Do I need to quarantine myself after traveling during the COVID-19 Pandemic?
SelftMany of us who are returning to beautiful Charlevoix from warm climates, pleasure cruises, adventure travel, or visiting family are probably wondering “have I been exposed to COVID-19?” It is human nature to reconnect and literally embrace friends, family, church and community groups, colleagues when returning from a trip. However, in the time of a world-wide pandemic, it is important to stop and ask: “Could I be infectious to others?” Why is this important? COVID-19 is 10-30 times more deadly than the seasonal flu depending on your age and immune status. Everyone above age 60 is in the highest risk group.
Quarantine vs. Isolation: Isolation separates sick people with a contagious disease from people who are not sick.” Quarantine “separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.” Certainly, if you feel that you were directly exposed to someone diagnosed with COVID-19 and now have symptoms (sore throat, fever, dry cough, shortness of breath), you should call your health care provider and, with their advice, get tested. You will likely be advised to self-isolate and be under medical surveillance and management. If you have the disease and are infectious, isolation is absolutely necessary to avoid infecting others.
Most returning travelers fall under the question of should I self-quarantine? The recent Annals of Internal Medicine reports a study showing the incubation period for COVID-19. Most people developed symptoms in 6 days of becoming infected, 98% in 12 days. So, two weeks is the recommended minimum time for self-quarantine from time of exposure to see if you develop symptoms.
Who should self-quarantine? This is a hard question to answer, because the answers keep changing. Definitions of risky crowd sizes keep changing, from 250, 100, 50, to no more than 10.
The original recommendations were to self-quarantine for travelers returning from major outbreak areas such as China, Southeast Asia, and Iran. Now the recommendations include the UK, and EU countries (as of March 15). But what about returning from Washington State or NYC, or a “large” convention? What about travelers who have been in “large” crowds?
The short answer is “Behave like you already have it!” It is worth taking precautions since the disease is rapidly spreading and wide testing is not yet available. Again, if you feel that you have been exposed directly by someone diagnosed with COVID-19, you should definitely self-quarantine. If you are not sure if you’ve been exposed and feel fine, you should still consider imposing self-quarantine, because you could have it and be contagious without symptoms. “Do unto others as I would have them do unto me.” See this CDC video to better understand how self-quarantining protects others: www.youtube.com/watch?v=dSQztKXR6k0
What does self-quarantine involve? Stay mostly at home. Work from home, if possible. Avoid in person group gatherings. Use remote conferencing for meetings. Maintain social distancing (six feet from others), no handshaking, hugging, kissing, etc. We recommend heel tapping, not elbow bumping. Good hygiene with hand washing with soap (see Alex Welch in NYT on “Why Soap Works” 3/13/20) or use backup hand sanitizer, and cleaning contact surfaces regularly with detergents or sanitizers. Sneezing and coughing into your elbow or disposable tissue. Wash clothes frequently. Minimize worry, anxiety, and depression by eating well, sleeping well, and exercise regularly. Read a good book, listen to, play, or sing your favorite music, call a family member or friend, and indulge in meditation or contemplative prayer. Take your dog for a walk. Of course, pet your dog or pet!
Welcome back! Wishing all good health and well-being. Peace be with you, Bill Wadland, MD, MS (public health), and Betty Wadland, RN (Certified Nurse Anesthetist).