Can People With COVID Isolate Together? Here's What Experts Say

With how highly transmissible the Omicron variant is, there's a good chance that multiple people in a household will get COVID at the same time. Here's how that could impact what isolation looks like.

Thanks in large part to the highly transmissible Omicron variant, COVID-19 continues to spread rapidly across the US. Data on daily case counts from the Centers for Disease Control and Prevention (CDC) show a steep increase in infections starting in late December. On Friday alone, more than 831,000 people in the country were newly diagnosed with the virus.

Given how highly infectious the virus—and, in particular, the now-dominant Omicron variant—is, there are plenty of households where more than one person is sick. If one person tests positive for COVID-19, it makes sense to isolate them from everyone else in the house. But what about if two or more people are infected? Is it OK to isolate together?

FWIW, this isn't something the CDC or any other major medical organization has addressed at this time. "No one is talking about this," William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Health. While it's understandable to want to have an isolation buddy, Dr. Schaffner says there are some things to keep in mind if you're interested in isolating with a friend, partner, or loved one. Here's a breakdown.

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Getty Images / Design by Jo Imperio

What is isolation, again?

Isolation is used to separate people with a confirmed or suspected case of COVID-19 from those who don't have the virus, according to the CDC. When you're in isolation, you should stay home and separate from others, ideally in a specific "sick room" or area, and use a separate bathroom if it's available, per the CDC. If you need to be around other people in your home, the CDC recommends wearing a mask.

The CDC suggests also doing the following when you're in isolation:

  • Monitor your symptoms and seek emergency medical care if you develop trouble breathing or other warning signs of severe COVID.
  • Take steps to improve your ventilation at home, if possible.
  • Avoid contact with other members of your household and pets.
  • Don't share personal household items like cups, towels, and utensils.

What are the current isolation recommendations?

In late December, the CDC changed its isolation recommendations. Now, the public health agency recommends that you isolate for at least five days (it used to be 10) from the day you developed symptoms or tested positive for the virus. After that, if you're fever-free for 24 hours and your symptoms are improving—of if you had always been asymptomatic—the CDC says that you can be around others but should do so with a face mask for an additional five days.

"The change is motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the one to two days prior to onset of symptoms and the two to three days after," the CDC said in a media statement about the change.

OK, so can you isolate with someone else?

This is a little tricky, Dr. Schaffner says. "The word is 'isolation,'" he says. "It doesn't mean 'cohabitation.'"

Still, he says, "there will be circumstances in which people in the same household are positive simultaneously or closely to the same time, and they're going to be maskless if they live together—for sure that's going to happen."

Isolating together can create some nuances and questions that wouldn't be an issue if you isolated alone, Dr. Schaffner says. A big one is timing: If you test positive for COVID-19 one day and your partner tests positive two days later, he still recommends sticking with your individual timeline for isolation. "You have to count the five days on an individual basis," he says.

There's also a question about variants. It's difficult to find out which variant of COVID-19 you have. Technically, there's a chance you could have one variant, like Delta, while someone in your household has another, like Omicron, Dr. Schaffner says. Still, Omicron is so prevalent right now—the CDC reports that it's responsible for 95.4% of all COVID cases in the US—that it's much more likely that you all have that, infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, tells Health. "For all intents and purposes, people can assume they all have Omicron," he says.

Even if you were to have one variant and someone you're isolating with were to have another, Dr. Schaffner says it's unlikely you'd swap variants. "There is some cross-immunity between variants," he points out.

Your viral load (ie, how much of the virus you're carrying in your body and shedding) could play a role in whether you should isolate with someone, Dr. Schaffner says. Meaning, if someone you're isolating with is coughing and sneezing more and they're carrying a higher viral load, you'll be exposed to that, too. (And that's where masking up and isolating separately would come in handy.) But, Dr. Schaffner says, "you have no way of knowing what your viral load is."

Finally, if you're interested in isolating with a friend or partner who lives someplace different, it's kind of a judgment call. Dr. Schaffner recommends just taking isolation "at its face value" and actually staying apart from others for a few days, while Dr. Adalja says you can isolate with someone else if you prefer. "If multiple members of a household or distinct households are positive for COVD, they can isolate together and there's really no benefit to them wearing mask," Dr. Adalja says.

If you do decide to isolate with someone else, make sure that everyone really should be in isolation. Don't just assume that because someone was exposed to COVID that they have the virus—that's what quarantine is for, a time when you stay away from others after having been exposed to see if you develop any symptoms. "[Isolating with others] is generally felt to be OK, as long as you're both already infected," John Sellick, DO, an infectious disease expert and professor of medicine at the University at Buffalo/SUNY, tells Health. "But if you were exposed together but only one person is sick, you shouldn't automatically assume that the other one is infected and isolate together anyway."

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