COVID-19 Information

Our COVID-19 Response Plan

Advanced Pediatrics is committed to providing quality and essential medical care to our patients during the coronavirus pandemic. We are following the guidance of the Center for Disease Control (CDC), Virginia Department of Health (VDH), the Commonwealth of Virginia, and the American Academy of Pediatrics (AAP) to inform and update our policies to keep our office safe for our patients and families.

We are taking the coronavirus and the disease that it can cause (COVID-19) seriously. We are adamant supporters of physical distancing and have dramatically changed our clinic processes so that we can provide essential care to all of our patients without putting anyone at undue risk.

Due to the changes made to the Covid-19 Vaccines, please call our office to verify which vaccine is needed.

Please have your child's vaccine history on hand to schedule an appointment.

Here's our plan in a nutshell:

Contact us First for All Appointments.

In-person Walk-In Clinic is Closed

All On-site visits (including Flu Shots) are by Appointment.

Schedule your child's COVID vaccine through our on-line scheduler.

Call to speak with our staff if seeking additional advice, wanting to schedule a well visit or other visit for a healthy child, or if preferring to schedule a parking lot of telemedicine visit for a sick child.

Well Child care has been separated from sick patient care.

Care will be provided in different locations. Care of well children will be in the clinic or via telemedicine. Care of possible COVID patients will be via telemedicine with drive thru testing and curb-side exams as needed.

Care will be provided by separate providers & staff who will all wear the appropriate personal protective equipment (PPE) and not cross over from sick patient to well child care.

Office Visit Policies.

Reserved for healthy patients only: Check-ups, flu shots, COVID shots and select sick patient visits that carry no COVID risk.Pre-Visit COVID Screening. All households will be screened for the presence of COVID symptoms or a known exposure in the 10 days prior to the visit. They will be screened at the time the appointment is made, 1-2 days prior to the visit and then again upon arriving at the clinic.

Masks required for everyone over the age of 2. All of our staff will be wearing a mask and those involved in direct patient care will also be wearing eye protection.

Siblings may present with a patient if getting a flu or COVID vaccination or due to childcare issues. Physical distancing in the clinic made easier by less overall traffic in the clinic as compared to normal.

Limited waiting room. It is our goal to room patients immediately upon arrival to the clinic. Heightened cleaning efforts. We are cleaning the clinic throughout the day with particular attention given to high touch surfaces and each clinic room is cleaned before and after use. You will also notice that all books and toys have been removed from the clinic.

Vaccinated staff. Our entire staff from the door screeners, front desk staff, nurses, lab technicians and all of the providers have been vaccinated against COVID-19 and the majority have been boosted. We strongly recommend the COVID-19 vaccination (Pfizer or Moderna) and boosters for everyone eligible.

Telemedicine has been the silver lining of the pandemic and is appropriate for sick and well patients.

It is ideally suited for evaluation of chronic, recurrent issues and mental health concerns. It is appropriate for evaluation of sick visit reasons that may only require a virtual exam.

It is the essential first step in evaluating patients with COVID like symptoms while not putting the rest of our patients at risk. Learn more about telemedicine at Advanced Pediatrics.

Parking Lot Visits for Exams & Testing of COVID suspect patients.

Outdoors where the ventilation is best.

Isolated to the back parking lot where there is no overlap with families presenting for well child care.

Performed by designated staff in the appropriate PPE.

Park in designated spots & text office upon arrival.

Additional information about COVID testing.

Testing Follow-up for COVID.

All COVID test results are placed on the portal for easy and quick access.

Portal message includes links to webpage information about what to do next

Follow-up telemedicine visits can also be scheduled if you call the clinic.

COVID Vaccination at Advanced Pediatrics

We strongly recommend and are proud to offer the COVID vaccine and boosters (if eligible) for all children aged 6 months and older.

