On Monday, D.C. Mayor Muriel E. Bowser (D) urged hundreds who attended Christ Church Georgetown in recent days to self-quarantine because of their exposure to the church rector, the Rev. Timothy Cole, who is the first known coronavirus patient in the District.
Some federal lawmakers are also self-quarantining after an attendee at the Conservative Political Action Conference in February was diagnosed with the virus. Sen. Ted Cruz (R-Tex.) and Rep. Douglas A. Collins (R-Ga.) each said Sunday that he had briefly interacted with the infected person and would stay at home “out of an abundance of caution.” Rep. Paul A. Gosar (R-Ariz.) said he and three of his staff members were self-quarantining “after sustained contact” with the infected attendee.
The House of Representatives’ Office of Attending Physician said in a statement that each person who came into contact with the ill individual received personalized recommendations from health officials and that everyone was in good health 11 days after the conference.
As a result, people have begun prepping in case of a scenario where doctors tell them to stay put. Costco, Walmart and Target shoppers have cleared shelves of toilet paper, bagged rice and hand sanitizer.
But as coronavirus concerns spur restricted travel and quarantine, questions are popping up about what it even means to be quarantined. Is everyone in quarantine infected? How does it work if you have roommates? Are you going to need the supplies you’re tossing into your shopping cart?
What is a quarantine?
When someone is quarantined, that doesn’t mean they are infected with the coronavirus.
Quarantines are meant to restrict the movement of people who may have been exposed to the contagious disease but haven’t tested positive.
The Centers for Disease Control and Prevention recommends 14 days to see whether flu-like symptoms develop. The 14-day incubation period is based on what researchers know about the incubation period of MERS, which is in the same family as the novel coronavirus.
Quarantine also doesn’t mean you can’t still live with your roommates or family. While the CDC recommends you stay in your own bedroom, use a separate bathroom if possible, wear a face mask around others, and don’t share dishes, towels or bedding, you don’t need to move out.
To prevent the virus from spreading, keep your distance from other people, prohibit unnecessary visitors, and wash your hands frequently. Do a daily wipe-down of “high-touch” surfaces, such as doorknobs, tabletops, toilets and phones.
If you need to share something with others while in quarantine, wash it thoroughly with soap and water.
It’s also wise to restrict contact with pets until researchers know more about whether animals can contract the virus. If avoiding your pets isn’t an option, wear a face mask and wash your hands before and after interacting with the pet.
The biggest lifestyle change in quarantine is the lack of mobility. The CDC recommends restricting activities outside your home, except when you need to go to the doctor.
“Do not go to work, school or public areas,” the CDC advises. “Avoid using public transportation, ride-sharing or taxis.”
Robyn Gershon, an epidemiology professor at New York University, updates a fact sheet daily that she sends to her students and colleagues with tips such as, “Don’t ride the subway if you’re symptomatic.” She said she understands that it can be confusing for people, especially when the terms quarantine and isolation are used interchangeably.
However, she’s optimistic that if testing for coronavirus improves, there will be less of a need to stay secluded for the full two-week period.
The concept of quarantine isn’t new. Even as the bubonic plague rolled through Europe in the 17th century, at least one village instituted a quarantine, which ultimately saved neighboring villages.
The CDC has considered quarantines before in recent history. When the H1N1 pandemic broke out in 2009, the agency chose not to quarantine. But in this case, public health officials had advance notice before the virus hit U.S. soil, Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, told the Los Angeles Times.
“What was different about this one is that the outbreak was caught so early before it really got to the United States,” she said. “But this is a situation where hopefully because of improved global capacity and surveillance and lab capacity, it was caught early before it spread around the world, and we had this window of time in which we could intervene to slow it down. I think that is different from other situations that we faced.”
What is the difference between quarantine, isolation and social distancing?
Now that you better understand quarantine, it’s useful to know how it differs from isolation and social distancing, two terms being bandied about by experts in the past few months.
Isolation is separating those with confirmed infections from the population so they can get better without passing on the virus.
Social distancing comprises tactics people use to separate themselves from others and reduce their risk of infection. That can mean anything from avoiding crowded events to greeting friends with a nod instead of a smooch or embrace.
Cuomo advised New Yorkers on Thursday to heed the advice of public health experts: Don’t shake hands or hug. But he acknowledged that changing your behavior can be a challenge.
