Exposed to COVID-19 ... What is next?

Editor's Note: The information published in this story is accurate at the time of publication. Always refer to uab.edu/uabunited for UAB's current guidelines and recommendations relating to COVID-19.

When an individual has been exposed to COVID-19, there are several factors to consider when determining appropriate next steps. So, you have been exposed to COVID-19. What is next?

According to the Centers for Disease Control and Prevention, COVID-19 exposure is defined as anyone who has been within 6 feet of someone who has COVID-19 for 15 minutes or more over a 24-hour period. When an individual has been exposed, there are several factors to consider when determining appropriate next steps. 

If you are fully vaccinated

People who are fully vaccinated do not need to quarantine after contact with someone who has COVID-19 unless they have symptoms.

An individual is considered fully vaccinated two weeks after their second dose of a two-dose vaccine, such as the Pfizer or Moderna vaccines, or two weeks after a single-dose vaccine, such as the Johnson & Johnson vaccine.  

Fully vaccinated people who have been exposed should take the following steps:

• Get tested three to five days after exposure, even if asymptomatic.
• Continue wearing a mask indoors in public for 14 days following exposure or until they receive a negative test result; longer if in a high transmission area.
• Quarantine for 10 days following a positive test or if they are symptomatic. 

“An important thing to note here is that, if you are fully vaccinated, you do not have to quarantine if you are asymptomatic,” said Ellen Eaton, M.D., assistant professor in the University of Alabama at Birmingham’s Division of Infectious Diseases. “It is recommended that you get tested three to five days after a close contact; but if you are feeling well, you do not have to miss school, work or other normal activities that you enjoyed before the pandemic.”

Eaton explains that additional benefits of being fully vaccinated include not having to get tested or quarantine before and after travel and refraining from routine screening tests required by some businesses.   

If you are unvaccinated 

Individuals who are unvaccinated and are considered a close contact must quarantine for up to 14 days after exposure and should watch for COVID-19 symptoms, including fever, cough and shortness of breath. 

Unvaccinated individuals can end quarantine before the 14 days if the following criteria are met:

• Quarantine can end on Day 10 if they have been asymptomatic during the first 10 days of quarantine. 
• Quarantine can end on Day 7 if an individual receives a negative test result on a test that was taken on Day 5 or later of quarantine.  

Before individuals can resume normal activities, they must complete their quarantine, be fever-free for at least 24 hours without fever-reducing medications and see an improvement in their symptoms (loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation).  

People who experience emergency warning signs during or after quarantine such as trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, or pale, gray or blue-colored skin, lips or nail beds should seek immediate medical attention. Those who continue to experience symptoms after the 14-day quarantine should also contact a health care provider.

If you have had COVID-19 

People who have tested positive for COVID-19 within the past three months from their exposure and recovered do not have to quarantine if they are not experiencing any symptoms. People who tested positive for COVID-19 three months or more before their close contact must follow quarantine protocols stated above based on their vaccination status. 

“Although the body makes antibodies after being infected with COVID-19, these antibodies are not enough to keep one safe in the long run,” Eaton said. “Vaccinations are still the safest and most effective way to prevent quarantine, hospitalization and death.” 

Masked or unmasked? 

COVID-19 spreads mainly through respiratory droplets that travel in the air through coughing, sneezing, talking, shouting or singing. Masks are a simple barrier to help prevent respiratory droplets from reaching others. 

A study in North Carolina schools reported the scientific analysis of data provided directly from 100 school districts and 14 charter schools from March to June 2021, representing more than 865,000 students and 160,000 staff. The data showed that proper masking was the most effective mitigation strategy to prevent secondary transmission in schools when COVID-19 is circulating and when vaccination is unavailable or there is insufficient uptake. 

The study also showed that distance was not a factor in the spread of COVID-19 when students/staff/teachers are masked. Masking was adequate to prevent within-school COVID-19 transmission. Therefore, according to the CDC, close contact students within the K-12 classroom do not have to quarantine as long as they are asymptomatic, and both the close contact student and the student with COVID-19 were correctly wearing well-fitted masks.  

“For adults who are fully vaccinated, there are scenarios when masking is not indicated,” Eaton said. “This would include areas where transmission is low and in small, private settings with other fully vaccinated individuals such as a shared meal or religious event. In areas where transmission is high, masking is still recommended for all adults in indoor, public settings such as a concert or indoor athletic event, according to the CDC.”  

At this time, everyone age 12 and older is eligible for vaccination, according to the Alabama Department of Public Health Guidelines. An appointment can easily be scheduled at uabmedicinevaccine.org, and walkups are also allowed. Find a vaccine clinic near you by visiting vaccinefinder.org.