There are two ways to get your child the COVID vaccine at our clinic:

1. NEW! Add it on at a clinic visit. Just come for your visit scheduled for another reason (for example, a check up, a consult or med refill visit) and we can give the COVID vaccine as part of the the visit. This applies for all COVID shots (primary series & boosters).
2. Use the on-line scheduler to set up a dedicated COVID vaccine visit. We have set times when you can bring your infant, child or teen in for a COVID vaccine visit. Check back weekly for additional appointment times as we will add additional slots as staffing and vaccine supply allow.

If neither of these options work for you, check www.vaccines.gov to schedule the vaccine at another location.

Did you know that:

We strongly recommended the COVID vaccine (and boosters if eligible) for children aged 6 months and older.

Our providers have vaccinated their children.

We strongly recommend the booster for everyone who is eligible.

100% of the Advanced Pediatrics staff is fully vaccinated vs. COVID.

Widespread vaccination is a critical tool to help stop the pandemic.

Drive Thru COVID Testing at Advanced Pediatrics

We have rapid and PCR COVID drive-thru testing available for patients and their families.

As supply & staffing allow. All Testing Billed to Insurance.

Call during available hours if your child is sick, had a positive home test, or had a possible COVID exposure.

You will have a telemedicine visit with your child's doctor. Medical advice, testing, isolation and quarantine in addition to return to school and return to sports guidance will be discussed as well. The provider can order testing for your entire family if appropriate and as staffing & test supply allow.

Drive thru testing will be ordered, typically same day. When you arrive for the test visit pull around back & text the office, a designated staff member wearing appropriate PPE will meet you at the designated parking spots in the back lot and collect the sample outside.

You will then be notified of the results via the portal. You will be referred to our COVID Guidance patient education webpage for information on isolation, symptom control, Return to School & Sports and guidance on how to handle household contacts. Log-in to theVirtual COVID clinic again if seeking additional support. Call the clinic if you are concerned about your child. Rapid results available same day, PCR results available within 1-3 days (may be longer during the omicron surge).

We are proud to offer multiple types of COVID testing:
The Rapid Antigen COVID test is performed on a swab of the nose (no deep swabs needed) and detects the presence of the spike protein unique to SARS-Cov 2 virus. These results are available within an hour. If positive, SARS-COV 2 is present and you have COVID. It can miss positive cases, however and a PCR test should be sent to confirm a negative result.
The Rapid Molecular COVID test is performed on a swab of the nose (no deep swabs needed) and detects the presence of the genetic material (RNA) unique to SARS-Cov 2 virus. These results are available within an hour. If positive, SARS-COV 2 is present and you have COVID. It can miss positive cases, however and a PCR test should be sent to confirm a negative result.
The PCR COVID test uses a swab of the nose (no deep swabs needed) and detects the presence of genetic material of the SARS-Cov 2 virus. It is considered the gold standard diagnostic test for COVID-19. If it is positive, you have COVID. Results are typically available in 1-3 days (may be longer during the omicron surge).

COVID-19 Parent Resources

What is Coronavirus?

Coronaviruses are a large family of viruses that are common in people (and some animals) and frequently cause the common cold. There is currently a world-wide outbreak of a new strain of the coronavirus. This virus appears to cause mild illness in most people who are infected, but it has caused serious respiratory problems in some elderly, chronically ill, and immuno-compromised people. The virus has been named “SARS-CoV-2” and the disease is called “coronavirus disease 2019” (aka “COVID-19”). Learn more from the CDC and the WHO.

What are the symptoms of coronavirus?

The symptoms of coronavirus include fever, cough and shortness of breath, similar to the flu. Some individuals will have sore throat, nausea and diarrhea as well. Children with COVID-19 generally have cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported. Reported illnesses have ranged from mild symptoms to severe illnesses that chest pain, blood clots and inflammation of the heart.

Is my child at risk for coronavirus?

