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If you've been exposed to the coronavirus
If you've been exposed, are sick, or are caring for someone with COVID-19 If you've been exposed to someone with COVID-19 or begin to experience symptoms of the disease, you may be asked to self-quarantine or self-isolate. What does that entail, and what can you do to prepare ...
If you've been exposed to the coronavirus
April 12, 2022
If you've been exposed, are sick, or are caring for someone with COVID-19
If you've been exposed to someone with COVID-19 or begin to experience symptoms of the disease, you may be asked to self-quarantine or self-isolate. What does that entail, and what can you do to prepare yourself for an extended stay at home? How soon after you're infected will you start to be contagious? And what can you do to prevent others in your household from getting sick?
Additional information on coronavirus and COVID-19 can be found on other pages within the Resource Center.
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Podcast:You think you've got COVID-19. Here's what you need to do (recorded 4/10/20)
We asked Dr. Mallika Marshall, medical reporter for CBS-affiliate WBZ TV in Boston and an instructor at Harvard Medical School, how we should react when we start to experience a dry cough or perhaps spike a fever. Who do you call? How do you protect your family? When does it make sense to move toward an emergency department, and how should we prepare? Dr. Marshall is the host of Harvard Health Publishing's online course series, and an urgent care physician at Mass General Hospital.Visit our Coronavirus Resource Center for more information on coronavirus and COVID-19.
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If you keep testing positive for COVID, when can you stop isolating? : Shots
Nobody wants to infect their friends and family, but do you really have to keep isolating at day 12, 13 or beyond? Unfortunately — and perhaps unsurprisingly — the science is not entirely settled.
Still testing positive after day 10? How to decide when to end your COVID isolation
June 30, 20225:02 AM ET
The science isn't entirely settled on whether a rapid antigen test indicates whether a person is still contagious.
Massimiliano Finzi/Getty Images
Many Americans have wrestled with this dilemma at some point during the pandemic, yet it still seems to come up again and again: When can you stop isolating after a COVID-19 infection? The question is especially vexing if you're feeling better, but still testing positive on a rapid test.
Even with the arrival of new subvariants, the basic ground rules haven't changed since omicron first came onto the scene: the Centers for Disease Control and Prevention says someone can stop isolating after five days if they're fever-free for 24 hours and are starting to get better — as long as they keep wearing a mask around others for another five days.
Some researchers have criticized these rules pointing to research that shows some people may remain infectious after day five. And many experts advise waiting until you test negative on an at-home test before venturing out.
But if you feel fine, it can be frustrating to wait, especially if you're in the subset of those who test positive past 10 days.
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James Hay, who studies infectious disease dynamics, remembers earlier this year when his sister continued testing positive for two weeks. Their family had plans to get together over the holiday — a gathering that included an older relative who was vulnerable to COVID.
"To us, that was just not worth the risk," says Hay, who's a research fellow at the Harvard T.H. Chan School of Public Health. "Going to the shops with a mask on, that's a different kind of risk consideration."
Testing to get out of isolation is tempting because it promises a straightforward answer. Unfortunately — and perhaps unsurprisingly — the science is not entirely settled.
"We don't have anything that says definitely you are contagious or definitely you're not," says Dr. Emily Landon, an infectious disease specialist at UChicago Medicine. "The best thing we have are these rapid antigen tests."
Unlike PCR tests, which search for genetic material from the virus, rapid antigen tests work by looking for the proteins that are packed inside the virus. A positive test generally correlates with the presence of infectious virus. Scientists can determine that by taking samples from someone who's been infected and trying to grow the virus in a lab — what's known as a viral culture.
Generally, most people who get infected are not still testing positive on an antigen test 10 days after symptom onset."If you have enough virus in your system to be turning one of these tests positive, that means your body probably hasn't yet fully cleared the infection," says Hay.
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But there is no perfect study that shows how likely it is that a positive test on a rapid test translates into shedding enough virus that you could actually infect another person, says Dr. Geoffrey Baird, chair of the department of laboratory medicine and pathology at the University of Washington School of Medicine.
"The answer to that is clear as mud," he says.
Indeed, infectious disease experts tend to differ about how much stock to put in a rapid test result when someone knows they're infected and deciding whether it's safe to rejoin the outside world.
After all, Baird points out that these tests were never designed to function as get-out-of-isolation cards. Relying on the result to tell whether you're truly still infectious is dicey, he says.
"There's actually a lot more discrepancy than anyone would be happy with," he says.
A positive antigen test could essentially be picking up leftover viral "garbage," which can include "dead viruses, mangled viruses ... viruses that are 90% packed together but not really going to work," says Baird. And the amount can vary depending on each person's immune system, the variants, the stage of the infection, and so on.
