Sharing a bed with someone who has tested positive for COVID-19 is a high-risk scenario for viral transmission within a household. COVID-19 spreads primarily through respiratory droplets and aerosols released when an infected person breathes, talks, coughs, or sneezes. Sleeping in the same immediate area significantly increases the duration and intensity of exposure to these airborne particles. Public health guidance prioritizes physical separation to interrupt this cycle of spread and protect uninfected household members.
Official Guidance on Household Isolation and Sleeping Arrangements
Public health organizations strongly advise against sharing a bed or even a room with an individual actively infected with COVID-19. Transmission is most efficient during continuous, close-range exposure. An infected person is considered most infectious during the first five days after symptom onset or the date of the positive test, making this period the most hazardous for close contact.
The ideal scenario involves the infected person using a separate bedroom and, if possible, a dedicated bathroom. This physical separation is the most effective intervention to prevent the virus from spreading to household contacts. Maintaining a separate airspace is the primary goal of isolation protocols, as continuous, uninterrupted exposure occurs over many hours of sleep.
Close proximity during sleep creates an environment where the viral load exhaled by the infected person is easily inhaled. Unlike brief daytime interactions, there is no opportunity to increase physical distance or interrupt the exposure. The infected individual should stay in their designated isolation area for at least five days, or longer if symptoms are not improving or if a fever is present.
Reducing Transmission in Shared Sleeping Environments
Complete separation is often impossible due to housing constraints or the need to provide direct care, requiring mitigation steps within a shared space. If a separate room is unavailable, maximizing the physical distance between beds is necessary. Some guidance suggests sleeping head-to-foot to increase the space between faces.
Ventilation is an effective strategy for reducing the concentration of infectious aerosols in shared air. This can be achieved by opening windows to bring in fresh outdoor air or by using a high-efficiency particulate air (HEPA) filter in the bedroom. These actions help to dilute and remove airborne viral particles constantly being exhaled.
The use of high-quality, well-fitting masks by both individuals is a further mitigation measure when sharing a room. An N95 or KN95 respirator offers better protection against inhaling infectious aerosols than a cloth or surgical mask. Both individuals should wear these masks whenever physical separation cannot be maintained.
Hygiene Protocols
Strict hygiene protocols must also be followed. Do not share personal items like cups, towels, or utensils. Hands should be frequently washed with soap and water for at least 20 seconds. High-touch surfaces in the shared room, such as doorknobs and light switches, should be cleaned and disinfected daily.
Monitoring and Testing Following Close Exposure
The uninfected person is considered a close contact and must follow monitoring and testing protocols, regardless of mitigation measures used. A close contact is someone who has been in the same household as a person with confirmed COVID-19. They should immediately begin monitoring for symptoms such as fever, cough, or fatigue.
The recommended timeframe for testing is at least five full days after the last close contact with the infected individual. The date of the last exposure is considered Day 0, making Day 5 the earliest reliable day for a test. Testing too early may result in a false negative because the viral load may not be high enough to be detected.
If the exposed person develops symptoms before Day 5, they should test immediately and isolate until the result is known. If the test is negative, they should continue to monitor symptoms and wear a well-fitting mask around others until at least Day 10 following the last exposure. A positive test result requires the exposed person to enter their own isolation period for at least five days.