HOME QUARANTINE FOR COVID 19
When assessing infection control measures, expected benefits are balanced against feasibility, ethical considerations, public attitudes, costs and the Infection Control Act. The most stringent measures are aimed at those most at risk of infection. The measures described below are based on the following assessment:
- People without symptoms pose little or no risk of transmission but the disease may develop gradually with non-specific symptoms. Measures depend on the probability of being infected (close contact or low risk contact).
- People with symptoms pose a high risk of transmission
Quarantine means the temporary restriction of movement / social interaction for people who have been exposed to an infectious agent but who have not yet developed a clinical disease. This can apply to individuals, for example, in their own home (home quarantine) or to larger groups in an apartment block, cruise ship, village or city.
Isolation is most often used as a term when patients with infectious disease are isolated in their own room within a health institution. Similarly, home isolation means that patients with a clinical presentation of and / or confirmed infection are isolated at home.
Isolation and quarantine of individuals can occur in other settings than the home if necessary. For example, tourists can be quarantined/isolated in a hotel. The same principles for quarantine and isolation apply when these measures are introduced outside of the home.
Recommendations
Home quarantine is recommended for:
- Close contacts of confirmed cases, i.e., those who have been in close contact with a confirmed case, including those who live in the same household.
- Quarantine also applies for everyone who has been to areas with ongoing transmission of COVID-19. This means that people who have been in areas with ongoing transmission should stay at home for 14 days after return, regardless of whether or not they have symptoms.
This means:
- do not go to work or school
- avoid travelling and do not use public transport
- avoid places where you can come into contact with others
Home isolation is recommended for:
- Confirmed cases, i.e., those who are confirmed with COVID-19, but do not need to be admitted to hospital.
- Suspected cases, i.e. those who are sick and being tested for COVID- 19.
Definition of a possible case
Patients with acute respiratory infection with at least one of the following symptoms:
cough, shortness of breath or fever and who, during the last 14 days prior to onset of symptoms, met at least one of the following criteria:
- have been in an area with widespread transmission of COVID- 19: areas with ongoing transmission
- have been in close contact (see below) with a confirmed case of COVID-19 disease
- have nursed / treated a patient, handled sample material or had similar close contact with a person with confirmed COVID-19, regardless of whether or not protective equipment is used
- have travelled outside the Nordic region and are healthcare personnel with patient contact (including students)
- have travelled outside the Nordic countries and are admitted into a health institution
Definition of a probable case
A patient with an inconclusive test for COVID-19 or positive pan-corona test and suspected according to the Norwegian Institute of Public Health’s definition.
Definition of a confirmed case
A patient with laboratory-confirmed COVID-19 disease confirmed by a laboratory with a verified analysis method, regardless of the clinic.
Definition of close contacts (high risk exposure)
A distinction is made between “close contacts” who have been exposed to infection and “low risk contacts” who may have been exposed.
“Close contacts” are people, who during the last 14 days:
- have lived in the same household as a person with confirmed COVID-19 disease
- have been in direct physical contact (e.g. shaken hands) with someone with confirmed COVID-19 disease
- have been in direct contact with saliva (e.g. been coughed upon) from someone with confirmed COVID-19 disease
- have been in close contact with, or been near (closer than 2 metres), face to face with a person with confirmed COVID-19 disease for more than 15 minutes
- have been in an enclosed space (e.g. a classroom, meeting room, waiting room etc.) with a person with confirmed COVID-19 disease for more than 15 minutes and closer than 2 metres
- have nursed / treated a patient, handled sample material from, or otherwise had close physical contact with a person with confirmed COVID-19 disease, without having used the recommended protective equipment
- have sat near (within two seat rows in all directions) a person with confirmed COVID-19 disease on a plane, or near other close contacts on a plane
- have been in the same travel group as a person with confirmed COVID-19 disease.
Definition of low risk contacts (other contacts with low risk exposure)
“Low risk contacts” are people who, during the last 14 days:
- are known to have been in proximity of a person with confirmed COVID-19 disease, without having had close contact
- have been in areas with widespread transmissionn: Areas with ongoing transmission
- have travelled by the same means of transport as a person with confirmed COVID-19.
- have nursed a patient or had similar close physical contact with a confirmed COVID-19 cases, even though the recommended infection control routines are followed.
Both close contacts and low risk contacts change status to suspected cases if they develop symptoms of respiratory infection.
Duration of home quarantine or home isolation
- Close contacts must be in home quarantine for 14 days after the last contact with the patient diagnosed with the virus. This also applies irrespective of whether you have tested negative for coronavirus during the period.
- If suspected cases receive a negative test result, their status changes. For low-risk contacts, home isolation ceases but they must continue to monitor symptoms. Close contacts return to home quarantine.
- Confirmed cases must be isolated as long as they have symptoms of illness. An individual assessment is made of when isolation may cease based on clinical symptoms and test results.
