With nearly 7,000 confirmed cases, there’s no doubt that the new coronavirus is rapidly spreading through the U.S. But due to several factors — a lack of available testing, the fact that the virus is highly contagious and that symptoms often don’t show for up to two weeks — the coronavirus, COVID-19, is likely far more widespread than we actually know. And during these early stages of the outbreak, it’s essential that Americans avoid contact with other people to reduce the spread.
Health experts all agree that some form of isolation — from the more minor, like social distancing, to the most severe, a federal quarantine — can make a huge difference in reducing the amount of people who are exposed to COVID-19 and help to “flatten the curve”: slowing the spread of the virus to ease the burden on healthcare workers.
Here’s what to know about each of these forms of isolation.
Social Distancing
The most flexible of these terms, social distancing is aimed at healthy people who do not have any signs of illness. The idea is to stay indoors as much as possible, avoid large groups (current guidance from the federal government recommends that Americans do not congregate in groups larger than 10) and stay six feet apart from other people.
This is aimed at slowing the spread of COVID-19. The virus is highly contagious and can spread in several ways — through air molecules from sneezing or coughing, or on surfaces, where it can live for around 24 to 72 hours, depending on the material. People can also be asymptomatic or carriers for the virus without realizing they have it. All of these factors mean that healthy people can unknowingly spread the virus to people who are at a higher risk of developing a severe, life-threatening reaction. By social distancing, those people are reducing the chance that the virus spreads.
“It’s important right now, because we don’t know how many people are infected,” Dr. William Haseltine, an infectious disease expert and Chair and President of ACCESS Health International, tells PEOPLE.
Self-Quarantining or Self-Isolation
The severity of isolation increases when people suspect that they may have COVID-19. For those who have recently come in contact with someone with a confirmed case of the virus, or those who are starting to show symptoms (such as coughing, sneezing, fever or respiratory problems), it is best to self-quarantine, or self-isolate, which are both medical terms.
That means staying home for 14 days, the time it takes to develop symptoms, isolated from other people to reduce the risk of exposure. People should make sure to wash their hands frequently, avoid sharing the bathroom and other spaces with other household members and refuse any visitors.
Self-quarantine is not legally enforced but is strongly recommended to those who know they have been recently exposed to COVID-19.
Several lawmakers and celebrities have said that they are self-quarantining after meeting with people who have tested positive, such as Canadian Prime Minister Justin Trudeau, whose wife has COVID-19, and Heidi Klum, who said she decided to stay inside after feeling sick.
Quarantine or Isolation
The most restrictive of the terms, quarantine or isolation refers to the medically necessary separation of people infected with COVID-19 from others who are not infected, either at home or in a hospital or medical facility, according to Johns Hopkins Medicine.
In some cases, state or federal governments will put people in a legally mandated quarantine. In early February, the U.S. state department evacuated hundreds of American citizens who were living in Hubei province in China, the epicenter of the COVID-19 outbreak, and placed them into federal quarantine at military bases across the country. They were required to stay for 14 days while doctors monitored their symptoms, and it was the first federally mandated quarantine in over 50 years.
In another case, a Kentucky man is currently being guarded round the clock by law enforcement after he refused to self-quarantine. Kentucky Gov. Andy Beshear had to declare a state of emergency to enforce the 53-year-old man’s quarantine.
“It’s a step I hoped I never had to take, but we can’t allow one person we know who has this virus to refuse to protect their neighbors,” said Beshear, according to the Associated Press.
Shelter-in-Place or Lockdown
Another legally mandated option is to place entire cities, states or countries under a shelter-in-place order, or a full lockdown.
The two are similar, and require all citizens to stay indoors. People are only allowed out to get groceries, medicine or other essentials, and the only workplaces that will remain open are grocery stores, pharmacies and emergency services like hospitals and police and fire departments. Under a shelter-in-place, the full terms of the restrictions — including how long it lasts — are up to lawmakers.
Several countries in Europe with major outbreaks of COVID-19 — Italy, Spain and France — are currently under lockdown. In the U.S., the greater Bay Area is under a shelter-in-place order as of Tuesday morning, and New York City Mayor Bill de Blasio said Tuesday afternoon that residents “should be prepared” to go under similar orders in the next 48 hours. However, that decision would require approval from New York state, and Gov. Andrew Cuomo has said he will not agree to it.
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