Yes, children as well as adults are at risk of illness from SARS-COV-2. Getting vaccinated is the best thing to do to reduce the risk of serious disease or severe complications from COVID.

What can I do to protect my family and child from COVID-19?

COVID-19 is thought to spread mainly from person-to-person, between people who are in close contact with one another and through respiratory droplets produced when an infected person coughs or sneezes.

To prevent the spread of illness, wash your hands frequently and avoid touching your eyes, nose and mouth. You should also practice physical distancing (6 feet apart) and it is advised that you avoid large group gatherings. If meeting up with others, do so outdoors. Also remember that wearing a mask keeps your germs to yourself and wearing one shows respect to others in your community. Always wear one indoors and use it outdoors as needed. Finally, we encourage everyone age 5 and older to get vaccinated and boosted when eligible. The vaccine is our best shield against serious disease and persistence of the pandemic.

Is it safe to send my child to daycare or preschool?

We have learned a lot in the past year about COVID and transmission amongst children in daycare settings. Generally speaking, we did not see a lot of outbreaks in daycare settings during the delta wave. Anecdotally speaking, we have seen cases cluster in daycares during the omicron surge in Dec-Jan 2021/2022. The decision to send your child to daycare should be a calculated one. Click here to read some important considerations when making this decision.

Is it safe to have playdates?

Many families have been asking this question. All in all, we encourage you to budget your exposure risks with the balance necessary to maintain mental health. If having playdates, we recommend finding a family that is taking similar precautions to your family, keep the play dates out of doors, encourage safe distance (6 feet) in between children and masking is always encouraged if children are older than the age of two years old.

As a side bar, many families ask about the safety of playground structures. Thankfully, data shows that the majority of transmission of COVID is through direct person to person contact and not through hard surfaces. If going to a playground, schedule it for a time when it is likely to be less crowded, bring hand sanitizer to wash your child's hands before and after playing, encourage them not to touch their face while playing and be ready to abort! if you feel uncomfortable.

Is it safe to send my child to school?

Children across the country have safely returned to school with physical distancing, strict masking, rules to stay home when sick and extensive contract tracing efforts. The omicron surge has taken hold of many communities over winter break, however, the the intent is for children and teens to resume in-person instruction after the holidays. Based on studies showing its efficacy during the delta wave, many local schools are piloting the Test to Stay Program this winter.

If you have specific health concerns for your child regarding school attendance, schedule a telemedicine or office visit with your child's medical provider.

Is it safe for my child to play sports?

Sports and other extra-curricular activities are important for ourphysical and mental health. Certainly, during a pandemic, we must consider the exposure risk from participation in any activity and this differs by the type of sport. Healthy Children offers the following guidance regarding sports participation.

Is it safe for my child to return to sports after a COVID infection?

There is a rare occurrance of hidden myocarditis after a COVID infection that may be unmasked by physical activity. This is more likely if your child had a prolonged or severe course (fever > 4 days, hospitalization required) or if your child has an underlying heart condition.

It is recommended that all children and teens with COVID defer all sports participation during their isolation period. Families of children or teens who had a mild or asymptomatic case should then monitor for any chest pain, shortness of breath, feeling faint or palpitations with exercise as they return to sports.

If symptoms develop, or if your child has an underlying heart condition, or they had a more severe course of COVID (fever > 4 days, hospitalization required), then they should have an office visit for a post-COVID cardiac evaluation prior to restarting sports. Contact our Clinic to schedule.

Learn more about Return to Sports after a COVID infection on our webpage Your Child Test Positive for COVID - Now What? and even more detail from the American Academy of Pediatrics.

What should I know about COVID-19 Testing?

Advanced Pediatrics is offering Drive-Thru COVID testing, use our VIRTUAL WALK-IN CLINICS to set up COVID testing. We offer three types of tests. We offer testing for all patients and depending on test supply and staffing constraints, will also often test all household members as desired.