This is partly why Baird did not bother to take a rapid test when he had COVID recently and had to decide when it was OK to return to work. After a week, when he was feeling better, he came back to the office, where everyone's required to wear an N95 mask.
Even if it is an imperfect tool, not everyone is down on using a rapid antigen test.
Landon says it's extra information that can give you a sense of how to proceed, especially if people are banking on the CDC guidance to determine whether to end isolation. That's because some people will still be infectious after five days, she says.
In fact, a study co-authored by Landon followed health care workers at the University of Chicago who had been infected but were feeling mostly better and went to get tested after five days. They found that more than half of them still tested positive on antigen tests after six days.
What to do if you test positive for Covid after your symptoms are gone
Some people are still testing positive for Covid, even after their symptoms are gone. Here's what you need to know about it, and what to do if it happens to you.
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What to do if you keep testing positive for Covid—even after your symptoms are gone
Published Wed, Jun 15 20229:10 AM EDTUpdated Tue, Jun 21 20223:43 PM EDT
Natalie A. Rahhal, Special to CNBC
wayra, E+ via Getty
Even after the fever has broken, the runny nose has dried up, the official five-day quarantine period has ended and the 10-day precautionary phase is over, some people are still testing positive for Covid — despite feeling totally fine.
If you find yourself in this situation, you might be puzzled over what to do, particularly since the Centers for Disease Control and Prevention offers little specific guidance on this front. It’s difficult to know exactly how many people this affects — most people self-test at home, so their results are untracked — but a pre-vaccine study of Florida school children in 2020 found that 8.2% of high school kids still tested positive 9-14 days after their first positive tests.
Even small percentages can affect millions of people, as the country’s total case count continues to rise: The U.S. has surpassed 85.7 million total Covid cases since the pandemic began, according to data from Johns Hopkins University, likely an undercount due to those at-home tests.
Here’s what you need to know about the phenomenon, and what to do if it happens to you:
What you should do if you keep testing positive after 10 days
Testing positive for Covid doesn’t necessarily mean that you’re contagious. Rapid tests detect certain protein pieces of the virus, but those proteins alone don’t cause infection. The same goes for PCR tests, which identify the virus’ genetic material in your system.
So, to work out if positive tests mean people are infectious, scientists culture samples from these tests in petri dishes to see if more virus can grow, indicating that it’s still alive and contagious. A recent Boston University study, which has yet to be peer-reviewed, used this technique and found that just 17% of people were likely still contagious six days after their first positive tests.
Unfortunately, there’s currently no way to know which category you’re in. But most experts say that as long as your symptoms are gone, you probably don’t need to isolate anymore.
The CDC recommends isolating for five days after you first test positive, and ending your quarantine as long as you’ve been fever-free for 24 hours and your symptoms are improving. The agency’s guidance adds that you should keep wearing a mask through day 10 — essentially a precaution in case you’re still contagious.
Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco, says she’d “feel really comfortable” with a symptom-free person emerging after five days of isolation, even if they’re still testing positive for Covid.
“Follow CDC guidance and wear a mask for the following five days,” she says.
Dr. Wilbur Lam, a pediatrics and biomedical engineering professor who led Emory University’s initiative to test Covid-19 diagnostics for the U.S. government, particularly recommends avoiding contact with people who may have compromised immune systems, or wearing a mask if you can’t avoid the risk.
“Scientists, including our own center, are really trying to figure out what the variables are that may affect why one becomes persistently positive on rapid tests, and what the implications are both from a biological and a public health standpoint,” he says.
What testing positive for more than 10 days could mean for your long-term health
Last month, the CDC issued an alarming warning that as many as one in five adult COVID-19 survivors may develop long Covid, potentially including long-term symptoms from fatigue and brain fog to circulation and digestive issues. Women, older people and those with chronic health conditions all appear to be at higher risk.
Covid isn’t the only pathogen that can cause such issues: Dr. Jeremy Kamil, a virologist at Louisiana State University Health Shreveport, notes that other viruses, like human papillomaviruses, can also wreak havoc on the body weeks or even years after the initial infection.
More than 10 days of positive tests are not a known risk factor for long Covid, but they do raise questions about where the virus could linger. Some viruses are known to hide in tissues that don’t produce symptoms — like fat cells or the gut, for example — before reemerging once it thinks the coast is clear.
Incidentally, this is one theory for why some people test positive for Covid beyond 10 days — but for now, it’s just a theory. Experts stress that if you do keep testing positive after your week-and-a-half stint is over, you probably don’t need to worry: The precautions are important to take, but you’re unlikely to harm yourself or those around you by ending your isolation.
That’ll remain true unless further research proves otherwise.