The LA County Health Officer orders require persons diagnosed with COVID-19 to isolate and their close contacts to follow Instructions for Close Contacts, which for some people include quarantine. See Quick Links to view Health Officer Orders and Instructions).
LAC DPH is attempting to contact all laboratory confirmed COVID-19 cases to interview them, initiate contact tracing, and provide isolation instructions and orders. In addition, in order to improve disease control, we are asking healthcare providers who diagnose a patient with COVID-19 (confirmed or presumed) to give their patient isolation orders and instructions. Patients with laboratory confirmed COVID-19 infection should also be instructed to provide quarantine orders and instructions to all their close contacts. See Ambulatory Patients with COVID-19 for more details.
If a patient with COVID-19 is unable to inform their contacts of the need to quarantine (e.g., the patient is severely ill or deceased), this responsibility falls to the diagnosing healthcare provider. See When the Confirmed Case Cannot Inform Contacts below for more details.
Isolation is used to separate people who are infectious with COVID-19 away from people who are not infected. Persons in isolation may be symptomatic (presumed or laboratory confirmed) or asymptomatic with a positive viral test for COVID-19. Persons under isolation orders are released when they are no longer considered infectious, see Ending Isolation and Return to Work/School.
Quarantine is used to separate close contacts of individuals with COVID-19 from others because they may be incubating virus and may become infectious at some point during their incubation period. Persons under quarantine orders are released when they are determined to no longer be at risk for spreading the virus, see Ending Quarantine and Return to Work/School.
Close Contact refers to any of the following people who were exposed to a person with confirmed COVID-19 (“case”) while they were infectious*:
*A patient with COVID-19 is considered to be infectious from 2 days before their symptoms started until their isolation period ends. Asymptomatic patients with a positive SARS-CoV-2 diagnostic (viral) test are considered to be infectious from 2 days before their test was taken until 10 days after their test was taken.
Note: A person is still considered a close contact even if they and/or the case were wearing facemask at the time of exposure. Exceptions to this are healthcare personnel wearing appropriate PPE and employees who were wearing a respirator as per Cal/OSHA regulations.
Confirmed COVID-19 – A patient with a positive SARS-CoV-2 viral (NAAT or antigen) test.
Presumed COVID-19 – A patient with clinically compatible symptoms of COVID-19 and no clear alternate diagnosis with/without exposure history. This presumptive clinical diagnosis is used when the provider has a high index of suspicion that a patient has COVID-19. See COVID-19 Risk Assessment and Presumptive Clinical Diagnosis for guidance.
Fully vaccinated-A person is considered fully vaccinated >2 weeks following the receipt* of:
*This guidance can also be applied to COVID-19 vaccines that have been listed for emergency use by the World Health Organization (e.g., AstraZeneca/Oxford). See CDC Clinical Considerations People vaccinated outside the Unites States footnote 2 for current WHO list.
Recently recovered from COVID-19 A person who had a positive viral COVID-19 test within the past 3 months (90 days) who has recovered from the previous infection. Recovered means they are no longer considered infectious (i.e., their isolation period has ended).
If the patient had symptoms with their most recent infection, the 90 days are from the onset of the initial COVID-19 symptoms. If they never had symptoms, then the 90 days are from the date of collection of the first positive viral COVID-19 test.
We are asking for your help to make sure that your patients understand that the isolation and quarantine orders are legal mandates that must be followed and why they are important. The following can be helpful:
If COVID-19 is laboratory confirmed or presumed, the diagnosing provider is asked to:
Persons with symptomatic COVID-19 can be released from isolation when the following criteria have been met:
Asymptomatic persons with COVID-19 who never developed symptoms may be released from isolation:
The patient must remain in isolation until either:
Note: Presumed COVID-19 patients who are close contacts to a confirmed case must continue to follow quarantine and other instructions for close contacts, even if they test negative for COVID-19 and/or have a clear alternate diagnosis. See Quarantine for more information.
Patients with Severe/Critical COVID-19 or Who Are Severely Immunocompromised
For patients with severe to critical illness or who are severely immunocompromised, the CDC recommends extending the duration of isolation or precautions from 10 days to up to 20 days from illness onset.
A test-based strategy for discontinuing isolation could be considered for persons who are severely immunocompromised, however the CDC recommends this be done in consultation with infectious disease experts.
When their isolation period ends, the patient is considered recovered and may resume their usual activities including return to in-person work and/or school. They should be reminded to follow COVID-19 precautions including masking, physical distancing, and hand hygiene. Neither Public Health clearance nor a negative COVID-19 test is required for return to work/school.
Close contacts of laboratory-confirmed COVID-19 cases are required to self-quarantine (stay home and separate themselves from others), per the Los Angeles County Health Officer quarantine orders, unless they are exempt.
