You tested positive for Covid-19. Now what?

How long will I be contagious?

The US Centers for Disease Control and Prevention says anyone testing positive for Covid-19 should be isolated for 10 days from the onset of symptoms. This means avoiding any contact with other people and not leaving home unless you have to go to a medical meeting. If you are asymptomatic and test positive and never develop symptoms, the isolation period should begin on the day you take the diagnostic test. It is believed that you will not be contagious after 10 days if you have not had a fever – and have not taken medicines to reduce your fever – for at least 24 hours and your symptoms are improving. The CDC recommends that immunocompromised patients and those with severe cases of Covid-19 be isolated for up to 20 days after symptoms occur.

Do I have to tell the people I have been in contact with that I have given positive results?

Anyone living with you should receive a Covid-19 test and quarantine for 10 to 14 days from the last contact with you. In some cases, the quarantine can be shortened to seven days with a negative test. If you have spent a total of 15 minutes within a 6-foot radius of anyone else in the last two to four days, you should contact those people and let them know that you tested positive. Some experts say that if you are masked and out there is a significantly lower risk and quarantine may not apply to these contacts, but it depends on the contact tracking guidelines in your local health department.

“Public health authorities vary 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 they are masked, we still consider ourselves exposed if they are at 6 feet for 15 minutes. Obviously, you are less likely to be contagious or exposed if both people are masked and less likely to transmit the virus outdoors, but there is a continuum where public health draws this line and can vary. ”

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

Isolation means avoiding any contact with humans as much as you can. Some cities and governments offer housing for people who need to isolate themselves. If this is not an option and you live with others, try to stay on your private bathroom floor or room if possible. Food and other essentials should be left out of the door. If someone enters your room or you have to venture out, make sure you are both masked. Some experts say that walking is not allowed while isolated. Others say as long as you are masked, you feel good and in an area where you can be easily very far from others, it is good to go outside for fresh air.

Should I have another diagnostic test after the 10-day isolation period?

Not. Many experts say this is not necessary and can lead to unwarranted stress and anxiety if another test is positive. The PCR test commonly used to diagnose Covid-19 is very sensitive and can detect virus particles that are dead or non-infectious weeks later, says Kristin Englund, an infectious disease physician at Cleveland Clinic. So there will be no accurate diagnosis if someone is still infectious or not, she says.

The only case in which a repeated diagnostic test may be required is for seriously ill and immunocompromised patients whose recommended isolation period is up to 20 days from the onset of the symptom.

What about the antibody test?

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

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

The only reason anyone might consider a test is if they couldn’t get a diagnostic test, but had Covid-19 symptoms and want to look back if that’s actually what they had, says Dr. Lin.

What if I don’t feel completely better after 10 days? If I keep coughing, do I have to worry about being contagious?

The CDC’s 10-day isolation recommendation only refers to being contagious. “The duration of symptoms does not correlate with contagion,” 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 routine. If the symptoms improve and you do not have a fever, it is normal, he says.

“I don’t think you have to wait until you’re completely asymptomatic to get out of quarantine and think about returning to normal daily activities,” says Dr. Englund. A recovery time of up to 28 days is reasonable, she says. After that, you should contact your primary care physician.

How long is Covid?

Long Covid is a term for patients with Covid-19 who have symptoms that may last for months after the initial acute Covid infection. Also called longhaulers, these patients often develop new and worsening symptoms even after recovering from their initial Covid disease. 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 National Statistics Office 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 get the Covid-19 vaccine if I had Covid and if so, how long do I have to wait?

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

Should I receive the vaccine if I have not been hospitalized, but have had monoclonal antibody treatment?

Several outpatients are now being treated with the two authorized monoclonal antibody treatments for patients at risk of hospitalization. These patients should wait at least three months before receiving the vaccine, says Dr. Wohl, because the body needs a few months to remove the antibodies and theoretically these antibodies could cling to the proteins the vaccine teaches the body to make them and hide them from the immune system.

Do you have any symptoms that are a red flag to seek medical attention?

Dr. Lin says that during your acute, active infection, if you feel short of breath and cannot speak in full sentences, it is a sign that your lungs are seriously infected and that you should seek medical attention. Other symptoms of the red flag include confusion or signs of a stroke, such as a sudden weakness in one part of the body or a loss of sensation. Dr. Lin says that if you cannot carry out your daily activities after recovering from acute Covid, consult a doctor.

When can I resume my normal exercise routine?

Experts say that you should not immediately return to your fitness regimen if you have done high-intensity pre-Covid exercise. “I would start coming back slowly,” says Dr. Wohl. “Listen to your body.” Even people who have not been hospitalized may have inflammation in their lungs and will not change oxygen as they normally would, he says. Exercise is tolerated, recommends Dr. Lin. “This particular virus tends to infect the lungs,” he says. “So we expect people to have potentially more problems to return to their normal exercise routine compared to other viruses.”

Any test Patients with Covid-19 should be able to check for organ damage, such as a chest scan or electrocardiogram?

Experts do not usually recommend doing tests or scans, unless there is a certain symptom that lasts a long time and does not improve, such as shortness of breath or fast heartbeat.

Can Covid-19 cause other latent viruses, such as Epstein-Barr virus, which causes mononucleosis or activate shingles?

Yes. When the body is stressed, latent viruses can reactivate. “In most cases, these are transient increases in levels and do not lead to any organ disease,” says Dr. Wohl. “We know people when stress or illness breaks out with other types of viruses, such as wounds or even shingles.” Under such conditions, they can break out, he says.

Write to Sumathi Reddy at [email protected]