The Tennessee Department of Health has released guidelines on the length of isolation necessary for those who have contracted COVID-19 (referred to clinically in the guidance as “a Case”) and the length of quarantine for those who share living space with a Case. 

Isolation

Under the guidelines, a confirmed Case must isolate for at least 10 days from the onset of symptoms and until the individual is, in the absence of fever-reducing drugs, without a fever for 24 hours and other symptoms are subsiding.  A severe or returning Case may have to isolate for no fewer than 20 days.  It’s all about the fever.  If, within the 10-day isolation period, a Case is without a fever for 24 hours, they must still isolate for the full 10 days.  If they are fever-free for 24 hours during the 10 days but then develop a fever while still within the 10-day period, they must experience another 24 fever-free hours before ending isolation.  As a result, a second fever could require the isolation to extend beyond 10 days.  For example, a Case isolates for 3 days and on day 4, the fever subsides.  Even though they feel fine and are without fever on day 6, they must remain isolated until the end of day 10.  If, however, the fever returns on day 6 and did not subside until day 8, they would still have to isolate for the full 10-day minimum.  But, if the fever subsides on day 4 and returns on day 9, they must remain isolated at least until the fever again subsides for a full 24 hours, even though that takes them beyond the 10-day isolation period.

The good news is that once a Case has isolated for the full 10 days, even if a fever or other symptoms return after the 10-day period, no further isolation is required. 

An asymptomatic Case who does not later develop symptoms may be released from isolation 10 days after specimen collection.

Contact Quarantine

The newly released guidance also requires “household contacts” who share living space with a Case to quarantine for a minimum of 24 days, or at least 14 days after the Case has completed their 10-day isolation period.  Of course, that means the “household contact” may have to quarantine longer depending on when the Case’s isolation period ends. For example, if a Case does not have a fever-free 24-hour period until day 16 of isolation because of relapses within the initial 10-day isolation period, “household contacts” will have a quarantine that lasts the 16 days for the Case and then an additional 14 days. 

The best way to shorten the quarantine period among household members is strict isolation of the infected person.  Avoid being in the same room, sharing a bathroom (or clean frequently and thoroughly after every use), and touching tableware, telephones, or other items used in common with others.  Observing strict isolation of the infected person will be much easier for some households than others.

Those who do not share a household with an infected person but still come into close contact (within 6 feet for 15 minutes or more) with a Case, must isolate for 14 days from the date of the close contact. 

Employers should keep these guidelines in mind when applying their attendance policies and administering leave requests.  Specifically, employees who are not COVID-positive and are otherwise required to be in the workplace may need to work remotely for an extended period of time while they are in quarantine following exposure to an infected member of their household, or they may need to be on a leave of absence if working remotely is not possible for their position.