PCR Tests. The best tests for diagnosing active infection with the novel strain of coronavirus that causes COVID-19 are either nasal or nasopharyngeal (NP) swabs that test for the genetic material (RNA) of the virus via PCR methods. This is the gold standard for diagnostic testing at this time. In the outpatient setting test results are usually available 2- 3 days later. These tests are very sensitive (meaning they miss few cases) and are very specific (meaning they don't mis-identify other infections as COVID).

Rapid Molecular Tests. There are also rapid COVID tests which test for the genetic material (RNA) of the virus via PCR or other methods. Depending on the technology used, these tests may be just as good as a PCR test, or more similar to a rapid antigen test in terms of accuracy and performance. At Advanced Pediatrics we have the ID-NOW Rapid Molecular Assay (Abbott) which tends to provide fast results and perform better than the rapid antigen test, but is not as good as the laboratory PCR test. It is best practice to follow-up all negative ID-NOW molecular tests with the more definitive PCR test.

Rapid Antigen Tests. There are also rapid COVID tests which test for the spike protein that is unique to SARS infections. These tests perform best on symptomatic patients within the first 5 days of symptoms. Tested from a nasal swab, these tests offer results in as little as 15 minutes. Studies show excellent agreement between rapid tests and PCR tests (the gold standard) when the rapid test is positive. If it's positive, you most likely have COVID. If the rapid antigen test is negative, however, you may still have COVID. It is best practice to follow-up all negative rapid antigen tests with the more definitive PCR test.

Scientists and private companies are in the process of developing serological antibody tests. These tests show if you have been exposed to the novel virus, but unfortunately do not prove that you would have immunity against a repeat exposure. For this reason, serologic testing is not recommended by the Center for Disease Control (CDC) nor the Infectious Disease Society of America (IDSA) until more information is known about the outcomes associated with test results.

What are the treatments for Coronavirus?

There are currently a few treatments for COVID-19 approved for high risk patients. These include monoclonal antibody therapy and a newly approved anti-viral pill. Beyond that treatments are generally supportive and in the case of serious disease may help with hydration, blood clot prevention & support breathing if needed. Learn about approved treatments for COVID-19 from the CDC.

What is Advanced Pediatrics doing to deal with Coronavirus?

Great question! Click here to learn more about our COVID Response Plan.

How do I talk to my children about Coronavirus?

The pandemic has changed our day to day lives dramatically. Children are resilient, but may need help processing all these changes. Below are some tips from Harvard Medical School as to how to have a discussion with your child about coronavirus without causing anxiety. Provide just enough information. Tell them what they need to know and what they can do about it. PBS has developed an informative comic strip for kids (& adults!) covering the basics about coronavirus.

Model calmness about the coronavirus. Children will look to you to see how afraid they should be.Limit news exposure about the coronavirus. Although news can keep us informed, sometimes news stories can use wording that is strong and scary for children.Keep an eye out for reassurance-seeking. It’s normal for children to ask questions, but if your child is repeatedly asking the same question and distress increases no matter how many times you answer the question, then anxiety may be taking over. In these instances, it may be important to ask for support to help your child deal with their worries.

Where can I get more information about Coronavirus?

We encourage you to read about COVID-19 from the World Health Organization (WHO), Center for Disease Control (CDC), Virginia Department of Health (VDH) and other reputable news reporting sources. Content on mainstream and social media may be inaccurate.

Known COVID exposure - now what?

USE OUR COVID VIRTUAL WALK-IN CLINIC TO DISCUSS YOUR CASE WITH A PHYSICAN AND SCHEDULE TESTING

QUARANTINE: The need to qurantine depends on your vaccination status. Fully vaccinated (plus booster if eligible)? You do not need to quarantine. There is still a chance that you could develop COVID and spread it to others however. Therefore, you should STRICTLY MASK FOR 10 DAYS after your last exposure. See tab on what to do if someone in your household is positive.

