Isolation instructions for COVID-19

Scenario A - High risk immunocompromised groups

This applies to you if you are:

• Immunocompromised (including receiving cancer chemotherapy, untreated HIV infection with CD4 T lymphocyte count <200, combined primary immunodeficiency disorder, taking prednisone >20 mg/day [or equivalent] for more than 14 days and taking other immune suppressive medications).

You should self-isolate and follow these instructions:

• You may be infectious for longer and are generally recommended to isolate for 20 days from the date your symptoms started or the date of your positive test if available (whichever is earlier) AND until your symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms such as vomiting or diarrhea) and you do not have a fever.
• Speak to your employer and follow your workplace guidance for returning to work.

Scenario B - Severely ill individuals

This applies to you if you are:

• Severely ill (requiring ICU level of care)

You should self-isolate and follow these instructions:

• You may be infectious for longer and are generally recommended to isolate for 10 days from the date your symptoms started or the date of your positive test if available (whichever is earlier) AND until your symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms such as vomiting or diarrhea) and you do not have a fever.
• Speak to your employer and follow your workplace guidance for returning to work.

Scenario C – Other individuals with COVID-19 symptoms or a positive test result

This applies to you if you are:

• Not listed above

You should self-isolate and follow these instructions:

• Isolate until symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms such as vomiting or diarrhea) and you do not have a fever.
• If you have a positive test result and no symptoms, you do not need to self-isolate unless symptoms develop, but you should follow the precautions below. If you develop symptoms, self-isolate immediately.

• For a total of 10 days after the start of symptoms (or date of positive test result, whichever is earlier), you should:
• Continue to wear a well-fitted mask in all public settings.
• Wear a mask as much as possible in public settings, including school and child care, unless under 2 years old (24 months). Exceptions would include removing the mask temporarily for essential activities like eating (e.g., when eating in shared space at school/work while maintaining as much distance from others as possible). 
• You can participate in activities where a mask is worn but you should avoid non-essential activities where removing the mask would be necessary (e.g., dining out, playing a wind instrument, high contact sports where masks cannot be safely worn).
• People who are exempt from masking (e.g., children under two years of age (24 months), etc.) may return to public settings without wearing a mask
• Not visit anyone who is immunocompromised or at higher risk of illness (e.g., seniors)
• Avoid non-essential visits to any highest risk settings. Where visits cannot be avoided, you should wear a medical mask, maintain physical distancing, and notify the highest risk setting of your recent illness/positive test. The person you are visiting should also wear a mask if they are able to.

If you are working in a highest risk setting:

• Follow setting specific guidance for self-isolation. If there is no setting-specific guidance, follow the instructions above in Scenario C. 

If you are working in a highest risk setting:

• Speak to your employer and follow your workplace guidance for returning to work. In general, you may return to work in a highest risk setting after self-isolating as above. Follow measures to reduce the risk of transmission for 10 days after the date your symptoms started, or the date of your positive test (whichever is earlier) including:
• Avoiding caring for patients/residents at highest risk of severe COVID-19 infection, where possible
• Ensuring well-fitting source control masking (e.g., a well-fitting medical mask or fit or non-fit tested N95 respirator or KN95)
• Reviewing PPE and IPAC practices, where possible
• Taking unmasked breaks in a separate breakroom, or with physical distancing, to avoid exposing co-workers
• Working on a single ward or area of the setting as much as possible
• Working in a single facility, as much as possible

• If you have symptoms, continue to isolate until your symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms such as vomiting or diarrhea) and you do not have a fever.

I was exposed to someone who has symptoms or tested positive for COVID-19

Scenario A - Close contacts who DO NOT live in a highest risk setting

This applies to you if you are:

• A close contact who does not live in a highest risk setting. This includes close contacts who live at home with the person who has symptoms or tested positive for COVID-19 and those who were exposed outside of the home.

You should follow these instructions:

• You are not required to self-isolate if you do not have symptoms. 
• If you develop symptoms of COVID-19, you should assume that you are positive for COVID-19 and follow these self-isolation instructions.
• For a total of 10 days after the last contact with the person who has symptoms or tested positive for COVID-19 (on a PCR or rapid antigen test), you should:
  • Self-monitor for symptoms and self-isolate immediately if you develop any symptom of COVID-19. Follow the instructions above if you have tested positive on a PCR or rapid antigen test or have symptoms of COVID-19.
  • Continue to wear a well-fitted mask in all public settings
    • Wear a mask as much as possible in public settings (including school and child care, unless under 2 years old). Exceptions would include removing the mask temporarily for essential activities like eating (e.g., when eating in shared space at school/work while maintaining as much distance from others as possible). 
    • You can participate in activities where a mask is worn, but you should avoid non-essential activities where removing the mask would be necessary (e.g., dining out, playing a wind instrument, high contact sports where masks cannot be safely worn).
    • People who are exempt from masking (e.g., children under two years of age, etc.) may return to public settings without wearing a mask
• Not visit anyone who is immunocompromised or at higher risk of illness (i.e., seniors).

• Avoid non-essential visits to any highest risk settings. Where visits cannot be avoided, you should wear a medical mask, maintain physical distancing, and notify the highest risk setting of your recent exposure. The person you are visiting should also wear a mask if they are able to.

• Employees working in highest risk settings should report their exposure and follow their workplace guidance.

