Two years into the pandemic, many don’t know what to do after testing positive for Covid-19. Do they have to self-isolate, and if so, for how long? How important is it to see a doctor? What therapies are available and who is eligible?
To help answer these and other questions, I spoke with Dr. Leana Wen, CNN medical analyst, emergency physician, and professor of health policy and management at George Washington University Milken Institute School of Public Health. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health” and a mother of two young children.
CNN: It seems like a lot of people are being diagnosed with Covid-19 right now. I have friends who have been very cautious throughout the pandemic and have now tested positive. Why is that?
Dr. Leana Wen: First and foremost, we are dealing with an extremely contagious sub-variant. The original Omicron variant was already more contagious than Delta and previous variants. Then we had BA.2, a subvariant of Omicron that was more contagious than Omicron, and now we have an offshoot of BA.2, called BA.2.1.21, which appears to be even more transmissible.
A more transmissible variant means that activities we previously thought were relatively safe are now at higher risk. This does not mean that we should avoid all activities, but rather that people who were very careful before can become infected now due to the contagion of this subvariant. Additionally, people previously infected with Omicron have some degree of protection against this new subvariant; those previously uninfected are now more susceptible. Fortunately, this variant does not appear to cause more severe disease in most people, and the vaccine and first booster still provide good protection against hospitalization and death for those infected.
Another reason for the rise in infections is that people are interacting more, including indoors and without masks. Whenever such interactions occur, there is a risk of transmission. Again, this is not to say that people should never associate with each other, but rather that they should be aware of the risk and take precautions, especially for immunocompromised people and others at higher risk. high in serious illness.
CNN: If someone is diagnosed with Covid-19, what should they do? Is isolation still recommended?
Magnifying glass: Yes, it does, and in fact, it’s the first thing I recommend people do if they test positive for Covid-19. Whether they have taken their own test at home and have a positive result or have received a positive result from a PCR test, they should immediately self-isolate. If they are at home, go to a room away from other people. If they are at work, put on an N95 mask to walk through public spaces and back home, ideally in your own vehicle.
CNN: How long do people have to self-isolate?
Magnifying glass: The day you test positive is day zero. If you had symptoms before that date, say the day before, that day is day zero, whichever comes first. Day 1 is 24 hours after the positive test or the onset of symptoms. You must be isolated from others for five days. This means not being in the same room at home as the people you live with and not going to work in person. If you must share a bathroom, for example, be sure to wear a properly fitted N95, KN95 or KF94 in these common areas, minimize your time in these areas and open windows as much as possible.
Also, I want to caution that the CDC does not say that after Day 5 you can freely associate with your family and people in your household. You could still be contagious. The CDC says you should always hide around others for days 6 through 10. This includes not having dinner with people you live with, indoors, on those days.
Many public health experts, including me, would recommend testing outside of isolation as an added level of precaution that also reduces inconvenience. That’s not what the CDC says, but I think it’s reasonable to start testing with a rapid home test on day 5. If you test negative on day 5 and day 6, and that you do not have a fever and your symptoms improve, you can be released from isolation. . This would make a period of isolation less onerous, especially for families who live in small spaces or have young dependent children.
CNN: What therapies should people be on? Should everyone have one?
Magnifying glass: It is important that you call your medical provider and ask if you are eligible for therapy. I would call it whether you have mild, severe, or no symptoms because you should know what your options are. There are three main types of therapy, all of which are meant to be taken before a person becomes seriously ill, to avoid hospitalization. Generally, the earlier you start therapies, the more effective they are.
The three options are antiviral pills (paxlovid and molnupiravir are the two licensed antivirals), monoclonal antibodies, and remdesivir. The pills are taken orally, while the other two require injections or infusions. They are intended for people who are at higher risk of progression to serious disease. Some of the therapies may not be readily available in your area. Others may interact with other medications or treatments you are taking.
I strongly recommend that people speak with their medical providers before they get sick so they have a plan. Someone in their 20s who is healthy is probably not eligible for these therapies, but someone in their 60s with certain chronic conditions will be. Know in advance what you would get if you tested positive and how you would access therapies, including after hours and on weekends. If you don’t already have this plan, call your provider immediately after you test positive and discuss the options.
CNN: How do you address skeptics who might ask what’s the point of getting vaccinated if vaccinated people can still be infected?
Magnifying glass: Let’s talk about the primary purpose of vaccination. The most important reason is to reduce the risk of serious illness and to prevent infected people from being hospitalized and dying. This is why it is so important to be up to date with vaccines, to get the initial shots and then the booster shots, because vaccinated and vaccinated people are much less likely to become seriously ill and die than unvaccinated people. .
Vaccination also reduces the risk of infection, but this risk still exists. For people who want to further reduce their risk of contracting Covid-19, other precautions remain important, including wearing an N95 mask or equivalent in indoor public places, and same-day testing before gatherings, especially if community levels of Covid-19 are high. .
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