Not fully vaccinated? You need to quarantine. Symptoms are most likely in the first few days after the exposure. STAY HOME FOR 5 DAYS after your last exposure. Then if still feeling well with no symptoms (and fever gone x 24 hours without medication), you may leave the house as needed, but should STRICTLY MASK FOR AN ADDITIONAL 5 DAYS. This will cover your 10 days of being possibly contagious. If you are unable to mask (such as young children) you should STAY HOME FOR 10 DAYS. See tab on what to do if someone in your household is positive.

SYMPTOM MONITORING: You should monitor yourself for symptoms closely over the next 10 days as they might occur at any time during that window.

Stay home and isolate if you develop symptoms.Seek medical attention if you have any chest pain, trouble breathing or anything else concerning to you.

TESTING RECOMMENDATIONS:Get tested if you develop any symptoms.

Isolate and STAY HOME if you have any test results pending.If no symptoms develop, consider getting tested on day 5 as this is most likely when your result would be positive.

Rapid antigen tests are very specific, meaning if it is positive, you have COVID. If negative, however, you may still have COVID and may still be contagious. A negative rapid antigen test should be confirmed by a PCR test if possible.

RETURN TO SCHOOL POLICIES: Vary by the School District and private institutionsFairfax County Public Schools: If fully vaccinated, then you may attend school if you STRICTLY MASK for 10 days from the date of last exposure. Current FCPS policy implies that a child who is vaccinated may return to school even if ongoing exposure to a positive household member. Please confirm this with your specific school (especially if multiple household members are positive) before sending your child to school. If not fully vaccinated, then your child must quarantine for 5 days; your child may return to school on DAY 6 if they are asymptomatic and strictly mask through DAY 10. If symptomatic, they should get tested. If unable to strictly mask, they should quarantine for 10 days.

Arlington Public Schools

Loudon County Public Schools

Prince William County Public Schools

Sources: Center for Disease Countrol (CDC) & Virginia Department of Health (VDH)

Updated 1/2/2022

If Your Child is Sick With: Runny nose, Congestion, Sore Throat, Headache, Cough, Trouble Breathing, Chest Pain, Vomiting, Abdominal Pain, Fever or Body Aches, It May Be COVID.

ISOLATE - KEEP YOUR CHILD HOME

If your child is having these symptoms, it may be COVID and they are very likely contagious.

It does not matter if they are vaccinated. It may be a breakthrough case.

ARRANGE FOR COVID TESTING FOR YOUR CHILD

Either through a home test, through our VIRTUAL WALK-IN COVID CLINIC or elsewhere as desired.

Call for a parking lot visit if you are concerned about your child's symptoms and would like a physical exam as well.We prefer children under the age of 12 months of age have a curb-side visit.

STAY HOME UNTIL PCR RESULTS ARE KNOWN. We may run a rapid COVID test on your child. This is very useful if the result is positive as it informs us right away.

If the rapid test is negative, however, there is still a chance that your child has COVID.You should keep your child home until the PCR result is available.

Per CDC guidance if you are unable to test, then you should presume it is COVID and keep your child home for at least 5 days and then have them strictly mask for 5 days. If unable to reliably mask, you should keep them home for 10 days.Return to School Guidance varies by the school and situation. See WHAT TO DO IF MY CHILD IS EXPOSED and WHAT TO DO IF MY CHILD IS POSITIVE for school specific guidance.

IF YOUR CHILD TESTS POSITIVE FOR COVID Please follow the Your Child Tests Positive for COVID - Now What? Guidance and Exposure to COVID - Now What? Guidance and Household Contacts with COVID - Now What? Guidance for other family members.

Call to schedule a telemedicine appointment to discuss your situation as needed.

QUESTIONS ABOUT SYMPTOM MANAGEMENT? Call the clinic for advice or use this symptom checker for guidance.

CONCERNED ABOUT YOUR CHILD'S SYMPTOMS? Please call the clinic to set up an appointment.

