COVID-19 Isolation and Exposure Guidance for the General Public

Updated August 15, 2022. Isolation and exposure precautions are important steps to help stop the spread of COVID-19.

Table of Contents

If you test positive for COVID-19 (isolate)

If you test positive for COVID-19 on either a rapid antigen or PCR test, you are required to self-isolate – whether you are vaccinated or not. Do not leave your home, except to get medical care. Do not visit public areas. Self-isolation means separating yourself from others to keep your germs from spreading. Regardless of vaccination status, all individuals who test positive should avoid people who are at high risk of severe disease for 10 days.

Anyone who lives, works or attends higher education in MA

Able to Mask Isolation Guidance
Yes

• Stay home and isolate for at least the first 5 days; you are probably most infectious during these 5 days

• If you never had symptoms or symptoms are improving,* you may end your isolation on day 6

• Wear a mask around others for 10 days (including in the household). You may remove your mask prior to day 11, if you have had two negative tests taken 48 hours apart.

No

• Stay home and isolate for 10 days

• If you never had symptoms or symptoms are improving,* you may end your isolation on day 11.

 

*Note: If you have or develop symptoms, continue to stay home, until you have not had a fever for 24-hours without the use of fever reducing medicine and your other symptoms are improving. If you were severely ill (were hospitalized) or have a weakened immune system, you should consult your healthcare provider before leaving isolation. 

Days to Isolate

  • Day 0, first day of symptoms OR day the positive test was taken, whichever is earlier
  • Days 1-4, continue to isolate
  • Day 5, last day of isolation if asymptomatic or symptoms are improving
  • Day 6, leave isolation (if you are able to wear a mask at all times when around other people, including in your household, through day 10). You may remove your mask prior to day 10, if you have had two negative tests taken 48 hours apart.

After you have ended isolation, if your COVID-19 symptoms recur or worsen, restart your isolation at day 0.

While everyone must isolate if they have COVID, individuals may be able to return to childcare, school or a healthcare setting sooner under certain conditions. See guidance on return to work, school and childcare, below.

If you were exposed to someone with COVID-19 (exposure precautions)

If you have been exposed to someone with COVID, you do not need to quarantine as long as you remain asymptomatic, regardless of your vaccination status. You must wear a mask any time you are around others inside your home or indoors in public for the 10 days following your exposure, unless you are unable to mask*.

If you were exposed and develop symptoms at any time, isolate and take a test and stay home until you know the result. If the result is positive, follow isolation protocols. If your test is negative or if you have remained asymptomatic, take a test on day 6.

  • If you have not had COVID-19 in the last 90 days, you can test with either a rapid antigen or PCR test.
  • People who had COVID-19 in the last 90 days should test with a rapid antigen test, not a PCR test.
  • People who had COVID-19 in the last 30 days are not recommended to test on day 6 but should use a rapid antigen test if they develop any symptoms.

 If you test positive, follow isolation guidance. For more information, please see CDC COVID-19 Exposure Guidance.

* You are unable to consistently wear a mask due to young age or medical or behavioral condition. 

Schools, childcare, and certain healthcare settings

Workers in schools, childcare, camps and certain healthcare settings have specific standards for returning to their workplaces, as do children returning to school, childcare or camp settings. It should be noted that these standards apply to their specific setting only, and all individuals must follow the isolation and exposure precaution guidance for the general population when outside of those settings.

Specific guidance and protocols on when individuals may return to these settings:

Return to work guidance for other business sectors

All business sectors aside from school, childcare, and certain healthcare settings must comply with isolation and exposure precaution guidance for the general population, including all non-health care congregate care setting/residential programs and shelters. Additionally, this guidance applies to emergency shelter programs, including individual and family homeless shelters, domestic violence and sexual assault shelters, and Veterans' shelters.

Frequently asked questions

The guidance issued for schools and childcares is different than the previously issued DESE guidance for schools and EEC guidance for childcare programs. Have those documents been replaced? What guidance should be followed?

The guidance for Children and Staff School, Childcare, and Camp settings is the most up-to-date guidance for children and staff in those settings. This guidance replaces all previously issued guidance by DESE and EEC. There is also setting specific guidance for healthcare workers and long-term care facilities.

If a person tests positive with a rapid antigen test (such as over the counter home tests or rapid tests from schools and testing centers) do they need to get a PCR test to confirm they are positive?

No. PCR test is not necessary or recommended to confirm a positive result on a rapid antigen test. Rapid antigen tests have a low rate of false positives. As a result, a person who tests positive on a rapid antigen test, almost certainly has COVID-19 and must follow isolation guidance.

If a person with COVID-19-like symptoms tests negative on a rapid antigen test, DPH recommends repeating an antigen test in 48 hours. Alternatively, these individuals could consider getting a PCR test. In the meantime, while waiting to take the additional rapid test or while waiting for the PCR results (which can take 24-72 hours) these individuals should assume they are positive and follow the isolation guidance.

What type of test is recommended for individuals?

While PCR tests were the first tests available and the most commonly used COVID-19 diagnostic tool up to this point, rapid antigen tests are now more widely available, and have clear advantages over PCR tests in many contexts.

Rapid antigen tests (such as at-home testing kits) can be easily used, and the results are available in as few as 15 minutes. Because antigen tests can be done anywhere and do not require laboratory analysis or trained personnel to collect the sample, they are convenient and accessible.

Please refer to the Guidance About COVID-19 Testing for more details on different test types and recommendations for use.

Does a person need to notify DPH or local board of health if they test positive for COVID-19?

No. In most cases, a public health authority does not need to be notified of a positive COVID-19 test. People should stay home and notify individuals they may have exposed to COVID-19.

