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Contact with a positive? Quarantine guide for vaccinated and non vaccinated and healthcare workers – Nursing

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Contact with a positive? Quarantine guide for vaccinated and non vaccinated and healthcare workers

In these days, the concomitance between the surge from Covid infections and the Christmas holidays, which increase the opportunities for meeting with friends and relatives, require an increase in prudence and prevention measures and, despite everything, it can happen to come into contact close with a positive Covid, so what to do?

Below, thanks to the indications of the Ministry, a brief guide to quarantine from Covid.

What is the difference between quarantine, active surveillance and isolation?

Quarantine and isolation are important public health measures implemented to avoid the occurrence of further secondary cases due to transmission of SARS-CoV-2 and to avoid overloading the hospital system.

The forty it takes place on a healthy person (close contact) who has been exposed to a COVID-19 case, with the aim of monitoring symptoms and ensuring early identification of cases.

L’isolation consists in separating as much as possible people affected by COVID-19 from healthy ones in order to prevent the spread of the infection, during the transmissibility period.

The active surveillance it is a measure during which the public health operator contacts the person under surveillance on a daily basis for information on health conditions.

Who should go to quarantine? And for how long?

Only those who have had “close contacts” go into quarantine“with an infected person. The Ministry of Health has set very clear rules: anyone who has been close to an infected person must stay in quarantine for 7 days if he was vaccinated with the second dose and 10 days in all other cases. After this period it is necessary to perform a molecular or anti-gene test to be able to return to work or otherwise leave the house without restrictions.

What does close contact mean?

The “close contact” (high risk exposure) of a probable or confirmed case is defined as:

  • a person living in the same home as a COVID-19 case
  • a person who has had direct physical contact with a COVID-19 case (e.g. handshake)
  • a person who has had unprotected direct contact with secretions from a COVID19 case (e.g. touching used paper handkerchiefs with bare hands)
  • a person who has had direct (face-to-face) contact with a COVID-19 case, at a distance of less than 2 meters and at least 15 minutes
  • a person who has been in an enclosed environment (e.g. classroom, meeting room, hospital waiting room) with a COVID-19 case in the absence of suitable PPE
  • a healthcare worker or other person providing direct assistance to a COVID-19 case or laboratory personnel handling samples of a COVID-19 case without the use of recommended PPE or through the use of unsuitable PPE
  • a person who traveled seated by train, plane or any other means of transportation within two seats in any direction relative to a COVID-19 case; the travel companions and the staff assigned to the section of the plane / train where the index case was sitting are also close contacts.
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Healthcare professionals, based on individual risk assessments, may assume that some people, regardless of duration and duration setting in which the contact took place, have had a high risk exposure.

I completed the vaccination course but I had a risky contact, what should I do?

I high-risk asymptomatic contacts (close contacts) of confirmed COVID-19 cases, including cases identified as cases of suspected or confirmed VOC variant, if they have completed the vaccination course for at least 14 days, they may return to the community after a period of quarantine of at least 7 days from the last exposure to the case, at the end of which a molecular or antigen test with negative result.
If it is not possible to perform a molecular or antigen test between the 7th and the 14th day, it is possible to consider concluding the quarantine period after at least 14 days from the last exposure to the case, even in the absence of a molecular or antigenic diagnostic test for SARS-CoV-2.

I low-risk asymptomatic contacts of COVID-19 cases, if they have completed the vaccination course for at least 14 days, they must not be quarantined, but they must continue to maintain the common sanitation measures envisaged to contain the spread of the virus, such as wearing a mask, maintaining physical distance, frequently sanitizing hands, following good respiratory hygiene practices, etc.

I have not completed the vaccination course, I have had a risky contact but I have no symptoms, what should I do?

I high-risk asymptomatic contacts (close contacts) of COVID-19 cases not identified as VOC Beta cases, if they have not completed the vaccination course for at least 14 days, they can return to the community after a period of quarantine of at least 10 days from the last exposure to the case, at the end of which a molecular or antigen test with negative result. If it is not possible to perform a molecular or antigen test between the tenth and the fourteenth day, it is possible to consider concluding the period of quarantine at least 14 days after the last exposure to the case, even in the absence of a molecular or antigenic diagnostic test for SARS-CoV-2.

