Frustrated!!

[cowboysandangels, BSN]

Are any of you having an issue with your HD contradicting the guidelines on quarantine and isolation dates?  Here the "rule" is a minimum of 10 days isolation after symptoms start and if you have had close contact, then you get to quarantine for 14 days from last contact.  Pretty straight forward I think, however I am getting conflicting dates from the health department.  Also, we were told that a person must quarantine for a minimum of 24 days if they are quarantining in the same house as the isolated person (14 days after last contact with the person contagious for 10 days).  This "rule" is not being followed at all.  Why are some HDs not sticking to the rules?  Frustrating.

   

[JoJoGo]

I think it is an interpretation thing. The county I live in "allows" household members to start their 14 day count down if the infected person is isolated to their own bedroom and bathroom, but the county I worked in this Summer said that as long as the infected person remained in the home the countdown didn't start until isolation was over (24 days). These two counties are adjacent and we have students that overlap both all over, so it can definitely be difficult to keep straight. Neither county have been able to keep up with contact tracing since the start of November, so now I am pretty much on my own with all of the students in our building and I use the separate bedroom/bathroom rule when I can, but we have still had students out for 24 days because some are too young to be able to separate from an infected parent.

[ruby_jane, BSN, RN]

And the CDC is now changing everything to around 10 days (symptoms or not). The whole when to quarantine with a household member has always been contentious. 12 more school sleeps until a break!

[cowboysandangels, BSN]

19 hours ago, ruby_jane said:

And the CDC is now changing everything to around 10 days (symptoms or not). The whole when to quarantine with a household member has always been contentious. 12 more school sleeps until a break!

Right?!?  So hard when everything changes so much.  I start every conversation with "as of today".  This has been the absolute most stressful year I have had in nursing in over 20 years! I am mentally exhausted as much as physically.  Winter break cannot come soon enough. 

[OyWithThePoodles, RN]

I certainly have experienced this with our health department. Getting letters for positive patients that say they are in quarantine instead of isolation, having seven year old's who you know cannot fully quarantine from their positive parent, only be in quarantine for the 14 days, quarantine or iso letters being dated with a start date and end date just one day apart (that makes it super fun for staff trying to explain to HR that they did actually take the 14 days off and need to be paid for the 14 days). MANY letters not received even still. Ours just recently decided to no longer follow any close contacts, just positive cases. The school nurses are to follow our own students/staff and write their letters of quarantine. When we asked if we could get iso letters for positives, they told us they weren't doing those anymore to decrease their workload since our district went all-virtual recently. The only problem is, students are still coming into the building for tutoring, or sports practice. We need those letters. 

All super frustrating. I know they are overwhelmed... but so are we. 

[Flare, ASN, BSN]

it's all clear as mud... we're doing 24 days for household contact here as well.  But then if that person has a positive test, they can drop that to 14 days. It feels like we're making it up as we go...

[Mavnurse17, BSN, RN]

We're doing the 10+14 day thing for students but not for staff.  I was told recently that the feds only pay employees for up to 14 total days of mandated isolation or quarantine, so taking the full 24 days for exposure to a household contact would make 10 of those days be out of the employee's PTO.  We'd only do it in extreme cases, like if an employee shares a 600 sq. ft apartment with 3 other people and it's literally impossible to distance; but for families with the space in the house "they should be able to maintain the distance."

[AdobeRN]

I started with the 10+14 day thing for students at beginning of the year - then district started to get push back from everyone and we were then told if parent tells us that positive person is completed isolated from others we only need to quarantine any close contacts for 14 days - so since September pretty much all close contacts are quarantined now for 14 days - nobody seems to have a problem with this including our local county Health department that has the 10+14 thing plastered all over their website and documents.  It is so frustrating sometimes when the rules are clear as mud. 

[NutmeggeRN, BSN]

23 hours ago, Flare said:

it's all clear as mud... we're doing 24 days for household contact here as well.  But then if that person has a positive test, they can drop that to 14 days. It feels like we're making it up as we go...

Right??? Cannot test out of Q but you can get sick and shorten it....oye!!!!!

[Jedrnurse, BSN, RN]

I'm waiting for the very recent CDC changes to trickle down and confuse things even more. So far my state is not changing anything.

[turtlesRcool]

On 12/3/2020 at 12:34 PM, OyWithThePoodles said:

When we asked if we could get iso letters for positives, they told us they weren't doing those anymore to decrease their workload since our district went all-virtual recently. The only problem is, students are still coming into the building for tutoring, or sports practice. We need those letters. 

Wait - what???  Your district decided they couldn't maintain safety while students sit at their desks wearing masks in class, but somehow it's safe for them to run around in close proximity to each other, breathing hard, and probably maskless?  Why on earth are they still playing sports in person while academics have shifted online?  

[JenTheSchoolRN, BSN, RN]

For me, since I'm the one doing all the contract tracing (and since we are doing surveillance testing weekly at my school, I can be the first person to see a positive result as well), I'm working with the CDC and my local DPH guidelines. We are thankfully all on the same page. 

For a positive case: 10 days since either onset of symptoms (if known) or date test was done (not date results were reported). Here for me it is important to note that Day 1 or symptoms is day 0 of 10; date of test is day 0 of 10.

If the positive case can isolate any from the household - separate room, separate bathroom - then the household folks can start quarantine prior to the positive case being cleared. This have been an option for some folks (sometimes if in a roommate situation in a 2 bed/2 bath apartment - roommate will leave food at the door for positive person), but 9.5/10 times when kids are in play that need hands on care and the parent or parents have tested positive, 24 days it is from the beginning.