What To Do If You Test Positive For COVID-19

Testing positive for COVID-19 is not exactly a positive experience. After all, wanting to go viral these days doesn’t tend to mean wanting to be infected by the severe acute respiratory syndrome coronavirus 2. But there’s currently a “silent” COVID-19 happening across the U.S. right now, as I recently covered for Forbes. This means that your risk for catching the SARS-CoV-2 will be higher, especially if precautions aren’t being taken. And if you do find yourself infected with the SARS-CoV-2 you do have to take some positive steps to protect yourself and those around you.

Step 1 After You Test Positive For COVID-19: Isolate Yourself

Testing positive means that in all likelihood you are shedding the virus, because the false positive rates for the commercially available tests are very low. Thus, a positive test means you should immediately stop interacting with other people who are not already infected because you could effectively be like a SARS-CoV-2 lawn sprinkler. Therefore, stay isolated until you are fairly certain that you are no longer shedding the virus.

Now, these days, it can be a bit tough to figure out how long to stay isolated. It used to be clearer for COVID-19: keep yourself isolated and away from others for 10 days. That’s because studies showed that a decent proportion of people can still shed the virus for seven, eight and even nine days after first becoming contagious as I covered for Forbes back in 2020. But since 2020, the Centers for Disease Control and Prevention’s recommended isolation period has gotten shorter and shorter. Some have argued that it’s been for financial reasons so that employers can get people back to work sooner. Regardless, the changing guidance did make it more difficult for people to know what to do.

Nowadays, the CDC no longer has separate COVID-19 isolation guidance and has rolled it into general respiratory virus isolation guidance, even though all respiratory viruses are not the same. This guidance says, “You can go back to your normal activities when, for at least 24 hours, both are true:

• Your symptoms are getting better overall, and
• You have not had a fever (and are not using fever-reducing medication).”

That’s not super-straightforward since “getting better overall” can be a rather subjective measure. Plus, with COVID-19 symptoms can fluctuate from day to day. All of this can be just as difficult to tell as whether your relationship with your cat getting better overall.

Moreover, the CDC does add, “When you go back to your normal activities, take added precaution over the next 5 days, such as taking additional steps for cleaner air, hygiene, masks, physical distancing, and/or testing when you will be around other people indoors.” Plus, the CDC does indicate, “Keep in mind that you may still be able to spread the virus that made you sick, even if you are feeling better.” So “If you develop a fever or you start to feel worse after you have gone back to normal activities, stay home and away from others again until, for at least 24 hours, both are true: your symptoms are improving overall, and you have not had a fever (and are not using fever-reducing medication). Then take added precaution for the next 5 days.”

OK, that’s not confusing at all, right?

The bottom line is that you can’t be reasonably sure that you aren’t still shedding enough SARS-CoV-2 to infect others until 10 days have elapsed. Repeatedly testing yourself and finding the tests to be negative can suggest that you are no longer contagious.

But a negative COVID-19 test is not great at completely ruling out a SARS-CoV-2 infection because the test has a high false negative rate. That’s because it is not easy to get a good saliva sample that has enough virus in it. Remember back in 2020 when the PCR tests required getting a swab sample from the back of your throat in a manner that seemed like your brain was being tickled? Well, the home tests these days are easier to perform, but they do come with a cost in accuracy since they don’t involve the same kind of samples and look for virus antigens rather than virus genetic material.

So, you may want to be careful for the 10 days after you first tested positive or began displaying COVID-19 symptoms. Therefore, it may be wise to use at least some combination of isolating yourself and wearing an N95 face mask over those 10 days.

Step 2 After You Test Positive For COVID-19: Notify Others

If you actually, you know, care about other people, you should notify everyone whom you could have possibly infected. Remember you could have been shedding virus without having any symptoms. So, think back to when you first began experiencing symptoms or tested positive, whichever came first, and then count a few days before that date to estimate when you might have first been contagious. Then inform everyone you shared a room or any other indoor or tighter outdoor space with from the start of your contagious period all the way up to when you commenced isolating yourself.

It may seem awkward to contact others under such circumstances especially if you don’t know them very well. Don’t simply tell them you may have exposed yourself to them. That may not be the best wording. Instead, let them know that you tested positive for COVID-19 and the date of the first positive test. It’s also good to relate to them whether you’re experiencing symptoms, when those symptoms began, what precautions you were taking at the time and how you may have interacted with them. As will be explained later, knowing all this info will help them decide their risk.

Naturally, you may not be able to find everyone you may have infected. For example, you can’t possibly call everyone who happened to be in the Newark Airport with you on such and such date. Or you may not have identified that hot guy or gal you were chatting up on the subway. And searching the Internet simply for “that hot guy or gal on the subway” won’t be fruitful.

Letting others know about your positive test can help them take precautions so that they don’t further infect others. This may include quarantining themselves or wearing a N95 face mask for up to two weeks. That’s because the incubation period—meaning the time between exposure and the emergence of COVID-19 symptoms—can range from two to 14 days. Their risk of being infected depends on how long they were with you, how close your interactions were, when they interacted with you and what precautions they were taking (e.g., if they were wearing a N95 face mask, they were less likely to have gotten infected.)

It can also help them plan for possible treatments, which brings up the next step…

Step 3 After You Test Positive For COVID-19: Ask A Medical Professional About Treatment Options

If you haven’t been vaccinated, are experiencing more severe symptoms or have risk factors for more severe COVID-19 outcomes such as being over 65 years of age, having chronic medical conditions or taking immunosuppressive medications then it may be good idea to start antiviral medications as soon as possible. Therefore, talk to a medical professional about whether you should get treatment and what kind. This should be a real medical professional and not someone who will use a magic 8 ball or something similar to determine what to do or tell you to eat dirt.

The currently available oral options are Paxlovid (nirmatrelvir/ritonavir) and Lagevrio (molnupiravir). The intravenous option is Veklury (remdesivir). Since antivirals work by preventing viral replication—which is basically the virus equivalent of doing the nasty and reproducing—these medications are much less effective after the first five days of the infection after the virus has already reproduced a lot. So time is of the essence, which is another reason you want to notify others of your COVID-19 test positivity as soon as possible.

Oh, and don’t believe that testing positive for COVID-19 means that you now will have enough immunity to prevent you from getting infected again. Immunity from being infected starts to wane after about four to six months. Additionally, such immunity is far from 100%. It’s not like wearing a full-body concrete condom. Plenty of people have gotten infected more than once within the span of just a few months if not a shorter time period.

Finally, testing positive should be a reminder that COVID-19 has not gone away. If you are going to be in close quarters with others, take appropriate precautions. This can include:

• Wearing a good quality face mask, preferably an N95 one.
• Making sure that the area is well-ventilated, preferably with an air purifier running if indoors.
• Keeping a reasonable distance from others.
• Washing your hands frequently and thoroughly. This includes lathering up with soap for at least 20 seconds, which is the amount of time it takes to sing from the start of the Divinyls song “I Touch Myself” through it’s first chorus.
• Staying to up-to-date on your COVID-19 vaccination

When you test positive for COVID-19, you are still at some risk for long Covid or more severe COVID-19 outcomes, regardless of who you are. Although you may not hear about COVID-19 as much these days compared to the first two years of the pandemic, SARS-CoV-2 will remain a threat for a while. You can be positive about that.