LAC DPH Health Update: Revised COVID-19 Exposure Period April 2, 2020 Coronavirus, COVID-19, LA County, LA Public Health 940 The Los Angeles County Department of Public Health (LAC DPH) has revised the time period that a patient with COVID-19 is considered infectious to begin 48 hours before symptom onset instead of from the first day of symptom onset. This is based on new recommendations from the Centers for Disease Control and Prevention (CDC). The recent Health Officer orders have been revised to require that individuals with presumed or confirmed COVID-19 notify all persons with whom they had close contact beginning 48 hours before their symptom onset. Laboratory confirmed COVID-19 cases can now be reported by sending the Medical Provider COVID-19 Report Form to a dedicated COVID-19 fax line (310-605-4274) as well as by secure email (see Reporting for more information). Situation While people with COVID-19 are most infectious when symptomatic, there is growing evidence of pre-symptomatic transmission. For this reason, the CDC revised the period of exposure risk to contacts from the “onset of symptoms” to “48 hours before symptom onset”. See CDC Public Health Recommendations for People in U.S. Communities Exposed to a Person with Known or Suspected COVID-19, other than Health Workers or other Critical Infrastructure Workers. Health Officer orders for isolation have been issued to state that individuals with presumed or confirmed COVID-19 must notify all of their close contacts that they need to be in quarantine for 14 days after their last contact with them using this revised definition of a close contact: A person is considered to be a close contact of a person with presumed or confirmed COVID-19 if, within 48 hours before that person’s symptoms began and until that person is no longer required to be isolated, they (a) were within 6 feet of a person with presumed or confirmed COVID-19 for more than 10 minutes or (b) had unprotected contact with the body fluids and/or secretions (such as being coughed on/sneezed on, shared utensils, or saliva or provided care without wearing protective equipment) of a person with presumed or confirmed COVID-19. LAC DPH has updated the patient home isolation instructions to include the new timeframe for providing all of their close contacts with home quarantine instructions. Visit the health professionals COVID-19 website for the latest versions of resources including instructions for patients on isolation, quarantine, and possible exposure, and information about provider reporting. Health care providers are encouraged to read the March 28 LAHAN, Ambulatory Patients with COVID-19; Healthcare Personnel Monitoring for more information on counseling and educating patients with COVID-19. This communication was sent by Sharon Balter, MD, Director, Division of Communicable Disease Control and Prevention, Los Angeles County Department of Public Health.