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SLO County issues new COVID health order. Here's what to do if you test positive

Tribune - 1/9/2022

Jan. 8—The spread of the omicron variant has created the "fastest, steepest increase" in COVID-19 cases in San Luis Obispo County since the beginning of the pandemic, according to the Public Health Department.

In response, the San Luis Obispo County Public Health Department issued a new health order on Friday that updated its isolation and quarantine guidelines for county residents who are exposed to or test positive for COVID-19.

Prior to the omicron-induced surge, the Public Health Department was sending individual letters and isolation instructions to people who tested positive for COVID-19. Now, Public Health is pointing the public to the county's COVID-19 portal to learn how to isolate and quarantine properly, said Dr. Penny Borenstein, county health officer.

The county guidelines mirror the state guidelines, which require that a person with COVID-19 isolate for at least five days and then test negative for COVID-19 in order to leave isolation, Borenstein said.

The guidelines that the state and county are following are stricter than those from the federal Centers for Disease Control and Prevention (CDC), which state that a COVID-19 patient can leave isolation after five days without a negative test if they are feeling better.

"We are aligning with the state of California, which put that testing requirement into their framework for testing out of isolation or quarantine, as opposed to the CDC, which simply said, you can leave isolation if you are asymptomatic, or considerably better (with) no fever," Borenstein said. "The state of California added a requirement to have a negative test day five or later in order to leave isolation."

How the five-day minimum on quarantine and isolation works with testing

There are two types of tests for diagnosing COVID-19 infection: the rapid, antigen tests that are available over-the-counter and polymerase chain reaction (PCR) tests, which are usually analyzed in a laboratory.

These diagnostic tests will tell if a patient is currently infected with the coronavirus. There and upsides and downsides to each option.

It typically takes a few days to get the results of a PCR test, while rapid antigen tests share results in 10 to 15 minutes.

However, the PCR test is more sensitive (fewer false negatives) and more specific (fewer false positives) than the antigen test, according to Public Health.

"For people who are symptomatic or known close contacts, using the antigen test to find positives is a very reliable reason to be testing," Borenstein said.

She said that a negative result on an antigen test fewer than five days after exposure to a COVID-19 patient does not mean you're in the clear, particularly if you're symptomatic or someone you live with or spent a lot of time with is positive.

Preliminary studies and anecdotal evidence show that the antigen tests may fail to detect an early-stage COVID-19 infection, according to health experts.

The requirement to test out of a five-day quarantine and isolation helps mediate some of the risk that comes with relying on the results of rapid tests failing to detect an early-stage COVID infection.

"It's related to sensitivity, but also having had enough time pass," Borenstein said. "It's possible to test too early for the virus to be picked up, and so that's why (testing on) day five is recommended."

The requirement to restrict movement for five days and to then test out of quarantine and isolation is recommended by experts, but has been challenging for community members who are struggling to locate at-home antigen tests and are experiencing longer wait times for PCR tests.

Borenstein said that this week was the first time that the four community test sites in San Luis Obispo County have struggled to accommodate walk-ins.

"The demand is outstripping our capacity," she said.

Borenstein also said that the Public Health Department is aware that antigen tests are difficult to find at local stores as well.

"It is really challenging, and we're aware of the frustration that's ensuing with all this messaging about 'test to get out of isolation, early test to make sure you're not positive' and then if you can't actually get the test, that can be very frustrating.

"We ask people to keep trying," she said.

What is the difference between quarantine and isolation?

Quarantine guidelines apply to anyone who has been in close contact to someone with COVID-19. meaning within 6 feet for 15 minutes or longer in a 24-hour period, according to the Public Health Department.

Isolation guidelines apply to anyone who tested positive for COVID-19, according to Public Health.

Quarantine guidelines also apply to anyone who was recently traveling and is not up-to-date on their vaccines or boosters.

So you were exposed to COVID-19, now what?

People with COVID-19 exposure are required to quarantine, according to Friday's health order. The goal of quarantine is to restrict the movements of the person to limit the spread of the virus, according to Public Health.

People under quarantine guidelines who are eligible for a vaccine or booster but have not yet received them must stay home for five days, avoid contact with others and wear a well-fitting mask, according to Public Health.

