1/ I wrote this over a month ago when I was working in our #covid19 emergency department pod.

Home-based transmission is a big deal (more data soon).

If your patient can’t safely isolate, please do not send them home. That’s not a safe discharge plan. https://www.washingtonpost.com/outlook/2020/04/21/isolate-home-coronavirus-quarantine/

2/ Safe isolation means actually separating from family - separate room, separate bathroom, can largely care for themselves etc.

Transmission potential highest for 2-3 days before symptoms / 7-10 days after symptoms

3/ Every patient needs a very thorough assessment of their home situation prior to being sent back from ED or wards.

This cannot be missed w/ #covid19 cases.

This is critically important.

Isolating at home is not a one-size-fits-all policy.

4/ As cases increase again w/ reopening, the safe isolation problem will come up once more.

Families will once again be at risk as breadwinners return to work.

They need to be protected.

We already know how this goes.

Indoor close contact transmission = high risk.

5/ Contact tracing efforts will do their best to track as many as possible as quickly as possible.

This may not keep pace everywhere, esp w/ rapid reopening.

If you believe you had a high-risk exposure event w/ a known or suspected #covid19 case, take your precautions.

6/ Public health departments, your doctors, and many others will be there to help.

If you’re not sure about an exposure, make the call to your local public health department to find out.

This will be a concerted, grassroots effort to get this right. Everyone has a part to play.