Sources: Center for Disease Countrol (CDC) & Virginia Department of Health (VDH)

Updated 1/2/2022

If Your Child Tests Positive for COVID-19, Your Child Should STAY HOME regardless of symptoms or vaccination status:

ISOLATE & MASK

You Child Needs to STAY HOME and ISOLATE FROM OTHERS FOR 5 DAYS. Your child is most contagious the first 5 days, but will likely still be contagious until 10 days have passed since they started with symptoms or from the date of the positive test if they have never had symptoms. After 5 days, if they are still having symptoms and/or fever then they should continue to stay home until they are well.

Once symptoms are improved and your child has been home at least 5 days, then your child can leave your house, but your child may still be contagious. Your child should STRICTLY MASK around others for the NEXT 5 DAYS. This will cover the 10 day contagion period.If your child is unable to mask (due to age or other reason), then they are to STAY HOME FOR 10 DAYS.

TESTING

Once someone has a positive test, there is no benefit (unless you are a health care worker) for that individual to have a repeat test. It just places strain on an already overburdened testing system.

If your child has a home or rapid test that is positive, your child has COVID. These tests are very specific for COVID and a false positive result, especially with the amount of COVID in our community right now, is EXTREMELY unlikely. Treat any positive test as a positive. A confirmation PCR is not necessary.

SYMPTOM CONTROL & TREATMENT

Please contact the clinic for medical advice if you are concerned about your child's symptoms or health. If your child has chest pain, trouble breathing or any other symptom concerning to you, please seek emergent medical attention.

For most children, COVID presents like a mild cold to a flu like illness and usual comfort measures suffice.Adolescents and teens older than the age of 12 with certain risk factors, including obesity, immunosuppression, neurodevelopmental disorders, type 1 diabetes, chronic kidney disease, congenital heart disease amongst others may be candidates for monoclonal antibody therapy. Call the office or log-onto the VIRTUAL WALK-IN COVID CLINIC (Weekdays 9-10am or 3-4 pm) to discuss this option with your child's physician.

If your child develops prolonged fever, chest pain or trouble breathing in the weeks to months after a COVID infection, seek medical care. This could be a rare complication of COVID infection in children known as MIS-C.

RETURN TO SCHOOL: Policies may vary by school district and private institution.Fairfax County Public Schools: If your child tests positive for COVID, regardless of vaccination or symptoms, needs to stay home for 10 days. Your child may return on day 11. Follow your schools notification procedures. As of 1/4, FCPS is no longer requiring a physician note or certification from the Health Department to certify the date of return.

RETURN TO SPORTS: Guidance from the American Academy of PediatricsYour child or teen should NOT engage in intense physical activity while still in the isolation/contagious period.

After the isolation period has ended, your child may get back to sports as able if they had a mild or asymptomatic course and your child does not have any underlying heart problems. Please just monitor for chest pain, trouble breathing or dizziness with exercise in the weeks after infection. If this occcurs, then please stop physical activity and call the clinic to schedule a post-COVID cardiac evaluation.If your child had a prolonged fever (4+ days), was hospitalized due to COVID or has an underlying heart condition, then please call our clinic to set up a post-COVID cardiac evaluation prior to returning to sports

QUESTIONS ABOUT HOUSEHOLD CONTACTS & EXPOSURE

Anyone in contact with you two days prior to symptoms starting or your positive test (if asymptomatic) who was around you for 15 minutes or more is considered a close contact.If you have questions about isolating from household members and their quarantine time periods. Refer to the Household contact tab.

Despite an ongoing exposure, current FCPS return to school guidelines for a student who is fully vaccinated but with a positive COVID household member are that they can attend school if they strictly mask. Please confirm this with your specific school before sending your exposed child to school.

PREVENT RECURRENT INFECTION & VARIANTS FROM EMERGINGNatural immunity is thought to confer 90 days of protection from a repeat COVID infection, although as new variants emerge this may change.

