Isolation instructions for COVID-19

What is self-isolation?

Self-isolation prevents the spread of COVID-19. Self-isolation means staying at home, avoiding contact with other people including those in your household if possible, and only leaving home for independent exercise or for critical reasons, like a medical emergency or urgent medical care. The duration and instructions for self-isolation are different for each individual who may have been exposed to COVID-19. The self-isolation instructions are based on a combination of each individual's age, symptoms, test results, vaccination status, place of work or residence, general health and travel history.

Last updated: October 3, 2022

Isolation instructions for COVID-19 and what to do after your COVID-19 test

The self-isolation instructions for those who have COVID-19 or are exposed to it may be different based on factors such as severity of illness, general health, travel history, and living or working in highest-risk settings.

What best describes you?

I have symptoms of COVID-19 or have tested positive on a PCR or rapid antigen test 

Scenario A - High risk 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).
  • Living in a highest risk setting.
  • Hospitalized for COVID-19 related illness but NOT requiring intensive care unit (ICU) level of care [See instructions in Scenario B for those who require ICU level of care].

You should self-isolate and follow these instructions:

  • 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.
  • Employees working in highest-risk settings should report their exposure and follow their workplace guidance on return to work.
  • Download our tested positive letter with instructions

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:

  • 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.
  • Download our tested positive letter with instructions

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 (i.e., seniors)
    • Avoid non-essential visits to any highest risk settings.
    • Employees working in highest-risk settings should report their exposure and follow their workplace guidance on return to work.
  • Download our tested positive letter with instructions

If you are working in a highest risk setting:

  • Speak to your employer and follow your workplace guidance for returning to work. For routine operations, you may return to work 10 days from the date your symptoms started or the date of your positive test, if available (whichever is earlier). 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.

If you do not meet the criteria above, follow the additional instructions in Scenario A or B, if applicable. 

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:

  • 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 RAT), 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.
  • 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:

You should follow these instructions:

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?

More information on travel is available from the Government of Canada travel website.

Related topics

Do I need to report my positive test result 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 must follow self-isolation instructions.

Please note, you do not need a confirmatory PCR test if you tested positive for COVID-19 on a Rapid Antigen test. It is not necessary to report positive Rapid Antigen test results to OPH.

Why am I still testing positive following isolation?

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. Note that individuals who develop new symptoms of COVID-19 should complete the provincial screening tool and follow the isolation and mask use instructions provided.


Rapid Antigen Test (RAT) after infection:
If a person tests positive using a RAT, with or without symptoms, 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.

After testing positive for COVID-19 on either a PCR test or RAT, individuals can begin participating in RAT screening programs (e.g., workplace programs that test for COVID-19 infection regularly in those without symptoms) 30 days after the initial COVID-19 infection. If the person develops new symptoms of COVID-19 during the 30 day period following a positive RAT, consult a health care provider to help with the decision on whether to do further testing. Note that 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

I have symptoms and I have done a RAT that is positive

You are no longer required or encouraged to get a confirmatory PCR or rapid molecular test. It is not necessary to report positive Rapid Antigen test results to OPH.

If you test positive from a rapid antigen test or are presumed positive based on your symptoms, see isolation instructions. 

You should also reach your close contacts by providing them with the close contact letter (this document is not in an accessible format). Individuals who are eligible for a lab-based PCR test are encouraged to get tested.

I have symptoms and I have done a RAT that is negative

Regardless of your test result, please follow the isolation instructions for those who have symptoms. 

If you are required to isolate as a close contact of COVID-19, please complete your isolation period.

You should also reach your close contacts by providing them with the close contact letter (this document is not in an accessible format). Individuals who are eligible for a lab-based PCR test are encouraged to get tested.

I do not have symptoms and I have done a RAT that is positive

You are no longer required or encouraged to get a confirmatory PCR or rapid molecular test. It is not necessary to report positive Rapid Antigen test results to OPH.

If you test positive from a rapid antigen test or are presumed positive based on your symptoms, see isolation instructions.

You should also reach your close contacts by providing them with the close contact letter (this document is not in an accessible format). Individuals who are eligible for a lab-based PCR test are encouraged to get tested.

I do not have symptoms and I have done a RAT that is negative

You do not need to self-isolate unless you are isolating because of a close contact (and meet the criteria for self-isolation).

I have symptoms but I tested negative on a PCR test. Do I (and my contacts) still need to isolate?

People who have symptoms that are eligible for testing and test negative on a PCR test may discontinue isolation once symptoms have been improving for 24 hours (or 48 hours for gastrointestinal symptoms such as vomiting or diarrhea) unless you also meet isolation criteria for close contacts. If you are a close contact and are required to self-isolate, you should complete your required isolation even with a negative PCR test. 

Accessing medical care during self-isolation

You should follow the self-isolation requirements. This is the law. However, there may be exceptions in certain situations.

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). You can break isolation in order to seek urgent medical care.

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 are COVID-19 positive or isolating due to symptoms or being a close contact. For non-emergency situations where you need medical help, visit a COVID-19 Care Clinic.

Isolation may also be broken to attend essential medical appointments with a healthcare professional that cannot be delayed, such as attending appointments for newborns 24-72 hours after discharge from hospital. Please discuss this with your healthcare provider before attending your appointment.

Outdoor exercise during self-isolation

You may leave your home for outdoor exercise by yourself or with a caregiver. You should maintain physical distance of at least two metres (six feet) from others at all times and wear a mask in common areas when leaving if you live in an apartment building, condo, or hotel. You should not go to outdoor fitness classes or personal training sessions. Do not attend any indoor fitness activities. 

Definitions

Close contact 

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 setting

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

Symptoms of COVID-19

As molecular testing (PCR and rapid molecular testing) is prioritized for those at increased risk of severe outcomes and those living and working in highest risk settings, molecular testing is no longer being recommended for all individuals in the community with symptoms of COVID-19. People who have symptoms and are not eligible for PCR testing are presumed to have COVID-19 and should follow these self-isolation instructions.

COVID-19 symptoms 

Type

Symptoms

(new or worsening, and not related to other known causes or conditions you already have)

Most common symptoms of COVID-19 

  • Fever and/or chills (Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher.)
  • Cough or barking cough (croup) (Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, COPD).)
  • Shortness of breath (Out of breath, unable to breathe deeply (not related to asthma).)
  • Decrease or loss of taste or smell (Not related to seasonal allergies, neurological disorders.)

Other symptoms of COVID-19

 

 

  • Sore throat (Painful swallowing or difficulty swallowing (not related to seasonal allergies, acid reflux, post-nasal drip).)
  • Runny or stuffy/congested nose (Not related to seasonal allergies, being outside in cold weather, chronic sinusitis unchanged from baseline.)
  • Muscle aches/ Joint pain (That is unexplained or unusual (not related to related to a sudden injury, fibromyalgia, or receiving a COVID-19 vaccine the past 48 hours).)
  • Headache (New and persistent, unusual, unexplained, or long-lasting (not related to tension-type headaches, chronic migraines, receiving a COVID-19 vaccine in the last 48 hours).)
  • Gastrointestinal symptoms (vomiting/diarrhea)
  • Extreme tiredness, lack of energy or feeling unwell (That is unusual or unexpected (not related to other known causes or conditions or receiving a COVID-19 vaccine in the past 48 hours).)

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