Borenstein said that, even if you are vaccinated and boosted, if you are symptomatic and had close contact with someone who has the coronavirus, don't rely on the results of an antigen test alone.

"If you're symptomatic and have a negative test or someone who you've had close contact with, like your significant other or someone in your household, if that antigen test is negative, and particularly if you're symptomatic — don't rely just on that," Borenstein said.

Five days after the initial coronavirus exposure, the quarantined person must get a COVID-19 test, according to the Public Health Department. If the test result is negative and the person has no symptoms, quarantine can end — technically.

"I would recommend that you get another test one to two days later to follow up. And that would be either repeating an antigen test, or better yet if you can do the PCR test," Borenstein said.

If the COVID-19 test result is positive, move into isolation.

Quarantine must continue for 10 days if the person does not take a COVID-19 test, under the new health order.

Quarantine guidelines are different for people who work in a healthcare setting or in preschool/childcare or K-12 education, and are outlined on the county COVID-19 website.

So you test positive for COVID-19, now what?

A person needs to isolate if they test positive for COVID-19, regardless of symptoms, vaccine status or past COVID-19 infection. This includes positive test results using a laboratory-based PCR test or an antigen test, according to Public Health.

People who test positive for COVID-19 need to stay home, and not attend work, school or social functions. If you live with other people, try to stay in a "sick room" and use a separate bathroom if possible.

Under the new health order, the only allowance for people with COVID-19 leaving the house is to seek medical care, Borenstein said.

After testing positive, the next step is to let people you were in close contact with know that you have the coronavirus. If you test positive somewhere that is not a community testing clinic, notify the Public Health Department.

Most people, particularly those who are vaccinated and/or boosted, have mild symptoms that don't require hospitalization, but monitor symptoms for severity nonetheless.

Isolation must last at least five days, according to the Public Health Department.

If the patient is unable or unwilling to take a test or symptoms are not resolving, they must stay in isolation for 10 days, according to Public Health.

COVID-19 positive patients should isolate for the duration of a fever, and if symptoms last more than 10 days, isolation should continue.

The only way to leave isolation, even if symptoms are alleviated, is to test out.

"I also want to really emphasize that people not think, 'Oh, great, I'm good to go. I tested negative, it's day 6, 8, 9, 10. I can do anything and everything,' we are strongly emphasizing that it is still very important to wear a mask at all times during that extended period of time," Borenstein said. "And if you can't wear masks, don't go to that place."

Borenstein said that people who are still in that 10-day isolation window, regardless of whether they tested out of isolation or not, should avoid places like restaurants, bars and gyms, but can leave their sick rooms, return to work and see family.

"We're really trying to emphasize that you should still be wearing a mask for the full 10-day period," she said.

Where to get a COVID-19 test and schedule a vaccine appointment

Free coronavirus testing is available at clinics in San Luis Obispo, Grover Beach, Paso Robles and Morro Bay. To make an appointment, visit slocounty.ca.gov/COVID-19/COVID-19-Testing or call 888-634-1123 to register by phone.

Testing is administered at 801 Grand Ave in San Luis Obispo, 1336 Ramona Ave #A in Grover Beach, 209 Surf St. in Morro Bay and 800 Pine St. in Paso Robles.

To make an appointment for a COVID-19 vaccine or booster, visit MyTurn.ca.gov or call 833-422-4255. The county Public Health Department is also administering vaccines and boosters on a walk-in basis at clinics in San Luis Obispo, Paso Robles and Grover Beach. To find shots at pharmacies near you, visit Vaccines.gov.

The clinics are open Monday and Wednesday, Thursday, Friday from 8 a.m. to 5 p.m. (closed noon to 1 p.m. for lunch), and Saturdays for vaccines only from 8:30 a.m. to 4 p.m.

Vaccines are administered at the San Luis Obispo clinic is located at 2191 Johnson Ave., the Grover Beach clinic is located at 286 South 16th St. and the Paso Robles clinic is located at 800 Pine St.

For more information, visit slocounty.ca.gov/COVID-19/Vaccines.

This story was originally published January 8, 202210:00 AM.

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