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How long after I get COVID
Testing positive for COVID-19 even without symptoms can be disruptive to life, but how long should we expect to test positive for?
The science behind COVID-19
How long after I get COVID-19 will I test negative?
Testing positive for COVID-19 even without symptoms can be disruptive to life, but how long should we expect to test positive for?29 October 2021
3 min readby
Close-up of young man getting PCR test at doctor's office.
This is a question that millions of us have asked ourselves, and with good reason. Testing positive for COVID-19, even if we have been vaccinated or don’t have any symptoms, is incredibly disruptive to our lives.
Unfortunately, many people can test positive for COVID-19 for weeks or even months, but there is good news: people are not likely to be contagious for that long, even if they test positive, and therefore are unlikely to transmit the virus to others.
It means we have to limit contact with members of our household, isolate for several days, thus withdrawing again from daily activities, and disrupt travel plans. After nearly two years of the COVID-19 pandemic, life being thrown into constant chaos can feel exhausting.
Positive does not equal contagious
The time taken to test negative after contracting COVID-19 depends on the severity of the case, and also on the test itself. PCR tests that hunt out parts of viral genetic material (RNA in the case of COVID-19) in our bodies and amplify it so we can detect it are extremely sensitive and can even pick up the presence of few viral fragments. This is because fragments of viral RNA can remain in our bodies long after the infection is over and the virus has been cleared from our system.
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Lateral flow tests that look for viral proteins called antigens are less sensitive and may be less likely to give a positive result several days after first infection. If we test positive on a PCR test but negative on an antigen test, then it's likely that we are not infectious and have just residual virus RNA.
Unfortunately, many people can test positive for COVID-19 for weeks or even months, but there is good news: people are not likely to be contagious for that long, even if they test positive, and therefore are unlikely to transmit the virus to others. However, if we test positive on a PCR as well as on a protein-based antigen test, then we might still be infectious. This is because having viral proteins for a long time means that the virus is replicating and producing more of its core material.
The World Health Organization (WHO) advises that people isolate for ten days after their symptoms start (or from when they are diagnosed if they are asymptomatic) plus three days after symptoms cease. There are exceptions to this depending on whether people are still symptomatic, says WHO: if a person is symptomatic for say, 30 days they will need to isolate until they are asymptomatic.
It’s important to note that WHO still recommends that vaccinated people who have COVID-19 symptoms or people living in contact with someone who has COVID-19 should still maintain caution regarding social interaction, despite some countries changing national guidance on this.
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What experts told me to do after my positive COVID
Rapid at-home tests mean many COVID-19 cases go unreported, but they’re a great tool for deciding when to leave isolation. I found that out firsthand.
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What experts told me to do after my positive COVID-19 at-home test
What experts told me to do after my positive COVID-19 at-home test It gets complicated to figure out how to report results and when you’re no longer contagious
By Anna Gibbs
Science writing intern, Spring 2022
APRIL 22, 2022 AT 7:00 AM
As many as 50 percent of those in the United States testing positive for COVID-19 in the coming weeks may find out via an at-home test, researchers say. That creates challenges for tracking case counts.
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After two years of successfully evading getting COVID-19 — including a few brushes with close contacts, a couple of are-they-just-colds? scares and lots of negative tests — I recently tested positive.
It felt both inevitable and shocking. I somehow avoided testing positive during the omicron surge that infected most of my friends this winter, so I figured that either I was invincible or I was next. Staring at my at-home rapid antigen test, I had to acknowledge that the long game of high-stakes tag was finally over. I was now “it.”
COVID-19 snuck up on me when I least expected it. Cases are low where I live in Queens, N.Y. And riding the subway felt low risk thanks to the federal public transit mask mandate. (A federal judge struck down the mandate on April 18, although the Biden administration announced April 20 it would appeal the ruling and some places, including New York City, are keeping masking requirements in place for the time being.) I had dined indoors, but I still wore my mask inside public spaces (SN: 3/25/22). So when I woke up with a sore throat on a Wednesday, I chalked it up to needing more sleep. Before I tested Friday evening, I was still convinced it was just another cold.
Two thick lines on my rapid test said otherwise (SN: 12/17/21). OK, I thought, I definitely have COVID. Now what?
These are my results the day I tested positive for COVID-19. I took two rapid at-home tests just to be extra sure — and then got a PCR test from a testing site so my results could be included in official case counts.
I had a pretty good idea of the first few steps, which had been drilled into my head ad nauseam: Isolate immediately. Text close contacts from the 48 hours before first symptoms. Stay away from other people and pets in the house.
It got blurrier from there. Since I tested myself at home, my COVID-19 test wasn’t official. Surely I should report my positive test; after all, public health regulations are often based on case numbers. But it turns out that playing my part was a lot harder than I would have thought.
When it comes to reporting at-home tests, “there is no formal recommendation,” says Autumn Gertz, an epidemiologist at Boston Children’s Hospital who works on COVID-19 surveillance. Without a federal program for reporting at-home tests, states are left to their own devices, and it’s confusing to make sense of where to report, which means that many people won’t.
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That’s problematic: Now that at-home tests are free and easy to access, at-home testing is becoming increasingly common. Gertz and colleagues are tracking at-home testing trends and say they have noticed a gradual increase in their use to detect COVID-19. In the coming weeks, Gertz says they expect 50 percent of people who get COVID-19 to find out from an at-home test.
Cases being underreported is nothing new. Even early on, asymptomatic and mild cases where the person never got tested wouldn’t make the case count. But at-home testing will make underreporting even more prevalent. The Institute for Health Metrics and Evaluation’s data show that only an estimated 7 percent of all U.S. COVID-19 cases are being reported, Katelyn Jetelina, an epidemiologist at the University of Texas in Dallas who writes the Your Local Epidemiologist newsletter, reports April 13 in a post titled “Can we trust case numbers?”
To make my case count, I donned two KN95 masks and walked to the COVID-19 testing booth on my street to get a PCR test that would be officially reported. (An official PCR test result may also be necessary for insurance coverage in cases that require medical care.) The downside is that I was contagious so there was a risk of exposing others to the virus, though I was masked for all but the swab. An alternative, Gertz suggests, is reporting your positive at-home test to a primary care provider. Some at-home test manufacturers also provide information about how to report results from that test.
But until public health reporting catches up with the quick transition to at-home testing, we’re flying blind. There are ways to find clues about what’s going on in your community, though.
For starters, become familiar with your local public health department website, says epidemiologist Michael Mina, the chief science officer at eMed, a company developing a system for at-home test reporting. Check to see if your community monitors wastewater, which is a better way to track the amount of SARS-CoV-2, the virus that causes COVID-19, in communities than case numbers or hospitalizations. Outbreaks Near Me, a project Gertz works on, also collects results from volunteers to help track COVID-19 trends down to the local level.
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.