So you caught COVID. What next? Who should you tell? Can you trust the test?
The Star-Telegram answers questions our readers want answered. Our mission is to help you navigate life in Tarrant County and North Texas. If you have questions you’d like us to consider, email us at findout@star-telegram.com.
We spoke with Dr. Prathit Kulkarni, assistant professor of medicine in infectious diseases at Baylor College of Medicine, about what to do if you test positive for COVID-19, when it’s safe to return to work and who you should inform about your test results.
What should I do after a positive test result?
Should you assume the result is correct? Yes. Positive results are highly accurate, so there’s a next to nothing chance that it’s a false positive.
Isolate for at least five days after testing positive. You can end your isolation after five days if you have been fever-free for 24 hours without using fever-reducing medication, and your other symptoms have improved.
If you don’t develop symptoms, you should still isolate for at least five days and wear a mask around others for an additional five days. That’s because even if you’re asymptomatic, you can still give the virus to others.
For anyone severely ill or immunocompromised, the Centers for Disease Control and Prevention recommends you isolate for 10 to 20 days, because you can be contagious for a longer period.
MORE: Are COVID vaccines billed to my insurance?
What do I do after a negative test result?
A negative test result means you likely do not have COVID-19 at the time. But it’s not a guarantee that you don’t have COVID.
If not enough time has passed after you’ve been exposed, it could be too early for the test to detect the virus. Because symptoms appear up to 14 days after you’re exposed, you may test positive a few days after your negative test.
Antigen tests are the most likely to give you a false negative. The Food and Drug Administration also has warned recently that antigen tests could be less effective in detecting omicron.
If you have symptoms but test negative, you may have received a false negative test result and still might have COVID-19. You should stay home and get a PCR test a day or more after the first.
If you’ve been in close contact to someone with COVID-19, but your test comes back negative and you’re not showing symptoms, unvaccinated individuals should stay home and away from other people for at least five days. Repeat the test in five days to a week, regardless of whether you’re vaccinated.
MORE: How to reduce your chances of false negative COVID test results
Continue to monitor yourself for the following symptoms:
Cough
Shortness of breath
Fever
Chills
Sore throat
Runny nose
Muscle pain
Headache
New loss in sense of taste or smell
If you develop any of these symptoms, you should take another test at least a day after your first test and isolate yourself until you get your test results.
Should I get tested again?
That depends. If you test negative and have symptoms of COVID-19 or were close to someone with it, take a PCR test and stay home until its results come in. That’ll typically take two to three days.
Can I test negative, then positive a few days later?
Test results reflect the state of illness at the time when you are tested, according to Texas Health and Human Services. You can test negative one day, and test positive on a later day. It takes two to 14 days after exposure for you to develop symptoms. If you’re still in the early stages of infection, it’s possible the test will not detect the virus and come back negative. Negative results may need to be confirmed with a PCR test, which is considered the most reliable test type.
Should you go to the doctor?
It’s best to seek medical advice from a healthcare provider via phone or video. For more urgent situations, care should be sought at an emergency department.
Who should I tell I have COVID-19?
As soon as you can, let anyone who you’ve recently spent time with know that you tested positive. They may have been exposed to the virus and should quarantine or get tested. That means anyone who was within six feet of you for 15 minutes or more in one day. By informing your close contacts that they may have been exposed, you are helping to protect them and stop them from spreading it.
Call your doctor. They’ll assess your symptoms and health risk, and tell you how to move forward.
If you live in Dallas County, employers can’t require you to provide a COVID-19 test result to return to work. You only need to tell co-workers that you’ve tested positive if you were in close contact for a prolonged period of time. But if you live in Tarrant County, it’s up to individual employers, so they could require a negative test before allowing you to return to work. DSHS has recommended Texas employers not have the testing requirement.
If you plan to travel internationally, you’ll need to get a COVID-19 test within one day before you return home to the United States, according to the CDC. It doesn’t need to be exactly 24 hours, so if you’re flying Friday, you can take the test any time on Thursday.
You’ll show your negative result to the airline before you board. This requirement applies to all travelers 2 and older, regardless of vaccination status or citizenship. It should be paper or digital documentation that includes:
- Type of test (indicating it is a NAAT or antigen test)
- Entity issuing the result (e.g., laboratory, healthcare entity or telehealth service)
- Sample collection date
- A negative test result must show the sample was taken no more than one day before the flight.
- A positive test result for documentation of recovery from COVID-19 must show the sample was taken within the 90 days before the flight.
