Determining Day Zero

first day of the first symptom

That's a great question... If I think back to conversations with our PH nurses, I imagine that if there was a consistent worsening of existing symptoms (I.e. headache and congestion that just keeps worsening or persisting), then I would count from the start of symptoms. But remember, isolation continues until symptoms resolve, so you are well within your boundaries to state that they must remain home beyond day 5.

If they started out with a headache and congestion, tested negative, but then got GI symptoms and a fever (or something like that) and tested positive 2-3 days later, I think I would count from the start of the new symptoms/positive test.

4 minutes ago, ihavealltheice said:

rst day of the first symptom

4 minutes ago, ihavealltheice said:

first day of the first symptom

Yes, this is what my gut tells me and what the 'first day of symptoms or day of positive test' that I have taught would say.  I guess I was thrown off by the negative tests.  I had also been advised to be conservative and use the pos test date since it was later but I don't want to make up new rules just to keep kids out of school for longer.  

I also keep reminding people that not too long ago we were quarantining for 14 days...not everyone is done @ day 5, regardless of what the business and political industries have to say...

So, this can be tricky. No two situations are ever the same and I really look at it case by case.

Symptoms can the day 0, but for some folks a baseline for them is a daily headache/congestion (especially for chronic allergy sufferers, like myself!). When that is the case here, I just use the test as day 0.

Sometimes I have seen students develop a 102 degree fever AND test negative that day on a rapid test. Fever goes away 12-24 hours later (and often they have zero symptoms after) AND then they test positive. In that case, I use fever day as day 0.

I also ALWAYS tell folks, if you still pretty sick on day 5, do NOT release from isolation at day 6. Because some folks will need more time. I've had a few staff that needed all 10 days just to be well enough to be back at work. In my state, school nurses need to test negative to return to work after day 5. I had COVID in early January and did not test negative on an antigen test until my day 7, even though 90% of my symptoms resolved by day 4 (headache and fatigue lingered with me for a good two weeks after I went back to work).  I can't require a negative test to re-enter, but if someone can rapid test day 5 and it is still positive, even with minimal symptoms, I've been advising isolation through day 7 at least (and can now hand out free rapid tests to the folks that need them to retest).