From The New York Times

What To Do If You Test Positive for COVID

As the Omicron variant continues to spread around the country, many more people, including those who have been vaccinated, will test positive for the coronavirus.

 

So what should you do if you’re one of them? We spoke to physicians and infectious disease experts about the steps you should take after a positive test or if you find out you’ve been in close contact with an infected person. Here’s their advice.

 

I just tested positive. What do I do now?

If you’re in public or around people when you get the bad news, put on a mask immediately. Then isolate yourself as quickly as possible, even if you don’t have symptoms. The U.S. Centers for Disease Control and Prevention recommends isolating for 10 days after you test positive.

 

What does it mean to isolate?

If you live with roommates or family, try to separate yourself from other people (and animals) as much as possible. “You should take yourself out of society,” said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco. “Wall yourself up in a cocoon.”

 

Isolating in a home with other people may be difficult, but do the best you can. That means staying in your room, away from other members of the household, even for meals. Someone should deliver food to your bedroom door if possible. If the home has more than one bathroom, designate one just for the infected person. If the infected person is a child or older person who needs assistance, both the caregiver and the infected person should wear a mask when the caregiver enters the room, and open the windows if possible.

 

If you must stray into common areas or share a bathroom while you’re infected, always wear a high-quality mask when you leave your room. If other people are in the house, they should mask up too when you’re in the same room. After using a shared bathroom, disinfect the toilet seat and handle, as well as the faucet handles, soap dispenser, counter and light switch. Close the lid before you flush, and turn on the exhaust fan. Open windows to improve ventilation in shared areas.

 

The people living in your household should take precautions, but they don’t need to panic about getting infected too, especially if they’re vaccinated. “The household rate of contracting Covid from someone is not 100 percent by a long shot, even with the more transmissible variants,” said Dr. Paul Sax, an infectious disease expert at Brigham and Women’s Hospital and professor at Harvard Medical School.

 

While it can help incrementally to continue to wipe down shared spaces, “the most important thing is keeping people from breathing air that is filled with germs,” said Tara Kirk Sell, a senior scholar at the Johns Hopkins Center for Health Security. If you have a HEPA air cleaner, place it in or outside your bedroom.

 

If you’ve tested positive and feel well, you can take a walk outdoors and get fresh air. If you’re in a city where you will cross paths with other people, wear a mask and keep your distance.

 

Should I take a second test to confirm the result?

If you tested positive after taking a rapid home test, you may want to take a second home test using a different brand or go to a testing center to confirm the result. False positives aren’t common with home tests, but they can happen. Even so, you should assume the positive result is correct, wear a mask and avoid close contact with other people until you get retested. If your positive test came from a laboratory, a second test isn’t necessary.

 

Can I find out if I got Omicron?

No. In most cases, you won’t know which variant of coronavirus you’ve caught and your lab test typically won’t tell you. In general, the guidance on isolation, monitoring and treatment does not change based on which variant infected you.

 

Who do I tell that I tested positive?

Think about where you’ve been and who might have inhaled your germs. Contact your employer and let them know. Most workplaces have protocols in place for contact tracing when an employee tests positive. You also want to alert anyone with whom you’ve spent time, going back at least two days before you got tested or started having symptoms, said Dr. Sax. The C.D.C. defines a close contact as someone who was less than six feet from you for 15 minutes or more.

 

It may feel overwhelming, or even shameful, to tell people about your positive test, said Dr. Ashish K. Jha, dean of the Brown University School of Public Health. “A lot of people think it’s some failure if you get infected,” Dr. Jha said. “This is an incredibly contagious variant. A lot of people are going to get it. That is not a moral failure.”

 

Don’t forget to tell your doctor too, particularly if you have an underlying medical condition, like high blood pressure or diabetes, that puts you at higher risk.

 

If the infected person is a child, call your pediatrician. You also need to call your child’s school, as well as anyone they’ve had close contact with at play dates, parties or other activities.

 

What treatment options do I have?

Monitor your symptoms. You can use a pulse oximeter to keep track of your blood oxygen levels. Most healthy people will get an oxygen reading around 95 to 99 percent. You should seek medical advice if the reading drops quickly or the level dips to 93 percent or lower. The devices can be less accurate for people with darker skin, so pay attention to the trend. If your reading drops by four points, it’s worth checking in with a doctor. You should also see a doctor if you take a turn for the worse, have trouble breathing or have any symptom that causes you concern.