All close contacts are required to monitor for symptoms of COVID-19 and take extra precautions for 14 days after their last exposure with the infectious case.
The following close contacts in the general public are exempted from quarantine as long as they remain asymptomatic:
To learn more about the public health recommendations for close contacts who are fully vaccinated or have recently recovered from COVID-19 please visit:
CDC recommends a quarantine period of 14 days based on estimates of the upper bounds of the COVID-19 incubation. The CDC has also provided acceptable shorter quarantine options.
The California Department of Public Health (CDPH) and LAC DPH support the CDC’s two options for shortening the recommended 14-day quarantine duration for the general public. Close contacts working and living in healthcare and high risk non-healthcare congregate settings have special quarantine considerations.
Note: CDPH updated its Guidance on Isolation and Quarantine for COVID-19 Contact Tracing on August 17, 2021. However, until Cal/OSHA changes the Return to Work criteria listed in its Emergency Temporary Standards (ETS), people with workplace exposures are required to continue following the close contact (quarantine) criteria listed in the ETS.
Close contacts who remain asymptomatic may discontinue self-quarantine under the following conditions:
To discontinue quarantine before 14 days, asymptomatic close contacts must:
If any symptoms develop during this 14-day period, the close contact should immediately self-isolate, get tested and contact their healthcare provider with any questions regarding their care.
If the close contact lives with someone who is immunosuppressed, at increased risk for severe disease, or unvaccinated, it is recommended that the close contact continue to wear a mask at home for the full 14 days.
Healthcare and High-Risk Non-Healthcare Congregate Settings-Special Quarantine Considerations
Refer to setting-specific guidelines or protocols for more information.
If a patient presents as a close contact, providers are asked to:
Post-exposure viral testing is recommended for close contacts, regardless of vaccination status.
Testing is not recommended for persons who had a positive COVID-19 test in the past 3 months. See Patients with a History of Recent Recovery from COVID-19 for more information.
Only FDA-approved viral COVID-19 tests that are collected and performed in a healthcare setting or certified testing site are acceptable documentation of infection status. Negative test results from home-test kits cannot be used to end quarantine early.
When ordering viral tests please make sure to confirm the patient’s current phone number(s) and address and include it in the laboratory requisition to facilitate prompt contact tracing if the result is positive.
Timing of testing
If symptoms develop, diagnostic testing should be performed immediately.
Unvaccinated close contacts - Testing is recommended 5-7 days after exposure. Negative viral test results on specimens collected after Day 5 can be used to end self-quarantine after Day 7 .
Fully vaccinated close contacts - CDC and CDPH recommend testing asymptomatic fully vaccinated close contacts 3-5 days after exposure.
Health and Human Services has issued a Limited Waiver of HIPAA Sanctions and Penalties During a Nationwide Public Health Emergency to cover these disclosures during the COVID-19 outbreak.
This is defined as a person who had a positive viral COVID-19 test within the past 3 months (90 days) who has recovered from the previous infection (i.e. their isolation period has ended). If they had symptoms with their most recent infection, the 90 days are from the onset of the initial COVID-19 symptoms. If they never had symptoms, then the 90 days are from the date of collection of the first positive viral COVID-19 test.
If the recently recovered person is
Develops new symptoms consistent with COVID-19 illness:
Healthcare providers should always use their clinical judgment and consider exceptions, particularly for patients who are severely immunocompromised.
Rationale - Per the CDC, reinfection is unlikely to occur within the first 3 months (90 days) after infection. Recovered persons, however, may continue to shed detectable but non-infectious SARS-COV-2 virus for up to 3 months.
For more detailed discussion of this evidence and CDC recommendations, see Interim Guidance on Ending Isolation and Precautions for Adults with COVID-19.
LAC DPH will attempt to contact patients with laboratory confirmed COVID-19 by phone in order to interview them about possible exposures and to identify others who may have also been exposed to the infection (contact tracing). They will leave a call back number if necessary. If they cannot reach the patient by phone, they will send a letter. LA County Public Health will provide information to cases and contacts about how to protect themselves and others from COVID-19 and information about resources for delivery of essentials such as food and medicines if needed.
This flyer explains to patients what to expect.
Instructions for patients - are available on webpages in English and Spanish and in PDFs in 13 languages– visit home isolation and quarantine and other instructions for close contacts to view these resources.
Short URLs - are available at the top of this page to make it easier to direct patients to the quarantine and isolation webpages over the phone.
Information about symptoms - information from DPH (ph.lacounty.gov/covidcare) and the CDC for people who want to learn about symptoms, or who have symptoms of COVID-19 but have not been tested or sought medical advice.Home Cleaning Guidance
Additional information for providers in multiple languages is available on the LAC DPH Print materials webpage.