If you are working in a highest risk setting:

• Speak to your employer and follow your workplace guidance for returning to work.

Scenario B - Close contacts who live in a highest risk setting

This applies to you if you are:

• A close contact who lives in a highest risk setting.

You should follow these instructions:

• You should follow the self-isolation guidelines of the highest risk setting. Speak to your facility operator.
• If you develop symptoms continue to self-isolate and get a PCR test if you are eligible. Follow the instructions above if you have tested positive on a PCR or rapid antigen test or have symptoms of COVID-19.

I developed COVID-19 symptoms after receiving Paxlovid treatment

If you develop COVID-19 symptoms 2-8 days following Paxlovid treatment for COVID-19, re-start your self-isolation from the day you developed rebound symptoms until your symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms such as vomiting or diarrhea) and you do not have a fever. 

I travelled internationally, what are the federal quarantine rules?

It is not necessary to report positive rapid antigen test results to OPH. People who have symptoms or test positive on a rapid antigen test and are not eligible for PCR testing are presumed to have COVID-19 and should follow self-isolation instructions.

Rapid Antigen Test after infection:
If a person tests positive using a rapid antigen test, they should follow isolation and mask use guidelines until they have completed the required self-isolation period and symptoms have been improving for 24 hours, even if a test repeated within the isolation period is negative.

Some people may have positive rapid antigen tests for up to 30 days. If someone develops symptoms of COVID-19, they should follow self-isolation instructions. If the person develops new symptoms of COVID-19 during the 30-day period following a positive rapid antigen test, consult a health care provider to help with the decision on whether to do further testing. Individuals who develop new symptoms of COVID-19 should complete the provincial screening tool and follow the isolation and mask use instructions provided. 

PCR Test after infection:
Continuing to test positive after recovery from COVID-19 infection is common. Some people still testing positive on a PCR test for weeks or months after their initial infection. This is because the PCR test is detecting viral remains that are no longer living and unable to cause infection. This means you are no longer contagious. Therefore, it is not recommended that individuals without symptoms undergo PCR testing for at least 90 days after the initial COVID-19 infection. If the person develops new symptoms of COVID-19 within that 90 day period, consult a health care provider to help with the decision on whether to do further testing. If you develop symptoms of COVID-19, you should follow should follow self-isolation instructions, regardless of test result. Individuals who develop new symptoms of COVID-19 should complete the provincial screening tool and follow the isolation and mask use instructions provided. 

Frequently Asked Questions about Rapid Antigen Testing (RAT) and PCR tests

• How to collect a sample for a rapid antigen test (RAT) 

Accessing medical care during self-isolation

If you have symptoms, you should should follow self-isolation instructions.

However, there may be exceptions in certain situations, such as needing to seek urgent medical care, or attending essential medical appointments with a health care professional that cannot be delayed (e.g., for newborns 24-72 hours after discharge from hospital). Please discuss this with your healthcare provider before attending your appointment.

If you are in distress, go to the nearest Emergency Department or call 9-1-1 (experiencing significant trouble breathing, chest pain, fainting, or have significant worsening of any chronic disease symptoms).

Note that urgent medical care includes babies under 3 months of age with a fever who should be seen by CHEO or the nearest emergency department. Be sure to tell the hospital you tested positive for COVID-19 or isolating due to symptoms.

Outdoor exercise during self-isolation

Close contact is someone who was in close contact with a person who had symptoms or tested positive for COVID-19 during the time they could transmit the virus to others (period of communicability). A person’s period of communicability is 48 hours before their first symptom started, or 48 hours before their test date (if they have no symptoms) until their self-isolation period has ended. Close contact is being within two meters (six feet) of a person who had symptoms or tested positive for COVID-19 for more than a brief encounter or having multiple close encounters, without adequate protection. See our Masks page for more information on using masks.

Some examples of high-risk situations include:

• Physical contact such as shaking someone’s hand, hugging kissing, being sneezed or coughed on
• Living in the same household (this excludes individuals who live in a completely separate unit such as a self-contained basement apartment)
• Providing care to someone (e.g., taking care of an elderly parent).

Please share this close contact letter to anyone you were in close contact with, beginning 48 hours before your symptoms started (or 48 hours before your positive result, if you have no symptoms), up until you started self-isolating. (This document is not in an accessible format.)

Return to self-isolation instructions

Highest risk settings include:

• Acute care settings such as hospitals, including complex continuing care facilities. 
• Congregate living settings, including, Long-Term Care, retirement homes, First Nation elder care lodges, group homes, shelters, hospices, correctional institutions and hospital schools.
• Employer-provided living settings of international agricultural workers.

Return to self-isolation instructions

Last contact

Last contact refers to the last day the close contact was exposed to the person who is isolating with COVID-19 symptoms, or with a positive COVID-19 test result:

• If the person with symptoms or with a positive COVID-19 test result is unable to effectively self-isolate in the home, household members would have ongoing exposure until the end of  the individual’s isolation period.
• If there is ongoing exposure, the last day of exposure to the person who has symptoms or tested positive for COVID-19 is the last day of the isolation period of the person who has symptoms or tested positive for COVID-19.

For example, if a child with COVID-19 was self-isolating from Monday to Saturday, the ‘last contact’ for the parent who was caring for the COVID-19 positive child would be Saturday.

Return to self-isolation instructions