COVID-19 Isolation Management for Schools, Workplaces, and Childcare

Posted October 14, 2020. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.


Note: This guidance only applies to settings outside the healthcare environment. For healthcare settings, please refer to Criteria for Return to Work for Healthcare Personnel with SARS-CoV-2 Infection (Interim Guidance)

New guidance has been issued by the Washington State Department of Health (DOH) to be used by school, childcare and workplace staff and by healthcare providers to help guide patients’ return to school/work following a positive symptom screen for COVID-19 with no known exposure to a COVID-19 case. The new guidance can be found here.

This guidance only applies to people without known exposure. People with known exposure should quarantine for 14 days from last contact to an infectious COVID-19 case, regardless of mask usage and test result post-exposure. People who are household contacts of a COVID-19 case must quarantine, in general, for 24 days from symptom onset of their COVID 19 -positive household member (10 days of their infectious period plus another 14 days from the last day of their infectious period), unless they are able to separate completely from each other. People with known exposure and symptoms should be tested soon after symptom onset.

When the COVID-19 rate in the community is moderate to high (>25 cases/100,000 population over 14 days), such as in Spokane County, the guidance applies to persons with one or more new, unexplained symptom(s)consistent with COVID-19 and no known exposure. Symptoms are broken down into two classes:

  • Class A symptoms: fever, cough, loss of sense of smell and/or taste, shortness of breath.
  • Class B symptoms: fatigue, headache, muscle/body aches, sore throat, congestion/runny nose, nausea or vomiting, or diarrhea (defined as two or more loose stools within a 24-hour period).

Any class A symptom (of any duration) should result in isolation for 10 days from onset of symptoms, unless:

  • The person tests negative for COVID, or
  • Has an alternative* condition diagnosed by a healthcare provider.
  • If a COVID test is done and is negative, the person must isolate until 24 hours after fever resolves without the use of fever-reducing medication and symptoms have improved, or per condition diagnosed by healthcare provider, whichever is longer.

Two or more class B symptoms (of any duration), or any class B symptom lasting more than 24 hours, should result in isolation for 10 days from onset of symptoms, unless:

  • The person tests negative for COVID, or
  • Has an alternative* condition diagnosed by a healthcare provider.
  • If a COVID test is done and is negative, the person must isolate until 24 hours after fever resolves without the use of fever-reducing medication and symptoms have improved, or per the condition diagnosed by healthcare provider, whichever is longer.

In symptomatic persons and when community transmission is moderate-high (as it is currently in Spokane County), a negative molecular rapid test (such as the Abbott IDNOW or the Cepheid Xpress) should be confirmed with a PCR test performed in a clinical laboratory when COVID is highly suspected. Negative rapid antigen tests in symptomatic individuals should also be repeated with a laboratory-based PCR. See CDC Interim Guidance for Rapid Antigen Testing for COVID-19.

DOH and SRHD continue to recommend that exposed individuals be tested for COVID-19, regardless of presence or absence of symptoms. Specimen collection should ideally occur five to seven days after exposure, and no sooner than 48 hours after exposure. A negative test does not negate the need for an exposed individual to continue and complete their quarantine period.

Current community COVID-19 rates are maintained here.

*Examples of alternative diagnoses made by a healthcare provider include childhood rash illness, acute otitis media, or a laboratory-confirmed diagnosis such as strep throat or non-COVID-19 viral pathogen. If testing for other viral pathogens, DOH strongly recommends testing for COVID-19 as well.