“I’m of Italian American descent, I’m a hugger,” Cuomo said. “But precautions during the flu season, don’t shake hands and don’t hug. During this season with coronavirus, if you want to take precautions, don’t shake hands, don’t hug.”
When should you self-quarantine?
The U.S. government is requiring evacuees from China’s Hubei province, a coronavirus hot spot, to undergo a 14-day quarantine. In addition, passengers exposed to the virus aboard the ill-fated Diamond Princess cruise ship were quarantined.
Companies have also asked their employees to self-quarantine if they visit affected areas such as northern Italy.
Generally, experts recommend staying home if you have been in an area where the coronavirus has spread and you are experiencing symptoms.
If you aren’t sure whether you should self-quarantine, ask a doctor.
How do you prepare for a quarantine?
To be quarantined, you probably don’t need to go somewhere special. Most homes will do — although Seattle-area officials bought a $4 million motel for patients they think may be special cases. But if you are in your home, make sure it is equipped with what you need for 14 days.
First, and likely most important to some of us, let’s talk food. Groceries that don’t go bad — canned soup, rice and pasta — are all easily available and what most people are stocking their pantries with.
“The difference between what we are talking about and other types of disasters like a hurricane or snowstorm is that there’s no indication we’d lose power,” Cotter said, adding he recommends frozen foods, as well as fruits and vegetables that don’t spoil quickly.
Another misconception is that people should buy bottled water in advance of quarantine, but Cotter said there is no reason to expect the water that flows from your sink will be contaminated. If you normally drink only bottled water, feel free to stock up, but if you are accustomed to tap water, there’s no reason for concern.
It’s always important to stay hydrated, coronavirus or not, Cotter said.
He said it’s also key to think about what you may use on a daily basis: shampoo, diapers if you have children, dog food for your pet, cleaning supplies and toilet paper.
But there’s such a thing as too much. There’s no need to amass an apocalyptic supply, Cotter cautions.
“Self-quarantine isn’t going to last forever,” he said, “and you’re potentially hurting other people if you’re hoarding.”
Project Hope has staff in China, helping overwhelmed health professionals. Cotter said the staff mostly orders food delivered. If you’re in quarantine, it’s unlikely you’d infect the delivery driver, but the easiest way to avoid contact is to pay online and ask the driver to leave your package at your doorstep.
Also, don’t forget to have something to keep you entertained for those long two weeks. Cotter bought board games, Scrabble and trivia.
Do you have to self-quarantine if your employer asks you to? What about the government?
The Department of Health and Human Services, which the CDC falls under, has broad authority to quarantine or isolate anyone “reasonably believed” to have been exposed to communicable diseases, including cholera, smallpox and infectious tuberculosis.
This exceptional power is rooted in the commerce clause of the U.S. Constitution, which allows Congress to regulate foreign and interstate commerce.
Further federal rulemaking has continued to strengthen that authority. For instance, a 2017 regulation says the government can quarantine people “as long as necessary to protect the public.”
“It’s like a curfew or an evacuation order if a natural disaster occurs. Just like when a hurricane is bearing down, people are ordered to leave coastal areas because no one can save them,” Scott Burris, director of the Center for Public Health Law Research at Temple University, told The Washington Post. “If we have a reasonable prospect of stopping or slowing this virus, even if we’re doing it with mittens on, the government can take emergency action.”
As for your company, if you have an at-will employment agreement and want to keep your job, you should probably follow your employer’s travel restrictions, labor experts recommend. If you are a member of a union, you may have more protections.
Teresa Bartlett, the senior medical director at Sedgwick, a claims management service, advises companies to follow CDC and World Health Organization guidelines and to check both agency’s websites to see whether there are new outbreaks.
The same goes for employees, who should notify their work if they are going to a place with confirmed cases, Bartlett said.
“It’s important they self-identify and notify their employer, so they can work from home if at all possible,” she said.
Recently, some companies have restricted nonessential business travel and workplace visitors, Bartlett said.
Even if you travel to a country without an outbreak, it doesn’t mean it won’t occur during your trip, meaning there’s a chance you could be quarantined abroad.
For that reason, Bartlett recommends packing extra clothes and travel-size hand sanitizer and wipes.