[MUSIC PLAYING] SPEAKER: So now, let's be very clear and define what we mean by case, contact, isolation, and quarantine. Those are important concepts that you'll have to really understand well throughout the rest of the course. So let's define what a case is, and what a contact is. A case of someone who has COVID-19, someone who could infect others, usually this is defined by a positive laboratory test, a PCR test usually, and we've already discussed that. Sometimes we may refer to cases that are suspect or probable cases, which means they may not have had a test yet, but we think they probably have the disease. So that could be someone that you know was exposed to another infectious patient, so you think they probably have it, but they just haven't had their test yet, but sometimes we refer to them as cases as well. So a contact is someone who had contact with a case while they were infectious. So basically, this is someone who's been exposed to someone who was infectious. And we care about contacts, because they could have been infected. And because of that, they need to take special precautions. So if you'll recall, a case is infectious during their illness, and the two days before their illness began. So you'll want to identify people who had some kind of contact with them during their infectious period. I mean, we talk about contacts, there are really three different kinds of contacts that you could think about. The first is direct physical contact. So anyone that had physical contact with someone who is infectious is at risk for infection. They are definitely a contact. We also talk about close contacts. And I want to define what a close contact means. So this means someone who may not have had any physical contact at all, but was close to the person who's infectious. They were within 6 feet of this person for at least 15 minutes or more. Now, 15 minutes is just a guideline. In some places, they'll ask about close contacts who were nearby the case for 10 minutes or more, or maybe 30 minutes or more. So there's some flexibility there. You'll need to talk with your jurisdiction, where you're working, to figure out exactly how they're defining those contacts. But this is the basic idea that you're nearby the person who's infectious for at least some period of time, and you're within 6 feet, which if you'll recall, is the distance that respiratory droplets can travel. There's a third type of contact that you may also want to think about, and those are people who have been in the same room for an extended period, maybe an hour or more with the infectious person, but they were more than six feet away. So sometimes these people could also be at risk. They may have had contact with the same surfaces, for example, of someone who is infectious. These are called proximate contacts, and sometimes you'll also be looking for these types of contacts when you're doing contact tracing. Now, let's define what we mean by isolation versus quarantine. Both of these terms mean that someone is going to distance themselves from other people. Someone is going to stop having contact with other people. But they mean slightly different things, so let's be clear about these. Isolation means keeping sick people separate from others, from healthy people, or any other person. This can be done with in home, so you can restrict yourself to your home. If you live with other people, you would also need to keep from having contact with other people even within the home. If you're unable to do that within your home, then you may need to go somewhere else to isolate yourself from other people. In some places, people may go to a hotel, or find another place where they can be separate from others. In hospitals, patients will have to have a separate space and have very limited contact with anyone else except health care workers who are wearing the appropriate masks, gloves, and gowns to keep them safe. How long should someone isolate from other people? Well, it should be for the duration of their infectiousness. And as we've already discussed, that will start two days before the onset of their illness, and it will last through the duration of their illness. Some people are sick longer than others, so their infectious period will be longer than others too. But in general, we would say that someone can stop isolating themselves from others safely if it's been at least 10 days after the onset of their illness, all of their symptoms are improving, and they haven't had any fever within the past three days, and this means that they haven't had fever in the past three days, and they also have not been taking medicines to suppress their fever for the past three days. So it's important to check that. So quarantine means restricting the movement and contact of healthy people who've been exposed with other people. So we isolate a case, but we quarantine contacts, because they've been exposed, and they could become infectious. Contacts should be quarantined for 14 days since the last contact they had with the infectious patient, the person who may have infected them. So it's important to know when their contact was to be able to figure out how long they need to quarantine. [MUSIC PLAYING]
