Key Messages The LA County Health Officer Isolation and Quarantine Orders for the general public were recently updated. They align with the California Department of Public Health (CDPH) Isolation and Quarantine of the General Public . The isolation requirements of COVID-19 cases, the definition of a close contact, and the quarantine requirements of close contacts are different from those recommended by the Centers for Disease Control and Prevention. Significant differences are the following: A person infected with COVID-19 (case) must have a negative COVID-19 test collected on or after Day 5 to end isolation on Day 6-Day 10 . If the case does not test or if their test remains positive, they are required to continue to isolate at least through Day 10. See Isolation for Persons with COVID-19 below. Close contacts in the general public do not need to quarantine as long as they remain asymptomatic, get tested between Day 3-Day 5, and wear a mask through Day 10 of their last exposure with the infectious case. See Close Contacts-General Public below. Restrictions or exclusions from work or other settings may still apply or be required by their employer . A close contact in the general public is any person who shared the same indoor airspace with someone with COVID-19 for a total of 15 minutes or more over a 24-hour period while the case was infectious. Healthcare providers should refer to the LAC DPH Provider Isolation and Quarantine Guidelines which provide more detailed information on the management of cases and contacts and include quick links to patient resources such as isolation instructions and instructions for close contacts . Isolation for Persons with COVID-19 All persons with COVID-19, regardless of vaccination status, previous COVID-19 infection, or lack of symptoms must isolate at least through Day 5. Discontinuation of isolation depends on symptom status and/or follow-up viral test results. Patient isolation instructions are available at ph.lacounty.gov/covidisolation . Day 0 is the first day of symptoms. For cases that remain asymptomatic, Day 0 is the day the first positive test was collected. Symptomatic COVID-19 Infection A. Isolation can end after Day 5 (on Day 6 – Day 10) ONLY if all of the following criteria are met: They have a negative viral COVID-19 test collected on Day 5 or later (antigen test preferred) and They have not had a fever for at least 24 hours without the use of fever-reducing medication and Their symptoms are improving. --OR-- B. Isolation can end after Day 10 (on Day 11 or later) if fever-free for 24 hours without the use of fever-reducing medications. If fever is present, isolation should continue until 24 hours after fever resolves. Patients with a presumptive clinical COVID-19 diagnosis who are ruled out —if the healthcare provider reassesses the initial diagnosis and concludes that the patient is not infected with SARS-CoV-2 (and they never tested positive), the patient can leave isolation after they have been fever-free for 24 hours. If they are close contacts they must continue to follow instructions for close contacts . Asymptomatic COVID-19 Infection Persons with COVID-19 who never developed symptoms may be released from isolation: A. After Day 5 (on Day 6 – Day 10) if they have a negative COVID-19 viral test result from a specimen collected on Day 5 or later (antigen test preferred). --OR-- B. After Day 10 (on Day 11 or later) from the date of collection of the initial positive viral test. Note: Most outpatients with follow-up positive viral tests may end isolation after Day 10. This is because patients who have recovered from COVID-19 can continue to have positive COVID-19 tests in upper respiratory specimens for up to 3 months after initial illness. CDC recommends extending isolation for patients who were severely ill or are immunocompromised. See Patients Who are Immunocompromised or Had Severe/Critical COVID-19 . Isolation after COVID-19 Rebound Patients experiencing a return of COVID-19 symptoms and/or re-testing positive within a week of recovery may be infectious and should re-isolate. Isolation may end 5 days after their rebound began if they have been fever-free for 24 hours without the use of fever-reducing medication and their symptoms are improving. Re-testing is NOT required to end re-isolation with COVID-19 rebound. They must wear a highly protective mask for at least 10 days after the start of their rebound. See Patient FAQs- COVID-19 Rebound . Close Contacts-General Public Close contact definition: anyone sharing the same indoor airspace (e.g., home, clinic waiting room, airplane, etc.) with someone with COVID-19 for a cumulative total of 15 minutes or more over a 24-hour period (for example, three individual 5-minute exposures for a total of 15 minutes) while the case was infectious*. *A COVID-19 case is considered infectious 2 days before symptoms began (or 2 days before initial positive test collection if asymptomatic) until their isolation ends. Asymptomatic close contacts in the general public do not need to quarantine, but are required to: Wear a highly protective mask around others indoors and when close to others outdoors, through Day 10. This includes wearing it at home. Monitor their health through Day 10. If symptoms develop, they must stay home and test for COVID-19. Test 3-5 days* after their last exposure (unless they recovered from COVID-19 in the past 90 days). If they test positive at any time, they must follow isolation requirements at ph.lacounty.gov/covidisolation . *If the close contact or someone with whom they live is at increased risk for severe illness, testing is recommended as soon as possible and, if negative, again on Day 5. Identifying infection early after exposure enables earlier action to prevent spread to others with whom they live and earlier access to outpatient treatment options should symptoms be detected. Instructions for close contacts are available at ph.lacounty.gov/covidcontacts . Visit the LAC DPH Healthcare Provider COVID-19 Information Hub and COVID-19 Vaccine Hub for the most current guidance. Refresh your browser to view the latest versions. publichealth.lacounty.gov/acd/ncorona2019/ This communication was sent by Sharon Balter, MD, Director, Division of Communicable Disease Control and Prevention, Los Angeles County Department of Public Health 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 .