Updated COVID-19 Quarantine Guidance for Orange County
December 21, 2020
The Centers for Disease Control and Prevention (CDC) recently published updated recommendations for quarantine of persons following exposure to a COVID-19 case, including options for a shortened quarantine period. In accordance with this guidance, along with additional guidance from the California Department of Public Health, the Orange County Health Care Agency recommends the following options for discontinuation of quarantine:

Recommendations for the General Population:
Asymptomatic close contacts (within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period) may discontinue quarantine after Day 10 from the date of last exposure with or without testing.

The OC Health Officer’s Order has been updated to reflect this quarantine period.
Recommendations for the General Population:
Recommendations for COVID-19- Exposed Persons Who Work in High Risk Settings:

  • Healthcare Workers ideally should be quarantined for 14 days after exposure. However, because staffing shortages often preclude this, healthcare employers may allow asymptomatic healthcare personnel to continue to work without a period of quarantine according to the CDC’s Contingency Capacity Strategies. Exclusion of exposed healthcare staff for any period of time, whether for 14 days or for 10 days with or without testing, lowers the risk of COVID-19 spread in healthcare settings.
  • Because household exposures pose the highest risk of infection, OCHCA strongly recommends that healthcare workers with household exposure be quarantined for 14 days as staffing capacity allows.
  • Emergency Response and Social Services Workers who work face to face with clients in the child welfare system or in assisted living facilities may return to work during staff shortages after Day 7 from the date of last exposure with a PCR test performed after Day 5 and a negative result.

All Contacts Released From Quarantine Before Day 14 Must:

  • Adhere strictly to all recommended non-pharmaceutical interventions, including consistent use of face coverings and maintaining a distance of at least 6 feet from others, through Day 14.
  • Use surgical face masks at all times during work for those returning after Day 7 and continue to use face coverings when outside the home through Day 14 after last exposure.
  • Self-monitor for COVID-19 symptoms through Day 14 and if symptoms occur, immediately self-isolate and contact their local public health department or healthcare provider and seek testing.
Background and Rationale for this Guidance:
The CDC has offered these options in order to help jurisdictions balance the risk of transmission with the personal and societal burdens associated with quarantine. However, any quarantine period shorter than 14 days carries a slightly higher risk that the person will become infectious after release. After a 14-day quarantine period, the estimated risk of being infectious is 0.1%. By comparison, the residual post-quarantine transmission risk for a 10 day quarantine without testing is estimated to be about 1% with an upper limit of about 10%. The residual post-quarantine transmission risk for a 7 day quarantine with a negative test at 5-7 days is estimated to be about 5% with an upper limit of about 12%. To prevent the spread of COVID-19, individuals as well as worksites and other community entities may continue to practice the more conservative 14-day period of quarantine.

The CDC suggests that quarantine can be ended at day 7 if testing before the time of planned quarantine discontinuation is negative and no symptoms develop. However, because this option carries a higher risk of infection developing after quarantine release, its use is not allowed in the updated health officer order, aside from staffing shortage situations in specific groups described above. 
Contact Information:
For questions or concerns please contact the Communicable Disease Control Division at 714-834-8180.
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