You tested positive for Covid-19. What now?

How long will I be contagious?

The United States Centers for Disease Control and Prevention states that anyone tested positive for Covid-19 should isolate himself for 10 days from the onset of symptoms. This means avoiding all contact with other people and not leaving the house unless you need to go to a doctor’s appointment. If you are asymptomatic and the test is positive and you never develop symptoms, the isolation period should start on the day you took the diagnostic test. It is believed that you will no longer be contagious after 10 days if you do not have a fever – and you have not taken medication 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 the onset of symptoms.

Do I need to tell the people I contacted that I tested positive?

Anyone living with you should take a Covid-19 test and quarantine it for 10 to 14 days from the last contact with you. In some cases, quarantine can be reduced to seven days with a negative test. If you have spent a total of 15 minutes at 6 feet from anyone else in the past two to four days, you should contact those people and let them know that the test was positive. Some experts say that if you are masked and away from home, the risk is significantly less and the quarantine may not apply to these contacts, but it depends on your local health department’s contact tracking guidelines.

“Public health officials vary on the boards,” 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 ourselves exposed if within 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 viruses if you are outdoors, but there is a continuum where public health draws that line and it can vary. “

When I am isolating myself, what can I or cannot do?

Isolation means avoiding all human contact as much as possible. Some cities and governments provide housing for people who need to isolate themselves. If that is not an option and you live with other people, try to stay in your own floor or room with a private bathroom, if possible. Food and other essentials should be left outside your door. If someone enters your room or you need to leave, make sure that both are masked. Some experts claim that hiking is not allowed in isolation. Others say that as long as you are masked, feeling good, and in an area where you can easily be far away from others, it is good to go out for some fresh air.

Should I do another diagnostic test after my 10-day isolation period?

No. Many experts say this is not necessary and can result in unwarranted stress and anxiety if another test is positive. The PCR test commonly used to diagnose Covid-19 is very sensitive and can detect dead or non-infectious virus particles weeks later, says Kristin Englund, an infectious disease physician at the Cleveland Clinic. “So it won’t be an accurate diagnosis if someone is still infectious or not,” she says.

The only case in which it may be necessary to repeat the diagnostic test is in severely ill and immunocompromised patients, whose recommended isolation period is up to 20 days after the onset of symptoms.

How about an antibody test?

Doctors do not recommend doing an antibody test in most cases. “Routine antibody testing after Covid’s diagnosis 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 every day.”

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

The only reason anyone can consider a test is if they have not been able to do a diagnostic test, but they have had Covid-19 symptoms and want to see retroactively whether it is in fact what he did, says Dr. Lin.

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

The CDC’s 10-day isolation recommendation is just contagious. “The duration of symptoms does not correlate with 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 are improving and you don’t have a fever, this is normal, he says.

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

What is long Covid?

Long Covid is a term for patients with Covid-19 who experience symptoms that can last for months after the initial acute Covid infection. Also called longhaulers, these patients often develop new symptoms and worsening, even after they recover from Covid’s initial attack. 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’s Office of National Statistics estimated that 20% of Covid patients 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 already got 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. Most people with Covid-19 are believed to have some natural immunity and will be protected against the virus again for at least three months. “Theoretically, the vaccine can increase a person’s immunity from being infected naturally,” says David Wohl, professor of medicine in the infectious disease division at the University of North Carolina, Chapel Hill. There is no reason to wait, he says, except to ensure that they are both out of the 10-day infectious period and fully recovered, since the vaccine can cause side effects or symptoms in some people.

Should I get the vaccine if I have not been hospitalized, but I have been treated with monoclonal antibodies?

More outpatients are now 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 the body takes several months to eliminate the antibodies and, theoretically, these antibodies could attach themselves to the proteins that the vaccine teaches the body to make and hide them from the immune system.

Any symptom that is a red flag to seek medical attention?

Dr. Lin says that during your acute and active infection, if you experience shortness of breath and are unable to speak complete sentences, this is a sign that your lungs are severely infected and you should seek medical attention. Other warning symptoms include confusion or signs of stroke, such as sudden weakness in a part of the body or loss of sensation. Dr. Lin says that if you are unable to perform your daily activities after recovering from acute Covid, consult a doctor.

When can I resume my normal exercise routine?

Experts say don’t go back to your fitness regimen right away if you’re doing high-intensity exercise before Covid. “I would come back slowly,” says Dr. Wohl. “Listen to your body.” Even people who have not been hospitalized may have inflammation in their lungs and not be exchanging oxygen in the normal way, he says. Exercise as tolerated, advises Dr. Lin. “This particular virus has a tendency to infect the lungs,” he says. “So we hope that people will potentially have more problems getting back to their normal exercise routine compared to other viruses.”

Any tests that Covid-19 patients should do to check for organ damage, such as CT scans or electrocardiograms?

Experts do not routinely recommend having tests or scans, unless there is a specific symptom that is lasting for a long time and does not improve, such as shortness of breath or a fast heartbeat.

Can Covid-19 cause other inactive viruses, such as the Epstein-Barr virus, which causes mononucleosis or herpes activation?

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

Write to Sumathi Reddy at [email protected]