You have tested positive for Covid-19. What now?

How long will I be contagious?

The U.S. Centers for Disease Control and Prevention say anyone who tests positive for Covid-19 should isolate themselves for 10 days from the onset of symptoms. That means avoiding all contact with other people and not leaving the house unless you have to go to a medical appointment. If you are asymptomatic and test positive and never develop symptoms, the isolation period should start on the day you took your diagnostic test. It is believed that after 10 days you are no longer contagious if you have not had a fever for at least 24 hours – and have not taken any fever-reducing medication – and your symptoms improve. The CDC recommends isolating immunocompromised patients and those with severe Covid-19 cases for up to 20 days after symptoms appear.

Should I tell people I’ve been in contact with that I tested positive?

Anyone living with you must undergo a Covid-19 test and be quarantined for 10 to 14 days from the last contact with you. In some cases, the quarantine can be shortened to seven days for a negative test. If you spent a total of 15 minutes within 6 feet (1.8 meters) with someone else in the past two to four days, contact those people and let them know that you tested positive. Some experts say that if you are masked and outside, there is significantly less risk and quarantine may not apply to those contacts, but it depends on the contact tracing guidelines of your local health department.

“Public health authorities differ in advice,” said Graham Snyder, medical director of infection prevention and hospital epidemiology at the University of Pittsburgh Medical Center. “In our jurisdiction, if you are masked, we still consider yourself exposed if you are 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 the virus when you are outdoors, but there is a continuum where public health draws that line and it can vary. “

If I isolate, what can I do or not do?

Isolation means avoiding human contact as much as possible. Some cities and governments provide housing for people in need of isolation. If that’s not an option and you live with others, try to stay on your own floor or room with your own bathroom if possible. Food and other supplies should be left outside your door. If someone enters your room or you have to go out, make sure you are both masked. Some experts say secluded walks are not allowed. Others say it’s okay to go outside for fresh air as long as you are masked, feel good, and in an area where you can easily be far from others.

Do I have to get another diagnostic test after my 10 day isolation period?

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

The only case where a repeat diagnostic test may be required is for critically ill and immunocompromised patients whose recommended isolation period is up to 20 days after the onset of symptoms.

What about an antibody test?

In most cases, doctors do not recommend having an antibody test done. “Routine antibody testing after a Covid diagnosis is not necessary,” said Michael Lin, an infectious disease physician at Rush University Medical Center in Chicago. “It’s expensive and it doesn’t change what you do day in and day out.”

Dr. Lin says, “We still don’t know if a positive antibody test result means you’re automatically protected, or vice versa, if a negative result means you’re at risk.” Doctors say it’s important to observe pandemic protections after having Covid-19, including wearing a mask, socializing, and avoiding crowded indoor areas. A vaccine is still recommended, so the results of an antibody test will not provide useful information, they say.

The only reason someone might consider a test is if they couldn’t get a diagnostic test, but had Covid-19 symptoms and want to see retroactively if they did, says Dr. Lin.

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

The CDC’s 10-day isolation recommendation pertains only to being contagious. “The duration of the symptoms does not correlate with infectivity,” says Dr. Snyder of the University of Pittsburgh Medical Center. Many patients feel fully recovered after 10 days or two weeks. But others may not be able to return to work and normal routines. If your symptoms improve and you don’t have a fever, that’s normal, he says.

“I don’t think you need to wait until you’re completely asymptomatic to get out of quarantine and consider going back to normal,” says Dr. Englund. A recovery time of up to 28 days is reasonable, she says. You should then contact your doctor.

What is Long Covid?

Long Covid is a term for Covid-19 patients who experience symptoms that can last for months after their first acute Covid infection. Also called long haulers, such patients often develop new and worsening symptoms even after they recover from their first bout of Covid. Some patients have never been hospitalized for acute Covid-19 and are young and healthy with no underlying medical conditions. A recent study from the United Kingdom’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’ve had Covid and if so, how long should I wait?

Yes you can, and experts say you should get the vaccine as soon as you qualify. Most people with Covid-19 are thought to have some natural immunity and will be protected from getting the virus again for at least three months. “Theoretically, the vaccine could boost a person’s immunity to a natural infection,” said David Wohl, a professor of medicine in the department of infectious diseases at the University of North Carolina, Chapel Hill. There’s no reason to wait, he says, other than to make sure you’re both outside the 10-day infection period and fully recovered, as the vaccine can cause side effects or symptoms in some people.

Should I get the vaccine if I have not been hospitalized but have received treatment with monoclonal antibodies?

More outpatients are now being treated with the two monoclonal antibody treatments approved for patients at risk of hospitalization. Those patients should wait at least three months before getting the vaccine, Dr. Immune System says.

Are there any symptoms that are a red flag to seek medical care?

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

When can I resume my normal exercise routine?

Experts say you won’t jump right back into your fitness regimen if you did high-intensity exercise before Covid. “I would start back slowly,” says Dr. Wohl. “Listen to your body.” Even people who aren’t hospitalized can have inflammation in their lungs and not exchange oxygen like they normally would, he says. Exercise as tolerated, Dr. Lin. “This particular virus tends to infect the lungs,” he says. “So we expect that people may have more difficulty returning to their normal exercise routine compared to other viruses.”

Are there any tests Covid-19 patients should undergo to check for organ damage, such as chest scans or electrocardiograms?

Experts don’t routinely recommend getting tests or scans unless there is some symptom that lasts for a long time and doesn’t improve, such as shortness of breath or a fast heart rate.

Can Covid-19 cause other dormant viruses, such as the Epstein-Barr virus, which activates mononucleosis or shingles?

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 organ disease,” says Dr. Wohl. “We know that people under stress or illness get other types of viruses, such as cold sores or even shingles.” They can flare up under such circumstances, he says.

Write to Sumathi Reddy at [email protected]