4 COVID-19 Questions: I've been exposed to COVID-19. What should I do?

Have I been exposed to COVID-19? What do I need to do about it?

When COVID-19 was just beginning to spread, little was known about how people became infected. Could you get it from your groceries? What about the clerk at the hardware store or the person who delivers my pizza? Now that scientists understand more about how COVID-19 is transmitted, it’s easier to identify when a person has been exposed to the virus.

What is close contact?

In most cases, exposure to COVID-19 involves close contact with an infected person. Close contact is defined as being less than six feet away from an infected individual for more than fifteen minutes. There are some caveats to this. If an unmasked, infected person coughs or sneezes in the direction of your face, this would be considered close contact.

In general, knowing someone in your workplace that was diagnosed with COVID-19 does not mean you have been exposed and need testing. Even if you use the same bathrooms or break room as this person, testing is not required unless you have had close contact. Instead, it is important to monitor your symptoms. If you develop a fever, a new cough, or loss of taste or smell, you should pursue diagnostic testing.

Where infection really happens

Contrary to reports you may have heard in the media, most transmission of COVID-19 is taking place among people who live together and have close interactions. Outside of some professional services that require close, in-person contact like the dentist, healthcare workers, and hairdressers, most people do not have “close contact” at work or in regular consumer settings like stores or restaurants. What this means is that the most likely source of infection is those that you live with and are close to like family, friends, roommates, and significant others.

A study from the Guangzhou Center for Disease Control and Prevention in China published in the medical journal Annals of Internal Medicine¹ looked at 3,410 contacts of 391 patients that tested positive. 127 of those contacts became infected, and almost all of the secondary infections occurred at home.

This study also found that people who had limited symptoms rarely caused additional infections. In fact, only 1 of the 305 asymptomatic cases was found to be the source of another infection. Most of the additional infections were caused by people with mild to severe symptoms. The most important predictor of a person's ability to spread COVID-19 was fever and a wet or productive cough. For individuals with these two symptoms, the infection was 10-20 times more likely to spread to others.

What does all of this mean?

It isn't likely that you'll get infected with COVID-19 by going to the grocery store or working in the same office building as someone who has been infected. Most cases of COVID-19 infection occur from close contact with individuals who are already showing COVID-19 symptoms. If you have been in close contact with someone who has tested positive for COVID-19, the CDC recommends that you quarantine for 14 days following exposure and monitor for symptoms of COVID-19.

What now?

COVID-19 is a new virus. It’s normal to feel confused, especially when the messaging is often conflicting and biased. At MedHelp, we’re here for you when you have questions about your health. Established patients are always welcome to contact their physician with any questions they may have and receive an answer in about 24 hours.

Read the next post in our series, What about Herd Immunity?

References:

¹Luo L, Liu D, Liao X, et al. Contact settings and risk for transmission in 3410 close contacts of patients with COVID-19 in Guangzhou, China. A prospective cohort study. Ann Intern Med. 2020. [Epub ahead of print]. 13 August 2020. doi:10.7326/M20-2671