Social Distancing, Quarantine, and Isolation. What is the Difference?

These are actually all different ways to prevent the spread of germs. They vary in strictness of contact with other individuals. Any of the three levels can be mandated or voluntary.

Social distancing is a common sense response to the presence of contagious germs in a community environment. It means keeping your distance from others. Most experts state that staying at least 2 meters (6 feet) away from another person will prevent the exchange of germs either person may harbor. Recommendations of social distancing often mention avoiding large gatherings. How large is large? There really is no formal definition. And of course, frequent thorough handwashing and cleaning of common surfaces, although not usually thought of as a means of social distancing, are good ways to prevent the spread of germs from one individual to another.

Quarantine and isolation are related terms, both being means to protect the general public from infection. But there are significant differences between the two that everyone needs to understand.

The word quarantine derives from an Italian word meaning “forty days.” This was how long ships that carried passengers with plague had to avoid sending people ashore in the early 17th century. Quarantines are intended to prevent people (or groups of people) who have been exposed to a contagious disease, but do not yet show symptoms of that disease, from unknowingly spreading the infection to others who have not been exposed to the disease. People who are in quarantine may be quarantined individually or with others of the same status, because everyone who is quarantined is assumed to have become infected through previous contact with someone who has the disease.

Self-quarantine may be self-imposed or initiated by a suggestion or request from authorities. It usually follows your having been in close contact with someone who has been infected with a contagious disease. Health departments do contact tracing of people after they have been diagnosed, to identify everyone who they may have infected. The health department will notify you of the contact and generally suggest self-quarantine if you have been exposed to someone with an identified case of the disease.

What should you do if you are quarantined, either required or by choice?

• Most important, do not panic. Quarantines are enacted for your health and the health of those you may come in contact with. 
• You will generally be given specific instructions by the health department or other authorities. Follow these instructions carefully. 
• Try to think of the period of quarantine as a form of “staycation.” You must not leave your home except if absolutely necessary. Plan on not going to church, work, or school, and no family gatherings or eating at restaurants. Use grocery and pharmacy delivery service where available.
• If you need medical care, please start by trying telemedicine or a virtual consultation. If you must go in to the doctor’s office or clinic, be sure to call ahead. That way the medical facility can ensure that you do not infect others when you are there.
• If you are quarantined with other individuals, even if they are members of your immediate family, avoid sharing items such as eating utensils, towels and bedding. Keep communal areas clean and disinfected. 
• While there is no evidence that pet animals can get sick from human flu viruses, it is wise to limit contact with pets as much as possible during the quarantine period.
• It is most important to follow basic hygiene practices, including frequent handwashing and covering coughs and sneezes, and keeping the environment clean, to avoid the spread of germs.

Isolation is for people who are showing symptoms of the communicable disease. For many diseases, this is the time when the infected person is most likely to spread the germs, although the germs that cause some diseases can spread before symptoms begin to develop. When persons in quarantine show symptoms, they are often then put into isolation. The purpose of isolation is the same as that of quarantine. Isolating patients with symptoms of a disease is intended to prevent germs from spreading to people who are well.

The origin of the word isolation is from a Latin word meaning “island.” An early example of the use of isolation to prevent the spread of disease was in 15th century Italy, where persons with plague were removed from the city of Venice to a nearby island. High level medical care may be needed by persons in isolation who have severe symptoms, and medical personnel must take exceptional care to avoid becoming infected themselves.

Can you be forced into quarantine or isolation? The short answer is, legally, yes. In the US, the Constitution’s Commerce Clause has been interpreted to mean that the federal government can quarantine and isolate individuals and groups to protect others from contagious diseases. States and tribes have similar localized authority. Governments at every level have “police powers” to enforce quarantines and isolation with punishments for disobeying them ranging from fines to imprisonment. The use of federal isolation and quarantine is rare in the US. The last time it was used was during the 1918-1919 Spanish flu pandemic.

If you are placed in quarantine of isolation, there are two important things you must do. The first is to stay calm. Fear is normal in these situations, but is not helpful. The best way to regain calm is to educate yourself from reliable sources of evidence-based information. The second thing you should do is to follow all mandates and fully cooperate with the authorities. Following requirements strictly will save lives, possibly those of you and your loved ones.