Key Messages The CDC and LAC DPH have revised the definition of a close contact to include being within 6 feet of the case for a total of 15 minutes or more over a 24-hour period . See Revised Isolation and Quarantine Orders below for the full definition. The LA County Health Officer Home Isolation and Quarantine orders have been revised. Isolation is mandatory for people with either laboratory-confirmed COVID-19 or a presumptive clinical diagnosis made by a healthcare provider. Quarantine is required for close contacts of laboratory-confirmed cases. See Revised Isolation and Quarantine Orders below. Re-testing of asymptomatic persons who have recovered from laboratory-confirmed COVID-19 is not recommended within the first 90 days after the onset of the initial infection/first viral positive test. See Patients who have Recently Recovered from COVID-19 . Providers are asked to remain vigilant for potential cases of multisystem inflammatory syndrome in children (MIS-C) as some students have returned to in-person school. Any patients meeting the case definition for MIS-C should be reported by phone within 1 working day. See LAC DPH MIS-C webpage . Updates LAC DPH COVID-19 Provider Testing Hub: These testing pages have been updated to include new information such as a diagnostic viral test summary table, testing FAQs, LAC DPH Testing Guidelines, and local laboratory information. Visit COVID-19 Provider Testing Hub . LAC DPH COVID-19 Clinical Diagnosis webpage: This new page includes information on COVID-19 risk assessment and presumptive clinical diagnosis, as well as the incubation period, infectious period, transmission, clinical presentation, and laboratory testing. Visit COVID-19 Clinical Diagnosis webpage . Revised Isolation and Quarantine Orders Isolation Criteria for mandatory isolation for COVID-19 are laboratory-confirmed COVID-19 or presumptive clinical diagnosis by a healthcare provider. Symptoms alone--fever, cough, or shortness of breath--are no longer criteria for isolation. New instructions on the duration of isolation for those who are initially clinically suspected to have COVID-19 and are re-assessed as not infected are also included. Healthcare providers are asked to make a presumptive clinical diagnosis of COVID-19 in patients with compatible symptoms and no clear alternate diagnosis, especially if they have high risk exposures (see COVID-19 Risk Assessment and Presumptive Clinical Diagnosis ). Please give the presumptive case isolation orders and instructions without waiting for laboratory confirmation (see Isolation action steps for providers). Duration of isolation for patients clinically suspected to have COVID-19 If the healthcare provider reassesses the initial presumptive diagnosis and concludes that the patient is not infected with SARS-CoV-2 (for example, a clear alternate diagnosis was found and the COVID-19 PCR test result is negative) the patient can be released from isolation after they have been fever-free for 24 hours. If for some reason diagnostic viral testing was not performed or the patient has a negative viral test result, but the suspicion for COVID-19 remains high, the provider should instruct the patient to continue isolation as a presumptive case. Isolation can be discontinued after at least 10 days have passed since symptoms first began, and after at least 24 hours have passed without anti-pyretics, and their symptoms have improved. Quarantine Revised orders require that only close contacts of laboratory-confirmed COVID-19 must quarantine. Close contacts of presumed COVID-19 cases no longer need to quarantine. Revised Definition of a Close Contact The definition of a close contact has been revised from being within 6 feet of the case for at least 15 minutes to being within 6 feet of the case for a cumulative total of 15 minutes or more over a 24-hour period . This is due to evidence of COVID-19 transmission after multiple brief close-range exposures (e.g. 15 one-minute exposures in a day). A close contact is defined as any of the following people who were exposed to a person with a positive diagnostic (viral) test (“the case”) while they were infectious*: a) An individual who was within 6 feet of the case for a total of 15 minutes or more over a 24-hour period , or b) An individual who had unprotected contact with the case’s body fluids and/or secretions, for example, being coughed or sneezed on, sharing utensils or saliva, or providing care without using appropriate protective equipment. A person with COVID-19 is considered to be infectious from 2 days before their symptoms first appeared until the time they are no longer required to be isolated. A person with a positive COVID-19 diagnostic (viral) test is considered to be infectious 2 days before the first positive test was taken until 10 days after that test was taken. View the LA County Health Officer Orders for Isolation and Quarantin e . Visit the LAC DPH COVID-19 Provider Hub for current resources and guidance. To view a printable PDF of this communication and other LAHAN communications, please visit publichealth.lacounty.gov/lahan . If this message was forwarded to you, please join LAHAN here .