You have tested positive for Covid-19. Now what?

How long will I be contagious?

The U.S. Centers for Disease Control and Prevention says anyone who tests positive for Covid-19 should self-isolate for 10 days from the onset of symptoms. This means avoiding contact with other people and not leaving the house unless you need to go to a medical appointment. If you are asymptomatic and the test is positive and you never develop any symptoms, the isolation period should begin on the day you take your diagnostic test. It is thought that you are no longer contagious after 10 days if you have not had a fever – and have not taken fever medication – for at least 24 hours and your symptoms improve. The CDC recommends that immunocompromised patients and those with severe cases of Covid-19 self-isolate for up to 20 days after symptoms appear.

Do I tell people I have been in contact with that I have tested positive?

Anyone who lives with you must take a Covid-19 test and be quarantined for 10 to 14 days from their last contact with you. In some cases, the quarantine can be reduced to seven days with a negative test. If you’ve spent a total of 15 minutes within 6 feet of someone else in the past two to four days, you should contact those people and let them know you’ve tested positive. Some experts say that if you are masked and on the outside there is much less risk and quarantine may not apply to these contacts, but that depends on your local health department’s contact tracing guidelines.

“Public health authorities differ in their advice,” says Graham Snyder, medical director of infection prevention and hospital epidemiology at the University of Pittsburgh Medical Center. “In our jurisdiction, if masked, we still consider you exposed if you are within 6 feet for 15 minutes. Obviously, you’re less likely to be contagious or exposed if both people are masked and less likely to pass the virus outside, but there is a continuum where public health draws that line and it can vary.

When I isolate myself, what can I or can’t I do?

Isolation means avoiding human contact as much as you can. Some cities and governments provide housing for people who need to self-isolate. If that’s not an option and you live with others, try staying on your own floor or in a room with a private bathroom, if possible. Food and other essentials should be left outside your door. If someone enters your room or if you need to go out, make sure the two of you are masked. Some experts say walks are not allowed in isolation. Others say that as long as you are masked, that you feel good, and that in an area where you can easily be very far from others, there is nothing wrong with going out to get some fresh air.

Do I have to have another diagnostic test after my 10 day isolation period?

Many experts say this is not necessary and can lead to undue stress and anxiety if another test turns out positive. The PCR test commonly used to diagnose Covid-19 is very sensitive and can detect dead or non-infectious viral particles weeks later, says Kristin Englund, an infectious disease physician at the Cleveland Clinic. “So it will not be an accurate diagnosis to know if a person is still contagious or not,” she says.

The only time repeated diagnostic testing may be necessary is in critically ill and immunocompromised patients whose recommended isolation period is up to 20 days after symptom onset.

What about an antibody test?

Doctors do not recommend taking an antibody test in most cases. “A routine antibody test after a diagnosis of Covid is not necessary,” says Michael Lin, an infectious disease physician at Rush University Medical Center in Chicago. “It’s expensive and it doesn’t change what you do day in and day out.”

Dr Lin says, “We still don’t know if a positive antibody test result means you are automatically protected or vice versa, if a negative result means you are at risk.” Doctors say it’s important to observe protections against the pandemic after having Covid-19, including wearing a mask, social distancing, and avoiding crowded indoor spaces. A vaccine is always recommended, so the results of an antibody test do not provide any useful information, they say.

The only reason someone might consider a test is if they were unable to get a diagnostic test but had symptoms of Covid-19 and wanted to see retroactively if that is in fact what they had, said Dr. Lin.

What if I don’t feel completely better after 10 days? If I am still coughing, should I be worried about being contagious?

The CDC’s 10-day isolation recommendation is only for being contagious. “The duration of symptoms does not match the contagiousness,” says Dr. Snyder of the University of Pittsburgh Medical Center. Many patients may feel fully recovered after 10 days or two weeks. But others may not be able to return to work and their normal routines. If your symptoms improve and you don’t have a fever, that’s normal, he says.

“I don’t think you have to wait until you’re completely asymptomatic to come out of your 40s and consider resuming your normal daily activities,” says Dr Englund. A recovery time of up to 28 days is reasonable, she says. After that, you should contact your attending physician.

What is the long Covid?

Long Covid is a term for Covid-19 patients who exhibit symptoms that can last for months after their initial acute infection with Covid. Also called long-haul, these patients often develop new symptoms that worsen even after recovering from their first episode of Covid. Some patients have never been hospitalized for acute Covid-19 and are young and healthy with no underlying medical conditions. A recent study by the UK Office of National Statistics estimated that 20% of patients with Covid have symptoms for five weeks or more and 10% have symptoms for 12 weeks or more.

Can I receive the Covid-19 vaccine if I have had Covid and if so, how long do I have to wait?

Yes you can and the experts say you should get the vaccine as soon as you qualify. It is believed that most people with Covid-19 have natural immunity and will be protected against the virus for at least three months. “Theoretically, the vaccine could boost a person’s immunity against natural infection,” says David Wohl, professor of medicine in the division of infectious diseases at the University of North Carolina, Chapel Hill. There is no reason to wait, he says, except to make sure that you are both outside the 10-day infectious period and fully recovered, as the vaccine can cause side effects or symptoms. in some people.

Should I receive the vaccine if I have not been hospitalized but have had treatment with monoclonal antibodies?

More and more outpatients are currently being treated with the two monoclonal antibody treatments authorized for patients at risk of hospitalization. These patients should wait at least three months before receiving the vaccine, says Dr Wohl, because it takes the body several months to clear the antibodies and theoretically these antibodies could cling to the proteins that the vaccine teaches the body to make and to hide them. immune system.

Are there any symptoms that are a red flag to see a doctor?

Dr Lin says that during your active and acute infection, if you feel short of breath and cannot speak in full sentences, it means your lungs are badly infected and you should see a doctor. Other warning symptoms include confusion or signs of a stroke, such as sudden weakness in any part of your body or loss of sensation. Dr Lin says if you can’t go about your daily activities after recovering from acute Covid, see a doctor.

When can I resume my normal exercise routine?

Experts say you don’t go straight back to your fitness routine if you were doing high-intensity exercise before Covid. “I was starting over slowly,” says Dr. Wohl. “Listen to your body.” Even people who haven’t been hospitalized can have inflammation of the lungs and not exchange oxygen as they normally would, he says. Exercise as tolerated, advises Dr. Lin. “This particular virus tends to infect the lungs,” he says. “We therefore expect that people will potentially have a harder time returning to their normal exercise routine compared to other viruses.”

Are there any tests that Covid-19 patients should get to check for organ damage, like chest scans or EKGs?

Experts don’t routinely recommend getting tests or scans unless there is a particular symptom that lasts a long time and doesn’t improve, such as shortness of breath or a fast heartbeat.

Can Covid-19 cause other dormant viruses, like the Epstein-Barr virus, which causes mononucleosis, or activation of shingles?

Yes. When the body is under stress, latent viruses can be reactivated. “In most cases, these are transient increases in levels and do not cause any organ disease,” says Dr. Wohl. “We know people who are stressed or when they have illnesses with other types of viruses, like cold sores or even shingles.” Under such conditions, they can burst, he says.

Write to Sumathi Reddy at [email protected]