What to do if you are testing positive for Covid-19 now
What to do if you are testing positive for Covid-19 now

What to do if you are testing positive for Covid-19 now

Two years into the pandemic, many are unsure of what to do after being tested positive for Covid-19. Should they be isolated, and if so, for how long? How important is it to see a doctor? What treatments are available and who is eligible?

To help answer these and other questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health” and the mother of two young children.

CNN: It looks like a lot of people are being diagnosed with Covid-19 right now. I have friends who have been very careful throughout the pandemic who are now testing positive. Why?

Dr. Leana Wen: First and foremost, we are dealing with an extremely contagious subvariant. The original Omicron variant was already more contagious than Delta and earlier variants. Back then, we had BA.2, a subvariant of Omicron that was more contagious than Omicron, and now we have an offshoot of BA.2, called BA.2.1.21, that seems to be even more transmissible.

A more transferable variant means that the activities we thought were relatively safe before are now at higher risk. This does not mean that we should avoid all activities, but rather that people who have been very careful before may become infected now because of how contagious this subvariant is. Also, people previously infected with Omicron have some degree of protection against this new subvariant; those not previously infected are now more susceptible. Fortunately, this variant does not appear to cause more serious illness in most people, and the vaccine and the first booster still provide good protection against hospitalization and death for those infected.

Another reason for the increased number of infections is that people interact more with each other, also indoors and without masks. Whenever such interactions occur, there is a risk of transmission. Again, this is not to say that people should never associate with each other, but rather to be aware of the risk and take precautions, especially for those with immunocompromised and others at higher risk of serious illness.

CNN: If anyone is diagnosed with Covid-19, what should they do? Is insulation still recommended?

When: Yes, it is, and it’s actually the first thing I recommend people do if they test positive for Covid-19. Whether they performed their own home test and have a positive result or got a positive result back from a PCR test, they should isolate immediately. If they are at home, then go to a room away from others. If they are at work, wear an N95 mask to transport through public areas and take home, ideally in your own vehicle.

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Isolation is not always easy, especially for those with small children and who live in multi-generational housing. If possible, identify another adult to care for young children so that the infected person can isolate themselves. If it is a child who has tested positive, appoint an adult to take care of that child. (We discussed more about the challenges of isolation with young children in this previous Q&A.)

CNN: How long do people have to isolate themselves?

Wen: The day you take your positive test is day zero. If you had symptoms before then, e.g. the day before, that day is day zero – whichever comes first. Day 1 is 24 hours after the positive test or occurrence of symptoms. You need to be isolated from others for five days. It does not mean being in the same room at home with people you live with and not going to work in person. If you need to share e.g. a bathroom, be sure to wear a snug N95, KN95 or KF94 while in these common areas, minimize your time in them, and open the windows as much as possible.

The CDC says that after the fifth day in isolation, if you do not have a fever and your symptoms get better, you can go into public spaces like grocery stores and at work and school, as long as you wear a well-fitting mask all the time. Many workplaces and schools have their own policies that are stricter than this and which may require, for example, a full 10 days before you return.

In addition, I would warn that the CDC does not say that after day 5 you can freely associate with your family and people in your home. You can still be contagious. The CDC says you still have to mask yourself around others today 6 to 10. That does not include eating with people you live with, indoors, these days.

With an increase in case of coronavirus, what precautions should you take for graduation and other festivities?

Many public health experts, including me, would recommend testing outside of isolation as an extra level of safety that also reduces the hassle. This is not what the CDC says, but I think it’s fair to start testing with a quick home test from day 5. If you test negative on day 5 and day 6 and you do not have fever and improved symptoms, you can leave isolation. It would provide a less cumbersome period of isolation, especially for families living in small rooms or having small children to look after.

A worker is preparing one of the new government-issued Covid-19 Antigen Rapid test kits she received to take a self-test while at home on Feb. 8 in Provo, Utah.

CNN: What therapies should people take? Should everyone get them?

When: It is important that you call your doctor and ask if you are eligible for treatment. I would call whether you have mild, severe or no symptoms because you need to know what your options are. There are three main types of therapies, all of which are designed to be taken before someone becomes seriously ill, to prevent hospitalization. In general, the faster you start the treatments, the more effective they are.

The three options are antiviral pills (paxlovid and molnupiravir are the two antiviral agents that have been approved), monoclonal antibodies and remdesivir. The pills are taken orally, while the other two require injections or infusions. They are intended for people who are at higher risk of progression to serious illness. Some therapies may not be readily available in your area. Others may have interactions with other drugs or treatments you are on.

I highly recommend that people talk to their doctors before they get sick so they have a plan. Someone who is in his 20s and healthy is probably not eligible for these treatments, but another who is in his 60s with some chronic medical conditions will be. Know in advance what you will get if you test positive and how you will access the treatments, including after hours and on weekends. If you do not already have this plan, call your provider immediately after you test positive and discuss the options.

For people who do not have a regular doctor, the federal government has atherapeutics locator, including a “test-to-treat” option where people can go to be tested, see an emergency care provider and get the therapies all in one place. Your local and state health departments are also likely to have additional information and resources.

CNN: How do you address skeptics who might be asking what is the point of being vaccinated if vaccinated people can still be infected?

When: Let’s talk about the primary purpose of vaccination. The main reason is to reduce the likelihood of serious illness and to prevent infected people from being hospitalized and dying. This is why it is so important to be up-to-date with vaccines, to get the first vaccines and then the boosters, because people who are vaccinated and boosted are much less likely to get seriously ill and die compared to people who are unvaccinated.

Vaccination also reduces the risk of infection, but that risk still exists. For people who want to reduce their risk of getting Covid-19 further, other precautions remain important, including wearing an N95 or similar mask while in an indoor public environment, and same-day testing before gatherings, especially if community Covid -19 levels are high.

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