 

Ask your doctor if you are eligible for monoclonal antibodies, a treatment that can help your body fight Covid-19 and lower your risk for severe illness, particularly for people in a high-risk group. For monoclonal antibody therapy to be most effective, it needs to be given soon after diagnosis, even if you’re not feeling bad yet. If you don’t have a regular doctor, you can also contact the infectious disease clinic at your hospital and ask about the treatment, said Dr. Celine Gounder, an epidemiologist at N.Y.U. medical school.

 

There is some concern that monoclonal antibodies will not work as effectively against the Omicron variant, but more research is underway, said Dr. Jennifer Lighter, a hospital epidemiologist and pediatric infectious disease specialist at N.Y.U. Langone.

 

On Wednesday, the Food and Drug Administration authorized the first pill for Covid-19. Developed by Pfizer and known as Paxlovid, the drug is authorized for patients age 12 and older who are vulnerable to becoming severely ill because they are older or have medical conditions such as heart disease or diabetes. The treatment is meant to be taken as 30 pills over five days. Read more about the pill here.

 

The Coronavirus Pandemic: Key Things to Know

The holiday season. With planned end of the year gatherings, the new Covid surge is prompting worries and cancellations. The Times asked experts to share some holiday guidance, as well as some tips on using at-home virus tests (if you can find any). Here is what to do if you test positive for the coronavirus.

 

The Omicron variant. The highly transmissible Covid version appears to be less severe than previous variants, according to new studies. Research also suggests many non-mRNA vaccines offer almost no defense against infection, though the Pfizer and Moderna boosters, which are mRNA-based, most likely provide strong protection.

 

New treatments. The Food and Drug Administration authorized in short succession the first two pill treatments for Covid-19 from Pfizer and Merck. The new drugs, which can be taken at home with a doctor’s prescription, will be available to some Covid patients who are at higher risk of becoming severely ill.

 

Around the world. After infections skyrocketed to record levels in South Africa, new cases have started falling, suggesting its Omicron wave may have peaked. In Europe, the Netherlands, Britain and Denmark adopted tough restrictions, while France, Spain and Italy are taking a more measured approach.

 

On Thursday, the F.D.A. also authorized a pill developed by Merck and known as molnupiravir, for people 18 and older who are vulnerable to becoming severely ill from Covid-19, according to a release from the administration. The treatment is meant to be taken as 40 pills over five days.

 

When can I stop isolating?

The C.D.C. recommends a 10-day isolation period for people who test positive, regardless of their vaccination status. To calculate your 10-day window, the C.D.C. advises that you consider day zero to be your first day of symptoms. Day one is the first full day after you develop symptoms. If you are asymptomatic, the C.D.C. counts day zero as the day of your positive test.

 

While schools and employers typically want you to isolate for 10 days before returning, some vaccinated people may be able to move more freely around their homes sooner if they aren’t living with high-risk people. If you are fully vaccinated and do not have symptoms, you could test yourself starting on day five of your illness, Dr. Jha said, and stop isolating in your room if you have two negative antigen tests a few days apart.

 

After 10 days of isolation, it’s a good idea to take a rapid antigen test to confirm you aren’t contagious. Dr. Jha recommends an antigen test over a PCR test in this scenario, because your PCR can remain positive for days or even months after you’ve recovered and are no longer spreading the illness.

 

If your symptoms persist, you should consult a doctor and remain isolated from others. You may also want to get another test, Dr. Sell said.

 

People who are immunocompromised or have other underlying conditions may be prone to a more prolonged infection. Depending on test results, your doctor may advise extending your isolation period to 20 days.

 

What if I’m exposed to someone who tested positive?

The C.D.C. has said that people who are fully vaccinated don’t need to quarantine after contact with someone who had Covid-19 unless they have symptoms. However, fully vaccinated people should get tested five to seven days after their exposure, even if they don’t have symptoms and wear a mask indoors in public for 14 days following exposure or until their test result is negative. This guidance could change as we learn more about Omicron.

 

The C.D.C. said on Friday that unvaccinated students who are exposed to the virus do not need to miss school after a potential exposure as long as two tests during the following week are negative. Read more about the “test to stay” protocol.

 

I’ve already had Covid. Am I at risk for reinfection?

Yes. The degree of protection you get from a previous infection varies widely. You’re more protected if you’ve also been vaccinated. Early studies suggest antibodies from a past Covid infection alone are not a strong defense against Omicron.

 

“Unfortunately, reinfection after people have had Covid before, can occur, and the protection of previous infections is very variable and unpredictable,” said Dr. David Rubin, the director of PolicyLab at Children’s Hospital of Philadelphia and a professor of pediatrics at the University of Pennsylvania’s Perelman School of Medicine. “So some people seem to be very protected and don’t get Covid again, and other people can get it again and even get quite severe disease again.”