Some sectors (e.g. schools, licensed daycare settings, long term care facilities, and other congregate care facilities) have specific reporting requirements and should continue to follow their established procedures for state and local notification of positive cases.

Do state or federal guidelines require employees to show a negative test or clearance letter to return to work following isolation or exposure? 

No. The Department of Public Health’s protocols do not require a test or return to work or school letter for asymptomatic exposed individuals or anyone returning from isolation; clearance letters are not necessary, and this requirement is discouraged. Neither local boards of health nor the Department of Public Health provide these letters and, if required, employees would need to obtain any return to work letters from their health care provider. If an employer chooses to require testing, a PCR should not be required.

What is the isolation requirement?

If you test positive you must isolate – whether or not you are vaccinated. This isolation means you must be alone, without direct contact with anyone else, until you can no longer spread the virus.

  • This isolation period must last for a minimum of 5 full days.
  • On Day 6, if you have not had any symptoms OR you have been fever free without the use of fever reducing medications for at least 24 hours and your other symptoms are improving, then you may resume your usual activities.
  • You must wear a well-fitting mask covering your nose and mouth at all times when you are with other people (even in your own household) from days 6 to 10. You may remove your mask prior to day 11, if you have had two negative tests taken 48 hours apart.
  • If you still have a fever or your symptoms are not improving OR you cannot wear a mask at all times, you must continue to isolate through day 10.

If your symptoms are not resolving on Day 6 then you should continue to isolate until your symptoms are resolving or through Day 10. After you have ended isolation, if your COVID-19 symptoms recur or worsen, restart your isolation at day 0.

What should I do if I have been exposed to someone with COVID-19?

If you have been exposed to COVID, you do not need to quarantine as long as you remain asymptomatic. You must wear a mask any time you are around others inside your home or indoors in public for the 10 days following your exposure, unless you are unable to mask*. Take a rapid antigen or PCR on day 6 or any time symptoms develop.

  • If you have not had COVID-19 in the last 90 days, you can test with either a rapid antigen or a PCR test.
  • People who had COVID-19 in the last 90 days should test with a rapid antigen test, not a PCR test.
  • People who had COVID-19 in the last 30 days are not recommended to test on day 6 but should use a rapid antigen test if they develop any symptoms.

If you test positive, follow Isolation Guidance. For more information, please see CDC COVID-19 Exposure Guidance.

* You are unable to consistently wear a mask due to young age or medical or behavioral condition

Resources are available to support you if you're required to isolate or quarantine, and need medical, housing, food, or other assistance. If you need help getting resources to stay at home, call your local board of health.

How do I know if I have been exposed to COVID-19?

People with COVID-19 are most able to spread it to others during the first 5 days of their infection but can also spread it up to 2 days before symptom onset or their positive test and for about 10 days after their positive test. If you were around someone during this time frame, especially if you spent over 15 minutes in close proximity to them, or doing activities that involved singing or shouting, you may have been exposed to COVID-19. Even if you were around that person for a shorter time frame, you should consider yourself an exposure, especially if you had direct contact with the respiratory droplets of that person (e.g., being coughed or sneezed on) while not wearing a mask or face covering. For more about understanding your risk of exposure, visit this CDC page.

What should I do during isolation?

  • If you are isolating, you should:
    • Stay at home
      • Rest if you are not feeling well
      • Use a separate bedroom and bathroom if possible.
      • Wear a mask and do your best to stay at least 6 feet away from other people in the house.
      • Do not leave your house to go to school, work, or run errands. If you have to go to a medical appointment, do not take public transportation, taxis, or ride-shares to get to your appointment. 
      • Do not have any visitors to your house during this time.
      • Do not share eating or drinking utensils with anybody.
      • Drink a lot of water. Avoid caffeine and alcohol since it can dehydrate you.
  • If you tested positive, tell other individuals who you may have exposed that they should follow exposure precautions.
  • Monitor your health every day and contact your healthcare provider if you have any questions about your health
    • Watch your symptoms. Look for emergency warning signs* for COVID-19. Call 9-1-1 to get emergency medical care immediately if you have:
      • Trouble breathing
      • Persistent pain or pressure in the chest
      • New confusion
      • Inability to wake or stay awake
      • Bluish lips or face
    • If you are have an exposure and develop symptoms, even if they are mild, you should get a rapid antigen or PCR test
    • If you need to seek medical care, call your doctor first before going and tell them you COVID-19 positive or are within 10 days of exposure to someone with COVID-19.

* This is not a list of all symptoms. Please call your doctor for any other symptoms that are severe or concerning to you.

  • All exposed individuals should take these steps to help stop the spread of COVID-19 during the 10 days after exposure:
    • Wear a mask around others for 10 days (including in the household)
    • Wash your hands frequently with soap and water for at least 20 seconds.
    • Do not share eating or drinking utensils with anybody.
    • Monitor your health every day.
    • If you need to seek routine medical care, call your doctor before you go and tell them you are within 10 days of exposure to someone with COVID-19.
    • Avoid people who are at high risk of severe disease for 10 days.

What should someone do who develops symptoms after they are exposed to someone with COVID-19?

Whenever anyone has symptoms of COVID they should isolate themselves away from others and get tested. People who had COVID-19 in the last 90 days should take a rapid antigen test rather than a PCR. If they have not had COVID-19 in the last 90 days, they can use either a rapid antigen test or a PCR. If a COVID-19 test is negative, they should stay home until they feel better. If symptoms persist, they should consider repeating an antigen test in 48 hours to ensure they do not have COVID. If they test positive at any time, they must isolate following current guidance and notify those they may have exposed.

Additional Resources

Last updated: August 17, 2022
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