Measures
Home quarantine
People in home quarantine may leave their home, but should avoid close contact with others.
This means:
- do not go to work or school
- avoid travelling and do not use public transport
- avoid places where you can come into contact with others
As long as no one in the household has symptoms of COVID-19, they are not considered to pose a risk of infection. It is therefore unnecessary for healthcare professionals to follow special advice for protection beyond standard precautions including hand hygiene.
People who are in home quarantine and healthcare professionals who are in contact with them should be vigilant for symptoms of respiratory infection among close contacts. In that case, the person will be defined as a suspected case. Follow the infection control measures for home isolation and contact a doctor for further assessment and testing for COVID-19.
Home isolation
Home isolation means that the patient stays at home. Healthcare professionals who visit patients isolated at home must follow recommended infection control measures, including the use of personal protective equipment. This also applies to healthcare personnel who are visiting other members of the same household.
Advice for people in home quarantine or home isolation due to Coronavirus
Home quarantine
Home quarantine is intended for people without symptoms of COVID-19 but who have been in close contact with a confirmed case or have been in areas with ongoing transmission.
If you are a close contact living with a person with COVID-19 you will find specific advice on this page:
- Advice for people in isolation at home
Be alert for symptoms such as cough, sore throat, breathing difficulties or fever. If these arise you will be defined as a suspected case, you must contact your doctor and should follow the advice given for isolation at home.
You may leave your home, but avoid close contact with others.
This means:
- do not go to work or school
- do not travel or take public transport
- avoid places where you can come into contact with others
Since close contacts have no symptoms, they are considered to pose a low risk of further infection. You and your household members do not need to follow special advice for protection beyond good hand hygiene and other basic infection control measures. Good hand hygiene with frequent hand washing with soap and water is recommended, especially after toilet visits, before cooking and before eating.
Advice for people living with a close contact
Household members can live as normal and go to work, school or childcare, but they should be alert for fever or respiratory symptoms. If these symptoms arise, contact your doctor or emergency out-of-hours clinic by phone for assessment, limit social contact and stay at home until your situation is clarified.
Home isolation
Home isolation means you must stay at home. You must not go out of your house, for example to visit shops or other public places. Your doctor will help to assess who can help you with any necessary purchases, in consultation with the District Medical Officer. Depending on the situation, this could be a neighbour or others, such as the community nursing service.
Be alert for symptoms
Contact the health service, preferably by phone, if your condition deteriorates (e.g. if you have difficulty breathing).
Visiting the doctor
If you need to see your doctor or another healthcare service, contact them and tell them that you have, or are being assessed for, COVID-19. This will help the healthcare service to take measures to prevent others from being infected. Do not use public transport or taxis. Inform the healthcare service if you do not have access to your own car.
Limit close contact with other people in your home
If possible, stay and sleep in a separate room to the others you live with. If you have several bathrooms and toilets, try to use a separate bathroom and toilet. If you only have one, make sure that you only use your own towel.
Coughing and sneezing
Cover your mouth and nose with a paper tissue while coughing / sneezing, or cough / sneeze into your elbow. Throw away used paper towels immediately, and then wash your hands.
Hand hygiene
Wash your hands frequently and thoroughly with soap and water. You can also use an alcohol-based hand disinfectant containing 70 per cent alcohol if soap and water are not readily available.
Laundry and cleaning
Place used textiles and bedding directly in the washing machine and wash at a minimum of 60 ⁰C. Clean surfaces such as bathroom sinks, toilets, door handles and kitchen counters frequently. Ordinary cleaning products are sufficient.
Advice for household members
If someone you live with is ill with COVID-19, you are considered to be a close contact and should be in home quarantine. Close contacts do not need to use protective equipment in the home but you should try to limit close contact with the isolated person.
Avoid unnecessary social contact for 14 days after the person was declared free of infection or, if more applicable, 14 days after you were last in contact with the infected person. Do not go to work or school and avoid public areas. Do not use public transport or taxis. Monitor your own health on a daily basis for signs of respiratory infection such as fever and cough up to 14 days after the last contact with the patient, or 14 days after the patient was declared infection-free. Contact your physician by telephone if you develop symptoms.
Where possible, there should be as few people in the house as necessary. Limit social contact and avoid visits.
You can help by observing the symptoms of the person who is ill or suspected of being infected with coronavirus. Contact the physician / emergency out-of-hours clinic by telephone if their condition worsens and inform them that the person has, or is being assessed for, COVID-19. This will help healthcare professionals to suggest the appropriate treatment and take measures to prevent others from being infected.
Good hand hygiene with frequent hand washing with soap and water is recommended, especially after toilet visits, before cooking and before meals.
Remember to wash or disinfect your hands:
- when you leave the room where the isolated person is staying
- before leaving the house
- after contact with the isolated person or any equipment they have used, such as bedding, cutlery etc.
If you have any further questions, contact your doctor by phone for further information.