Isolation (the separation of persons with confirmed or suspected contagious disease) and quarantine (separation/restriction of movement of persons that have been exposed to a contagious disease) are critical to stopping COVID-19 transmission.
Enforcing isolation and quarantine requires resources and systems, including strategies for securing location and ensuring food, nutrition, and medication, and financial support. People in isolation and quarantine require continued monitoring in case they require further care or testing.
Case investigators and contact tracers will assess the most appropriate place for isolation and quarantine--either at home, in a government-secured location (e.g., hotel), or in a hospital.
Care resource managers ensure access to nutrition and required medications, whether by neighbor, friend, family member, or delivery service.
Case investigators? should assess for potential challenges of isolation and quarantine, including loss of income and loss of ability to care for others, that may make compliance difficult. Public health programs such as tuberculosis control programs have provided “incentives and enablers” for this purpose. Examples include covering mortgage or rent payments, providing daycare or elder care, and others. Direct financial compensation for those with lost wages should be considered.
Health officers have legal authority to order isolation and quarantine. Local programs may vary in their approach. Some issue orders immediately whereas others seek voluntary cooperation without a legal order initially. States may need to provide additional support if local health departments need mass provision, monitoring, or enforcement of legal orders.