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NYC Health: Preventing Household Transmission of SARS-CoV-2

December 1, 2020


The New York City Department of Health and Mental Hygiene (DOHMH) has provided the following guidance:


There is increasing evidence that exposure to SARS-CoV-2 within households is one of the most common and important risk factors for COVID-19, underscoring the importance of prevention measures in the home. Given that infectiousness appears to be highest starting approximately two days before symptom onset and during the following week, and transmission can originate from asymptomatic persons, it is critical for patients to promptly initiate prevention measures when COVID-19 is suspected, diagnosed, or an exposure is identified.

Findings From Studies on Household Transmission Include the Following:

• Transmission of SARS-CoV-2 to household members is common; studies have found secondary transmission rates ranging from approximately 15% to 50% within households.

• Most secondary transmission occurs early in the patient’s course of illness.

• Both children and adults can transmit SARS-CoV-2 to household contacts.


Preventing Household Transmission:

Isolation should begin as soon as symptoms develop, or a positive diagnostic test result is received. Delaying isolation increases the likelihood of transmission to other household members. Similarly, quarantine should be initiated immediately after someone learns they have been exposed to COVID-19 or returns from an area that is subject to NYS travel quarantine restrictions.


Individuals who do not live alone should strongly consider completing isolation or quarantine outside their home, especially if they cannot separate from others or live with people who have risk factors for severe COVID-19. The Take Care Hotel Program is available to help make this possible.


Individuals Isolating or Quarantining at Home and Who Live With Others Should:

  • Use a separate bedroom and bathroom from other household members, whenever possible.

  • Maintain at least 6 feet of distance from others at all times, including household members.

  • Wear a face covering while in shared areas of the home and encourage other household members to do so, even if 6 feet of distance is maintained.

  • There is growing scientific evidence that, in addition to providing effective source control, face coverings can prevent wearers from inhalational exposure to SARS-CoV-2, potentially preventing transmission.5

  • Follow good hand hygiene practices, including washing hands regularly.

  • Clean frequently touched surfaces, such as counters, doorknobs, and phones. Clean them after each use and at least once every day.

Resources to Support Isolation and Quarantine:

New York City (NYC) and State (NYS) offer several resources to support safe and effective isolation and quarantine:

  • Take Care Hotel Program: The Test and Trace Corps offers a hotel room free of charge for up to14 days so that people with COVID-19 and close contacts can complete isolation or quarantine away from other household members. The program offers private rooms with bathrooms; free transportation, meals, and WiFi; COVID-19 testing; and on-site medical support. To book a hotel room, call 212-COVID19 (212-268-4319).

  • Take Care Package: The Test and Trace Corps provides care packages to all people with COVID-19 and their close contacts to help them if they choose to isolate or quarantine at home. Packages contain personal medical-grade masks, at-home COVID-19 diagnostic specimen collection kits, a pulse oximeter, a thermometer, hand sanitizer, and sanitizing wipes.

  • GetFood Program: The Test and Trace Corps can connect people to emergency food home-delivery services. Vegetarian, kosher, and halal options are available.

  • Paid Family Leave: Under NYS law, a person who must miss work because of COVID-19 may be eligible for paid sick leave. This includes people who were isolated because they or their minor child tested positive (or had symptoms of COVID-19) or were quarantined because they were exposed to someone who had COVID-19. People can call 855-491-2667 to request a quarantine or isolation order. The person requesting leave will then need to submit the order to their employer along with supporting documentation. For more information, visit PaidFamilyLeave.ny.gov/COVID19.


Please see the attached document for additional information:

covid-19-providers-dear-colleague-update
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