Mask when indoors.Stay home when sick.

Get vaccinated and boosted when and if eligible once the isolation period ends.

If You (a Parent or Adult) Test Positive for COVID-19, STAY HOME regardless of symptoms or vaccination status:

ISOLATE & MASKING:

You Need to STAY HOME and ISOLATE FROM OTHERS FOR 5 DAYS. You are most contagious the first 5 days, but will likely still be contagious until 10 days have passed since you started with symptoms or from the date of the positive test if you have never had symptoms. After 5 days, if you are still having symptoms and/or fever then you should continue to stay home until you are well.

Once symptoms are improved and you have been home at least 5 days, then you can leave your house, but you may still be contagious. You should STRICTLY MASK around others for the NEXT 5 DAYS. If you are unable to mask for any reason, then you should STAY HOME FOR 10 DAYS.

TESTING

Once you have tested positive, there is no benefit (unless you are a health care worker) to getting tested again. It just places strain on an already overburdened testing system.

If you have a home or rapid test that is positive, you have COVID. These tests are very specific for COVID and a false positive result, especially with the amount of COVID in our community right now, is EXTREMELY unlikely. Treat any positive test as a positive. A confirmation PCR is not necessary.

TREATMENT

Please contact your own physician for medical advice if you are concerned about your symptoms or if you are considered high risk for severe disease from COVID (based on age or underlying medical condition), particularly if you are not vaccinated or boosted. There are some treatments available to adults such as monoclonal antibodies that may help prevent serious disease. Talk to your physician about them.

For most individuals, COVID presents like a mild cold to a flu like illness and usual comfort measures suffice.If you have chest pain, trouble breathing or any other symptom concerning to you, please seek emergent medical attention.

QUESTIONS ABOUT HOUSEHOLD CONTACTS & EXPOSURE

Anyone in contact with you two days prior to symptoms starting or your positive test (if asymptomatic) who was around you for 15 minutes or more is considered a close contact.

If you have questions about isolating from household members and their quarantine time periods. Refer to the Household contact tab. If you need additional information, log-on to our VIRTUAL WALK-IN COVID CLINIC - Weekdays 9 - 10 a and 3-4p.

PREVENT RECURRENT INFECTION & VARIANTS FROM EMERGING

Natural immunity is thought to confer 90 days of protection from recurrent infection, although as new variants emerge this may change.Mask when indoors. Stay home when sick.Get vaccinated and boosted when and if eligible once the isolation period ends.

Source: Centers for Disease Control (CDC) and Virginia Department of Health (VDH)

How do people living together manage quarantine when they cannot be separated from the person with COVID-19?

It is very important for people with COVID-19 to remain apart from other people if possible, even if they are living together. If separation of the person with COVID-19 from others in the home is not possible, the other members of the household will have ongoing exposure, meaning they will be repeatedly exposed until that person is no longer able to spread the virus to other people. People with COVID-19 can spread the virus to other people for 10 days after they develop symptoms, or 10 days from the date of their positive test if they do not have symptoms. Others can then develop symptoms anytime in the 10 days after the date of last exposure. In total, this suggests that symptoms for an ongoing contact could develop at any point over 20 days from when the first person tested positive.

What do you do if someone in your household is positive?

The positive person should isolate as able from the rest of the household. If this is not possible, then the family may elect to cohort together. Cohorting may extend the period of quarantine for those who not fully vaccinated or boosted and also places them at increased risk for acquiring COVID, however, in some cases it is the logical choice in particular when young children who need the care of an adult are involved.

All members of the household should consistently wear a well fitted mask with each other and including the person with COVID-19. If possible, one member of the household should care for the person with COVID-19 to limit the number of people in the household that are in close contact with the infected person.

Household contacts should get tested immediately when they learn that they are a close contact.

