While vaccination significantly reduces the risk of severe illness, hospitalization, and death, it does not completely prevent infection or the ability to transmit the virus to others. Public health guidelines require isolation for anyone testing positive for COVID-19, regardless of their vaccination status, to curb community spread. The duration and criteria for ending this isolation period are based on the progression of symptoms and align with guidance for other common respiratory viruses.
Determining the Isolation Period Length
The isolation period for individuals with COVID-19 is no longer a fixed number of days but is instead determined by the improvement of symptoms. Current guidance recommends staying home and away from others if you have COVID-19 symptoms not explained by another cause. This means the required duration of isolation is individualized and based on when the person begins to feel better.
The isolation period should last until at least one full day has passed since the person has been fever-free without using fever-reducing medication. This symptom-driven timeline replaces the previous fixed-day isolation rule. The goal of isolation is to cover the time when a person is most infectious, typically the first few days of illness.
If you test positive but never develop symptoms, isolation can end once you meet the fever-free and symptom-improvement criteria. If symptoms return or worsen after ending isolation, you should restart the process at day zero, staying home until you meet the criteria again.
Criteria for Ending Isolation
To safely end isolation, two main conditions must be met: the resolution of fever and the overall improvement of other symptoms. A person must be fever-free for at least 24 hours without using fever-reducing medications, such as acetaminophen or ibuprofen. This 24-hour window indicates a sustained reduction in the body’s inflammatory response.
In addition to being fever-free, the person’s other symptoms must be improving before leaving isolation. This improvement refers to symptoms like cough, congestion, or fatigue becoming noticeably milder. The loss of taste or smell may persist for weeks or months after recovery, but this single symptom does not delay the end of isolation.
If symptoms are not improving, or if the fever persists, isolation must continue until both criteria are fulfilled. For individuals who were severely ill or are immunocompromised, a healthcare provider may recommend a longer isolation period or a test-based strategy to minimize transmission risk.
Post-Isolation Precautions
After meeting the criteria to end isolation, a period of heightened safety precautions is recommended for the following five days. This period acknowledges that a person may still be able to transmit the virus even after feeling better and being fever-free. The most important precaution during this time is consistently wearing a high-quality, well-fitting mask when around other people.
The mask should be worn in all public settings and at home when in shared spaces with others. Additional protective measures are strongly suggested, including maintaining distance, increasing ventilation, and practicing frequent hand hygiene. These actions help protect those around you, particularly individuals at higher risk for severe illness, such as the elderly or those with compromised immune systems.
Individuals should also avoid travel and gatherings where masking may be difficult or impossible during these five post-isolation days. If symptoms or fever return or worsen during this precautionary period, the isolation protocol should be restarted immediately.