoms.
- Do not travel during your 5-day isolation period. After you end isolation, avoid travel until 10 days after the day of your positive test. If you must travel on days 6-10, wear a well-fitting mask when you are around others for the entire duration of travel. If you are unable to wear a mask, you should not travel during the 10 days after your positive test.
- Do not go to places where you are unable to wear a mask, such as restaurants and some gyms, and avoid eating around others at home and at work until 10 days after the day of your positive test.
After you have ended your isolation, you can consider antigen testing. With two sequential negative tests 48 hours apart, you may remove your mask sooner than day 10. If your antigen test results are positive, you may still be infectious. You should continue wearing a mask and wait at least 48 hours before taking another test. Continue taking antigen tests at least 48 hours apart until you have two sequential negative results. This may mean you need to continue wearing a mask and testing beyond day 10.
Note: Isolation and testing recommendations differ for exposed health care providers. To view health care provider guidelines, visit
www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html.
B. Individuals should be evaluated for exposure in households, congregate settings, and outbreaks/clusters
When follow-up is performed, close contact is defined as being less than 6 feet away from an infectious person for more than 15 consecutive minutes AND the case, the contact, or both were not wearing a face covering during the interaction. Acceptable face coverings are described in CDC guidance at www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/types-of-masks.html.
C. Those who have been exposed to COVID-19 may need to stay home and should mask and get tested.
Individuals who are exposed to COVID-19 no longer need to quarantine, regardless of vaccination status.
You should wear a well-fitting mask around others for 10 days from the date of your last close contact with someone with COVID-19 (the date of last close contact is considered day 0). Get tested at least 5 days after you last had close contact with someone with COVID-19, even if you do not develop symptoms. If you test positive or develop COVID-19 symptoms, isolate from other people and follow recommendations for isolation.
Note: Quarantine and testing recommendations differ for exposed health care providers. To view health care provider guidelines, visit
www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html.
D. Vaccination
COVID-19 vaccines are safe and effective.
For the best protection, everyone 6 months and older is recommended to stay up to date with their COVID-19 vaccines, which includes getting boosters if eligible.
More information about vaccination is available at www.cdc.gov/coronavirus/2019-ncov/vaccines/keythingstoknow.html.
E. Managing Special Situations
School
Students and teachers who test positive for COVID-19 should remain home until they are no longer infectious. If a case of COVID-19 is identified in a school, exposed students and teachers should follow recommendations to wear a well-fitting mask and get tested. If a student or teacher becomes symptomatic, they should stay home while ill and consider getting tested.
The general recommendations for outlined above in this document do apply to K-12 School settings. Additional CDC guidance is available at www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-childcare-guidance.html.
If a cluster or outbreak of COVID-19 is identified in a school, additional investigation may be warranted to determine if targeted public health recommendations and/or laboratory follow-up is required. Consult with an epidemiologist at IDPH or contact your regional epidemiologist if an outbreak is suspected.
Child care
Child care attendees and staff who test positive for COVID-19 should remain home until they are no longer infectious. If a case of COVID-19 is identified in a child care facility, exposed attendees and staff should follow recommendations to wear a well-fitting mask and get tested. If an attendee or staff member becomes symptomatic, they should stay home while ill and consider getting tested.
The general recommendations for outlined above in this document do apply to child care settings. Note that for children who test positive who are unable to consistently wear a mask when around others (including all children under 2 years of age) the safest option is to isolate for a full 10 days or utilize the test based strategy described above. Additional CDC guidance is available at www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/child-care-guidance.html.
If a cluster or outbreak of COVID-19 is identified in a child care facility, additional investigation may be warranted to determine if targeted public health recommendations and/or laboratory follow-up is required. Consult with an epidemiologist at IDPH or contact your regional epidemiologist if an outbreak is suspected.
Congregate Living Settings
Due to the higher health risks of persons residing in long-term care settings, symptomatic residents and staff testing positive on antigen testing for COVID-19 should start the appropriate isolation period. Asymptomatic residents or staff testing positive should be re-tested using confirmatory PCR testing within 48 hours of the when the positive antigen specimen was collected.
More detailed guidance related to interpreting antigen testing results and the subsequent mitigation steps to enact can be found at https://idph.iowa.gov/Emerging-Health-Issues/Novel-Coronavirus/Long-Term-Care.
Correctional and Detention Facilities
In certain high-risk congregate settings that have high risk of secondary transmission and where it is not feasible to cohort people (such as correctional and detention facilities, homeless shelters, and cruise ships), CDC recommends a 10-day isolation period for residents. During periods of critical staffing shortages, facilities may consider shortening the isolation period for staff to ensure continuity of operations. Decisions to shorten isolation in these settings should be made in consultation with public health and should take into consideration the context and characteristics of the facility. CDC’s setting-specific guidance provides additional recommendations for these settings.
CDC guidance for correctional and detention facilities can be found at https://www.cdc.gov/coronavirus/2019-ncov/community/correction-detention/guidance-correctional-detention.html.
Homeless Shelters
In certain high-risk congregate settings that have high risk of secondary transmission and where it is not feasible to cohort people (such as correctional and detention facilities, homeless shelters, and cruise ships), CDC recommends a 10-day isolation period for residents. During periods of critical staffing shortages, facilities may consider shortening the isolation period for staff to ensure continuity of operations. Decisions to shorten isolation in these settings should be made in consultation with public health and should take into consideration the context and characteristics of the facility. CDC’s setting-specific guidance provides additional recommendations for these settings.
Specific guidance for homeless shelters can be found at https://www.cdc.gov/coronavirus/2019-ncov/community/homeless-shelters/plan-prepare-respond.html.
Patient Care Settings
Due to the nature of patient care/healthcare settings, the frequency and types of interactions they have with patients, and the procedures performed, COVID-19 risk can vary. The CDC has made numerous resources available for healthcare workers, many of which are setting specific, that can be found at https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html.
You can also consult with the IDPH Healthcare Associated Infections (HAI) Program by calling CADE at (800) 362-2736 and asking to speak with the HAI Program or emailing hai-ar@idph.iowa.gov.
Reported Incidence Is Higher than Usual/Cluster/Outbreak Suspected
Consult with the epidemiologist on-call at CADE, (800) 362-2736. CADE can help determine a course of action to prevent further cases and can perform surveillance for cases that may cross several county lines and therefore may be difficult to identify at a local level.
If the number of reported cases in any city or county is higher than usual, or if an outbreak is suspected, investigate clustered cases to identify other potential illnesses and exposures. Recommendations can then be made for people to stay home after an exposure or while sick and testing recommendations can be shared.
F. Travel
If you are planning to travel:
- Check your destination’s COVID-19 situation before traveling. State, local, and territorial governments may have travel restrictions in place.
- Wearing a mask over your nose and mouth is recommended in indoor areas of public transportation (including airplanes) and indoors in U.S. transportation hubs (including airports).
- Do not travel if you are sick, or if you tested positive for COVID-19 and are recommended to isolate.
- Consider getting tested before and after you travel.
CDC travel guidelines change frequently. Before you travel, check the latest guidelines by visiting
www.cdc.gov/coronavirus/2019-ncov/travelers/index.html.