Thread by @CarolynCannu

In the coming days, you may learn of holiday exposures to friends/loved ones w COVID. What should you do? Quarantine for 14 days is best.

1. Quarantine works to break chains of transmission. By taking yourself out of circulation, you'll be less likely to "pass it on."

2. Quarantine only works if ppl can adhere. There are so many roadblocks!

Some are behavioral/psychological, like optimism bias. i.e., "I feel fine! I'm sure I'll be fine! I'll just keep working"

Some are structural. i.e., "I have rent to pay. I have no choice but to work."

[We all have to advocate for worker protections/policies that ALLOW ppl to stay home when exposed. Fragile policies allow for viral transmission.]

3. For the duration of the pandemic, public health professionals have recommended 14 days of quarantine. Why? After an exposure...

Ppl tend to develop symptoms and/or test positive within 2-14 days. By staying away from ppl--even in your own house!--for 14 days, you eliminate opportunities for the virus to infect another person. Even if you become positive, the viral transmission hits a wall + ends with YOU!

4. NOW, the CDC is saying ppl can cut the quarantine short. "1) quarantine can end on day 10 without a test or 2) quarantine can end on day 7 after receiving a negative test result." This change was made as a strategy to increase adherence, BC TWO WEEKS is a long, hard time!

5. So what to do? After exposure to COVID, should I quarantine for 14 days from the last contact w that person? For 10 days? For 7 days? CDC acknowledges THE SAFEST ANSWER IS STILL to quarantine for 14 days.

This new study explains why: cdc.gov/mmwr/volumes/6…

6. In this study of 185 *household (i.e., really close, sustained) contacts of ppl w COVID, 109 (59%) went on to develop symptoms or test positive within 14 days of the first patient's symptom onset.

Pause. Risk of transmission within households is HIGH.

7. Importantly, the majority (76%) of those 109 ppl who went on to develop COVID became symptomatic or tested positive WITHIN 7 days. In other words, most of the ppl who eventually got sick did so within a week of first being exposed.

86% of the 109 became positive within 10 days. (That means some people became ill/positive on days 11-14...)

8. Of the people who remained "clear" (not symptomatic + tested negative) through day 7--

1 of 5 became positive btwn days 8-14.

9. If quarantine had lasted only 7 days, the "healthy on day 7" ppl would have gone out into the world, + some would have transmitted the virus...

Among people "healthy on day 10"--a smaller fraction (7%) went on to develop illness/test + by day 14.

10. The bottom line is that 14 days is still the safest bet for reducing onward transmission of SARS-CoV-2.

14 days is better than 10.

10 days is better than 7.

7 is better than 0.

If you've been exposed to COVID, ideally count 14 days from that exposure. Stay alone, at home

If you can.

Monitor for symptoms.

Get tested between 5-7 days after the exposure.

Importantly--even if you don't think you are sick--stay *away* from others in your house. Sleep, eat, work, watch Netflix separately. Masks on in shared spaces, windows open whenever possible.

Seek guidance if someone in your home tests +. Quarantine is more complex in that situation, because your quarantine begins when their infectious period *ends! (This means that your 14 day quarantine *begins 10 days after your family member/roommate develops symptoms/tests+.

For those who have been through this--it is grueling and feels forever long. It's a huge sacrifice on behalf of public health. It's necessary to break chains of transmission.

One hope for the new year: policies that support people in quarantine. Paid time off. Job protection.

If you have a loved one in quarantine, call to check in. Keep them in your thoughts, texts. Send/deliver food, supplies, medicines. Reassure them and remember them.