I low-risk asymptomatic contacts COVID-19 cases not identified as VOC Beta cases, if they have not completed the vaccination course for at least 14 days, they must not be quarantined, but they must continue to maintain the common sanitation measures envisaged to contain the spread of the virus, such as wearing a mask, maintaining physical distance, frequently sanitizing hands, following good respiratory hygiene practices, etc.

I am a healthcare professional and I have completed my vaccination course, but I have had a risky contact, what should I do?

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Healthcare professionals or other persons providing direct assistance to a COVID-19 case or laboratory personnel handling samples of a COVID-19 case, if they have completed the vaccination course for at least 14 days, will have to observe the measurement of the active health surveillance from the last exposure to the case, and not the quarantine.

Should anyone who traveled with a positive person go to quarantine?

If the trip was by car, the answer is yes. For airplanes, however, unless otherwise specified by the health authorities, passengers who were two rows away from the positive do not have to stop. The provision is from the Ministry of Health.

What should someone who has had a “close contact” but is negative on a first test do?

Quarantine cannot be avoided. All those who have come into contact with a positive must stop even if after 24 or 48 hours they take a swab that gives a negative result. The valid test to exit the quarantine can be done after 7 days (for vaccinated with two doses) or after 10 for all the others.

How should family members of a quarantined person behave?

The ministry recommends taking protective measures at home as well: you should keep the mask at home and never eat with the person in quarantine. The person who has come in contact with a positive must sleep alone and use only one room. When using the bathroom, he should clean it and possibly not share it with other people in the household.

At the end of the quarantine what to do to return to work?

At the end of the quarantine period, of 7 or 10 days, if no symptoms have appeared, the person can return to work after having performed a test and the period of absence is covered by the certificate. If symptoms appeared during the quarantine, you should notify your doctor. The Department of Public Health, which deals with health surveillance, will carry out the swab for the search for Covid-19. In the event of a positive outcome, it will be necessary to wait for clinical recovery and perform a molecular test after at least 3 days without symptoms. If the molecular test is negative, the person will be able to return to work, otherwise the isolation will continue.

Positivity

I tested positive in a molecular or antigen test for SARS-CoV-2, I’m not a Beta variant case, what should I do?

the asymptomatic people tested positive for SARS-CoV-2 that have not been identified as VOC Beta cases, may re-enter the community after a isolation period of at least 10 days starting from date of collection of the positive swab, at the end of which it is executed a molecular or antigen test with negative result.

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the symptomatic people tested positive for SARS-CoV-2 that have not been identified as VOC Beta cases, may re-enter the community after a isolation period of at least 10 days from the onset of symptoms accompanied by a molecular or antigen test with negative result performed after at least 3 days without symptoms (not considering the alterations of smell and taste). In case of further positive finding of the diagnostic test performed after 10 days from the onset of symptoms or from the positive swab in the asymptomatic, it is advisable to repeat the test after 7 days (17th day).

I am a long-term positive case of non-Beta variant, I have had symptoms, what should I do?

COVID-19 cases not identified as VOC variant cases (“variant of concern“) Betas that continue to be positive in the molecular or antigen test for SARS-CoV-2, if they have had no symptoms for at least 7 days (not considering the alterations of smell and taste), they will be able stop isolation at the end of the 21st day.

I am a long-term positive case of Beta variant, what should I do?

SARS-CoV-2 cases identified as cases of VOC Beta variant, suspected or confirmed, both symptomatic and asymptomatic, will be able to stop isolation only afternegative molecular test occurred.

The end of the isolation / quarantine period may be certified, depending on the organization adopted by the individual Regions, by the Doctor of the Prevention Department or Public Hygiene Service of the ASL competent for the area, by the General Practitioner or by the Pediatrician of free choice.

Buffers-validity

If you discover that you have been in contact with a positive person or fear infection from Covid-19, it is important to choose the right day to take a test. Depending on how long it has been since the hypothetical Sars-Cov-2 infection, the different types of tests have a different probability of being false negative (i.e. the person is infected but tests negative).

The most reliable test is the molecular swab, which is quite accurate (90-95%) as early as the third day following exposure to the virus. Molecular positivity rates remain fairly reliable even after two weeks.

The rapid antigen test, i.e. almost all those made in pharmacies, are generally less reliable (60-70%) and they have a window that goes from the fourth to the tenth day following the infection. If done before, or after, they have very high false negative rates.

Finally, the serological test (the one performed by blood sampling), is able to detect the presence of IgM antibodies starting from the 9th day up to one month after the infection and the IgG antibodies from the third week onwards.

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