- Information that identifies the person (full name plus at least one identifier such as date of birth or passport number)
- Test result
If you recently recovered from COVID, you’ll instead provide documentation of having recovered in the past 90 days, including your past positive test result and a letter from a licensed healthcare provider or a public health official stating that you were cleared to travel.
It can be a PCR, antigen or approved home test. For a home test to be approved, it should be a viral test, either a nucleic acid amplification test or an antigen test, with emergency use authorization from the FDA. It will usually be labeled rapid antigen test or viral antigen test.
What if you test positive before your flight home from another country? You’ll need to isolate yourself for at least five days and rebook your flight.
If you take a test in person, whoever administered your test will report your result to your local public health agency. You don’t have to report the positive result of an at-home test to your health department, but health experts recommended that you do. Reporting it will help ensure an accurate count of positive cases and help with pandemic response planning.
Tarrant County Public Health recommends residents report at-home test results through the online reporting form here.
How long should I stay home after testing positive?
You can stop self-isolating when you meet all the following criteria:
- It has been at least five days since your symptoms first appeared or, if you never had symptoms, since the date you had a positive test
- You are fever-free for one full day without the use of fever-reducing medications
- Your symptoms are improving.
Can I be around roommates or family?
Try to limit contact with household members as much as possible. Try to stay at least six feet away from them at all times. Use a separate room and bathroom if possible. Avoid sharing personal items like utensils, food and drinks. Also, wear a mask when you have to be around other people.
How long will I feel sick?
You should feel better in just a few days to a week.
What treatment should I get?
If you’re generally in good health before you get COVID, you can stay home and manage your symptoms like you would for a cold or flu. Get plenty of rest, stay hydrated and get good nutrition. Take over-the-counter medicines such as acetaminophen to help you feel better. Call your doctor if you get sicker, especially if you have shortness of breath.
Call 911 if you experience:
- Trouble breathing
- Persistent pain or pressure in the chest
- New confusion or inability to wake up or stay awake
- Bluish lips or face.
If you’re immunocompromised, such as a medical condition or you are 65 years or older, call your doctor as soon as you test positive, and they’ll recommend a treatment to prevent severe illness and hospitalization. They might suggest monoclonal antibodies, which help strengthen your immune response to the virus. Monoclonal antibodies bamlanivimab and etesevimab or casirivimab and imdevimab will be combined to treat you.
Or, your doctor may prescribe the recently FDA-approved Pfizer pills that are used for mild to moderate cases.
If you get hospitalized, doctors will likely administer antiviral drugs like remdesivir.
How long will COVID remain in my system?
You’ll likely test positive for five to 10 days. In rare cases, the virus can be detected in patients for as long as three months. “Somebody’s PCR tests, meaning molecular tests, can stay positive for a long time. But that doesn’t necessarily mean that they’re infectious or contagious for such a long period of time,” Kulkarni said.
How long will I be contagious?
You can spread it to others two to three days before symptoms start and are most contagious one to two days before you feel sick. According to the CDC, most people remain infectious up to 10 days after having symptoms. If you’re immunocrompromised, you could be contagious for as long as 20 days.
After you test positive, make sure to wash your hands often and disinfect objects you give to anyone else.
When can I get back to the office?
You can get back to work after at least five days of isolation and consultation with your doctor. Wear a mask at all times, stay six feet away from co-workers and try not to eat around others.
When can I go out?
After your five-day isolation, try to avoid travel for another five days. If you have to travel, wear a mask.
Don’t go anywhere where you have to take off your mask, like restaurants and some gyms. Avoid eating around others at home or work until 10 days after your symptoms appeared.
Also, wait at least 10 days before being around anyone 65 or older or who has a medical condition.
When should I isolate longer than five days?
The cases when you should isolate for longer than five days include:
- If you are not feeling better or are continuing to have a fever
- If you have more severe illness
- If you are immunocompromised (exact timeframe can vary from one patient to another)
- If you have a positive antigen test towards the end of the five-day isolation.
What safety precautions should I take after isolation?
While not required, try to take a rapid antigen test if you have access to one towards the end of your five-day isolation. If you test positive, you should isolate for another five days.
Wear a mask for at least five days after isolation, and keep a physical distance from others, Texas Health and Human Services says. Even if you’ve had COVID-19, you can get reinfected and infect others.
The CDC recommends you mask with two layers when you’re in indoor public spaces. You can wear a cloth mask with multiple layers of fabric, or a cloth mask over a disposable mask.
Don’t layer two disposable masks, or a KN95 with another mask.
If you are unable to wear a mask when around others, you should isolate for 10 days instead of five.
This story was originally published January 9, 2022 at 8:00 AM.
