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COVID-19: When Can Those With Weakened Immune Systems End Home Isolation?

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The White House issued The President’s Coronavirus Guidelines for America: 30 Days to Slow the Spread on March 16, 2020. These guidelines state that people with compromised immune systems should stay home and away from other people to minimize their risk of getting sick with coronavirus. 

If you have a compromised immune system and become sick with COVID-19, you need to take care of yourself and also ensure that you don’t spread germs that make your family sick. For now, the latest guidance from the Centers for Disease Control and Prevention (CDC) for ending home isolation is the same for those who have weakened immune systems and those who do not. 

What Does Being Immunocompromised Mean? 

When people have immune systems that can’t mount normal responses to fight off infections, they are described as being immunocompromised. Some health conditions and medical treatments can lower the immune system and cause people to have a greater risk of catching an infection. 

These conditions include cancer treatments, such as chemotherapy, radiation or a bone marrow transplant. People who have received an organ transplant or who have HIV, AIDS or an inherited immune-deficiency condition are also considered to have compromised immune systems, according to the CDC.

People with autoimmune disorders, such as inflammatory bowel disease (IBD) or multiple sclerosis, take corticosteroids or other immune-weakening medications to help reduce and prevent damage to their body caused by their condition. Prolonged use of these drugs places them at higher risk for severe illness with COVID-19, the CDC says. 

What to Do if You Are Immunocompromised 

If you have a compromised immune system and are concerned that you have been exposed to coronavirus, or you develop a fever and symptoms such as a cough or difficulty breathing, call your physician or your local Department of Health right away for medical advice. You can also check the CDC’s online Coronavirus Self-Checker Tool to help you make decisions about seeking care.  

If you are sick with COVID-19 and isolated at home, you must take measures to prevent spreading the disease to your loved ones. Remember that the virus spreads when infected people cough or sneeze respiratory droplets that make others sick after they breathe them in the air or touch a contaminated surface and then touch their nose, mouth or eyes. 

Follow these steps while you are in home isolation: 

  • Avoid touching your nose, mouth and eyes. 
  • Clean and disinfect surfaces and objects daily. For example: phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets, smartphones and bedside tables. 
  • Do not share dishes, glasses, eating utensils, towels or bedding with other family members. Wash and dry them thoroughly after use. 
  • Let another person clean surfaces in other areas of the home. He or she can refer to this list of recommended disinfectant cleaners and follow manufacturers’ instructions on product labels. 
  • Stay home and away from others in your family as much as possible. If possible, stay confined to your own room and use a separate bathroom. 
  • Use a tissue whenever you cough, sneeze or blow your nose and throw it in the trash. 
  • Wash your hands immediately with soap after coughing and sneezing into a tissue — every time. Use soap and water for at least 20 seconds or use an alcohol-based hand sanitizer with at least 60% alcohol, covering all your hand surfaces and rubbing them together until they’re dry. 

When Can Immunocompromised People Discontinue Home Isolation? 

Currently, there is limited information on when immunocompromised people who had COVID-19 can discontinue home isolation. Past experience with other viral respiratory infections like the flu suggests that these people may shed potentially infectious virus and viral material for an extended period after they recover, says the CDC
 
The CDC issued interim guidance on March 16, 2020, for discontinuing home isolation for immunocompromised people who were sick with coronavirus. Currently, their direction is the same as for people whose immune systems are not compromised and varies depending on whether testing is available as follows: 

  • If testing is available, maintain isolation at home until: 
    • Your fever has resolved without the use of fever-reducing medications 
    • Your respiratory symptoms, such as a cough and shortness of breath, have improved 
    • The results from two consecutive nasopharyngeal swab tests, collected more than 24 hours apart, are negative for the virus (only one swab is collected at each sampling)

 

  • If coronavirus testing is not available or feasible, physicians and public health officials may advise you to discontinue home isolation if you meet the following conditions: 
    • At least three days (72 hours) have passed since your fever stopped without the use of fever-reducing medications 
    • Your respiratory symptoms, such as a cough and shortness of breath, have improved 
    • At least seven days have passed since your symptoms first appeared

The CDC advises that the state and local health authorities may adapt this guidance as they respond to rapidly changing circumstances with the spread of coronavirus in different communities. Stay up-to-date with the latest recommendations in your area. 

We’re Here to Help 

If you have a compromised immune system and need advice, we can help answer your questions. You can use the AdventHealth App to access your medical records, message your care team or be seen by a physician through a video visit in the comfort of your own home. Visit our Coronavirus Resource Hub for more information and answers to your Coronavirus FAQs

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