Contacts who are not fully vaccinated or boosted need to also quarantine at home. While their date of first exposure is when the household contact got sick or tested positive (whichever was first), if they are living in the home with the person who is positive and not able to completely isolate (separate living areas, bathrooms, kitchen etc), then they have an ongoing exposure. They may develop symptoms at any point while that person is contagious and then symptoms may also develop up to 10 days after that person is no longer considered contagious. Thus, their quarantine period would be at least 20 days assuming no one else got sick in the interim. See below for details.

Contacts who are fully vaccinated and boosted if eligible, need to strictly wear a mask at home and outside the home if they venture out during the time period that anyone in the household is in isolation plus 10 days afterwards. This is because symptoms could develop during the period of ongoing exposure and also within 10 days after the last exposure. See below for details.

What should I do if multiple people I live with test positive for COVID-19 at different times? Recommendations for this situation depend on vaccination status:

When multiple members of the household become infected at different times and the people with COVID-19 can’t isolate from other members of the household, close contacts who are unvaccinated or not fully vaccinated or not boosted and > 6 months out from second shot, should:Get tested when they first learn of the positive exposure.

Quarantine immediately. Quarantine throughout the isolation period of any infected person in the household. When this last person finishes up their isolation period, this the date of last exposure. Start the post-exposure quarantine period now. For example, if the last day of isolation of the person most recently infected with COVID-19 was June 30, the new 5-day quarantine period starts on July 1 and would go throughJuly 5. Household member could leave the house on July 6 but should continue to STRICTLY MASK for an additional 5 days through July 10. If the exposed household member is not able to mask, then they should stay home for 10 days after the last household positive member finishes their isolation. This would be 20 days at a minimum if everyone in the house came out of isolation on the same day.

If possible, get tested 5 days after the last household member finishes isolation.Wear a mask when in contact with any person with COVID-19 while that person is in isolation.

Wear a mask when in contact with other people in the home until quarantine ends.Isolate immediately if they develop symptoms of COVID-19 or test positive.

When multiple members of the household become infected at different times and the people with COVID-19 can’t isolate from other members of the household, close contacts who are fully vaccinated and boosted if eligible in this situation should:

Get tested 5 days after their first exposure. A person with COVID-19 is considered infectious starting 2 days before they developed symptoms, or 2 days before the date of their positive test if they do not have symptoms.Get tested again if possible 5 days after the end of isolation for the most recently infected member of the household.

Wear a mask when in contact with any person in the household. Wear a mask indoors in public until 10 days after the end of isolation for the most recently infected member of the household or until the fully vaccinated close contact receives their final test result. For example, if the last day of isolation for the person most recently infected with COVID-19 was June 30, the new 10-day period to wear a mask indoors in public starts on July 1 and would go through July 10 and end on July 11.

Isolate immediately if they develop symptoms of COVID-19 or test positive.

I had COVID-19 and completed isolation. Do I have to quarantine or get tested if someone I live with gets COVID-19 shortly after I completed isolation?No. If you recently completed isolation and someone in your household tests positive for the virus that causes COVID-19 shortly after the end of your isolation period, you do not have to quarantine or get tested as long as you do not develop new symptoms. Once all members of the household have completed isolation or quarantine, refer to the guidance below for new exposures to COVID-19.

People who had COVID-19, recovered, and completed 10 days of isolation and then during the 90 days following the end of isolation come into close contact with someone with COVID-19 do not have to quarantine or get tested if they do not have symptoms. But they shouldWear a mask indoors in public for 10 days after exposure.

Monitor for COVID-19 symptoms and isolate immediately if symptoms develop.Consult with a healthcare provider for testing recommendations if new symptoms develop.

If more than 90 days have passed since recovery from infection, people who had COVID-19 should follow recommendations for close contacts based on their vaccination status.

Advanced Pediatrics

Phone: 703-938-5555

Fax: 703-319-8580

Address: 100 East St SE, Suite 301, Vienna, VA 22180

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