What counts as being exposed to COVID-19?

Infection and Spread Testing and Contact Tracing

If my mom went to the hair salon on Thursday (hair stylist was masked, mom wasn’t) and her hair stylist developed COVID-19 symptoms on Saturday, then I saw my mom (outside, not distanced or masked) on Sunday, am I exposed and should I get tested?

A: We get it, figuring out when and if to consider yourself exposed to a case of COVID-19 can feel complicated. Let’s tackle this one step at a time.
First, what counts as being exposed (i.e. having close contact) to someone with COVID-19?

In the community setting, if you are <6ft away from someone for a cumulative time of >15 minutes over a 24-hour period, this is considered “close contact”. If you have “close contact” with a case of COVID-19 any time starting from 2 days before the person develops symptoms, or if they are not symptomatic, 2 days before they test positive-you are exposed. You are also exposed if you have “close contact’ with a case any time before they can end isolation period (i.e., 10 days after symptom onset and after resolution of fever for at least 24 hours and improvement of other symptoms or 10 days after positive test, if no symptoms). So, if your mom was <6ft from her stylist for >15 total minutes (most likely given the nature and average duration of a haircut) on Thursday, and her stylist developed COVD-19 symptoms on Saturday, your mom’s close contact with her stylist falls within that 2 day window before her symptom onset, and your mom would be considered exposed. NOTE: The definition of close contact does *not* depend on whether individuals were wearing masks or not.

Given she is exposed, what should your mom do next?

If your mom is *vaccinated*, the U.S. Centers for Disease Control and Prevention (CDC) recommends she monitor for symptoms and wear a mask indoors in public for 14 days or until she gets a negative test result (testing recommended 3-5 days after exposure even if an individual has no symptoms). So, if your mom is vaccinated, since she was exposed on Thursday, she would get tested sometime between Sunday-Tuesday. [NOTE: It is recommended that individuals who live in areas with high transmission wear masks in public already, regardless of vaccination status, and sadly very few people don’t live in such an area at this point].

If your mom tests negative, she should still monitor for symptoms until 14 days have passed since she was exposed, and if she does develop symptoms, she should isolate herself from others as soon as possible. If she tests positive, she should immediately begin isolation (see link with info on protocol for isolation below). Vaccinated individuals who are exposed to a case of COVID-19 and live with anyone who is vulnerable to complications of COVID and/or is unvaccinated, might also consider wearing a mask inside their house and minimizing contact with others in their household until getting a negative test-just to err on the side of caution.

If your mom is *not vaccinated*, CDC recommends she quarantine (i.e., stays home) for 14 days after the exposure, monitor for symptoms and avoid contact with high risk individuals in her household to the extent possible during that period. She may be able to shorten her quarantine period to 10 days without getting tested, if she hasn’t developed symptoms up to that point, but would still need to wear a mask in public and continue to monitor for symptoms through day 14. She may also be able to shorten her quarantine period to 7 days, if she gets a test on day 5 or later and tests negative (i.e., end quarantine on day eight). Again, she should still wear a mask in public and monitor for symptoms up to day 14. If she tests positive or develops symptoms anytime within that 14 day window, she should begin isolation immediately. See link to our previous post on ending quarantine early below.

What about you, are you also exposed? Should you get tested? If so, when?

Since you saw your mom Sunday, if she develops symptoms or tests positive between Sunday and Tuesday (i.e., the two days after your visit), AND you were <6 ft from her for >15 cumulative minutes during your visit (i.e., had close contact), you would be considered exposed. Until you know if she develops symptoms or tests positive during this window of time though, you are only a “contact to a close contact” and there is not a recommended quarantine or testing protocol for you. That said, if you live with others that are high-risk of complications, you might avoid close contact with them until you know whether you were exposed or not. If by Wednesday, your mom hasn’t developed symptoms or tested positive, you are probably in the clear in terms of having been exposed. It would make sense however, to hold off on having more close contact with her until she ends her quarantine, to rule out the possibility of becoming a close contact moving forward. If you wanted to get tested as an added assurance, you could, but should wait until 3-5 days have passed since your last contact with her (i.e., you would get tested between Wednesday-Friday).

So, let’s recap. Your mom was most likely exposed. You are only considered exposed, however, if your mom becomes a case AND you had close contact with her during the 2 days leading up to her developing symptoms or testing positive (or at any point during her subsequent isolation period). If that happens, you would need to follow CDC guidelines for quarantine and testing according to your vaccination status and then for isolation if you test positive or develop symptoms.

We realize this outlines a highly specific scenario, but we hope you can extrapolate to your own situation the next time you aren’t sure whether you are exposed or not. Keep in mind also that these are general guidelines used for contact tracing (i.e., identifying people who may have been exposed to a case), but in reality many factors can influence your chances of becoming infected once you are exposed to someone with COVID-19. These factors include proper mask use, ventilation, vaccination status, duration of contact, and proximity to the case and the transmissibility of the variant-which we know is higher for Delta than past variants of SARS-CoV-2. Our best bet for not getting exposed to COVID-19 is to use as many of our SMARTS as possible (SPACE-6ft or more, Masks-wear them, Air-improve ventilation, Restrict-keep number of people small, Time-keep duration short, and Shots-get vaccinated)!

See here for CDC definition of close contact

See here for CDC guidelines for isolation after testing positive or developing symptoms

See here for our previous post on ending quarantine early

Link to Original FB Post