You Tested Positive for Covid. Now What?

The Omicron variant has fueled a rise in Covid-19 cases across the United States. Here’s what you need to know if you get infected.

A positive result from a Covid-19 rapid antigen test.
Credit...Octavio Jones/Reuters

Dani Blum and

As the Omicron variant continues to spread across the country, many more people, including those who have been vaccinated, will test positive for the coronavirus.

So what should you do if you’re one of them? We spoke to physicians and infectious disease experts about the steps you should take after a positive test or if you find out you’ve been in close contact with an infected person. Here’s their advice.

If you’re in public or around people when you get the bad news, put on a mask immediately. Then isolate yourself as quickly as possible, even if you don’t have symptoms. The U.S. Centers for Disease Control and Prevention recommends isolating for at least five full days, followed by five days of wearing a mask around others, as long as you don’t have a fever and any other symptoms are improving. If you are seriously ill with Covid or have a weakened immune system, the C.D.C. recommends an isolation period of 10 to 20 days. If you have a fever, the agency advises you to stay home until the fever resolves. Read more about the new C.D.C. guidelines.

If you are waiting for test results but have symptoms of Covid-19, the C.D.C. now recommends that you isolate anyway, regardless of vaccination status.

If you live with roommates or family, try to separate yourself from other people (and animals) as much as possible. “You should take yourself out of society,” said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco. “Wall yourself up in a cocoon.”

Isolating in a home with other people may be difficult, but do the best you can. That means staying in your room, away from other members of the household, even for meals. Someone should deliver food to your bedroom door if possible. If the home has more than one bathroom, designate one just for the infected person. If the infected person is a child or older person who needs assistance, both the caregiver and the infected person should wear a mask when the caregiver enters the room, and open the windows if possible.

If others are in the house, always wear a high-quality mask when you leave your room. Everyone should mask up in shared spaces. After using a shared bathroom, disinfect the toilet seat and handle, as well as the faucet handles, soap dispenser, counter and light switch. Close the lid before you flush, and turn on the exhaust fan. Open windows to improve ventilation in shared areas.

The people living in your household should take precautions, but they don’t need to panic about getting infected too, especially if they’re vaccinated and boosted. “The household rate of contracting Covid from someone is not 100 percent by a long shot, even with the more transmissible variants,” said Dr. Paul Sax, an infectious disease expert at Brigham and Women’s Hospital and professor at Harvard Medical School.

While it can help incrementally to continue to wipe down shared spaces, “the most important thing is keeping people from breathing air that is filled with germs,” said Tara Kirk Sell, a senior scholar at the Johns Hopkins Center for Health Security. If you have a HEPA air cleaner, place it in or outside your bedroom.

If you’ve tested positive and feel well, you can take a walk outdoors and get fresh air. If you’re in a city where you will cross paths with other people, wear a mask and keep your distance.

If you tested positive after taking a rapid home test, you may want to take a second home test using a different brand or go to a testing center to confirm the result. False positives aren’t common with home tests, but they can happen. Even so, you should assume the positive result is correct, wear a mask and avoid close contact with other people until you get retested. If your positive test came from a laboratory, a second test isn’t necessary.

If you receive a negative test on your rapid home test, don’t use that as your sole basis for decision making. The C.D.C. advises that a negative result on a rapid home test does not rule out a Covid infection. To improve the results from an antigen test, the agency recommends testing twice over a three-day period with at least 24 hours and no more than 48 hours between tests.

No. In most cases, you won’t know which variant of coronavirus you’ve caught and your lab test typically won’t tell you. In general, the guidance on isolation, monitoring and treatment does not change based on which variant infected you.

Think about where you’ve been and who might have inhaled your germs. Contact your employer and let them know. Most workplaces have protocols in place for contact tracing when an employee tests positive. You also want to alert anyone with whom you’ve spent time, going back at least two days before you got tested or started having symptoms, said Dr. Sax. The C.D.C. defines a close contact as someone who was less than six feet from you for 15 minutes or more.

It may feel overwhelming, or even shameful, to tell people about your positive test, said Dr. Ashish K. Jha, dean of the Brown University School of Public Health. “A lot of people think it’s some failure if you get infected,” Dr. Jha said. “This is an incredibly contagious variant. A lot of people are going to get it. That is not a moral failure.”

Don’t forget to tell your doctor too, particularly if you have an underlying medical condition, like high blood pressure or diabetes, that puts you at higher risk.

If the infected person is a child, call your pediatrician. You also need to call your child’s school, as well as anyone they’ve had close contact with at play dates, parties or other activities.

Monitor your symptoms. You can use a pulse oximeter to keep track of your blood oxygen levels. Most healthy people will get an oxygen reading around 95 to 99 percent. You should seek medical advice if the reading drops quickly or the level dips to 93 percent or lower. The devices can be less accurate for people with darker skin, so pay attention to the trend. If your reading drops by four points, it’s worth checking in with a doctor. You should also see a doctor if you take a turn for the worse, have trouble breathing or have any symptom that causes you concern. You can learn more in our story, Why Days 5 to 10 Are So Important When You Have Coronavirus.

Ask your doctor if you are eligible for monoclonal antibodies, a treatment that can help your body fight Covid-19 and lower your risk for severe illness, particularly for people in a high-risk group. For monoclonal antibody therapy to be most effective, it needs to be given soon after diagnosis, even if you’re not feeling bad yet. If you don’t have a regular doctor, you can also contact the infectious disease clinic at your hospital and ask about the treatment, said Dr. Celine Gounder, an epidemiologist at N.Y.U. medical school.

Only one monoclonal antibody treatment, sotrovimab made by GlaxoSmithKline and Vir Biotechnology, has performed well against Omicron in laboratory experiments. Although the supply of sotrovimab is very limited, the Biden administration is in talks with GlaxoSmithKline about securing more doses to be delivered by early next year.

The Food and Drug Administration has authorized two different oral treatments for people who are vulnerable to becoming severely ill because they are older or have medical conditions such as obesity or diabetes. Paxlovid, developed by Pfizer, is authorized for high-risk patients age 12 and older, and is meant to be taken as 30 pills over five days. Another pill treatment from Merck, known as molnupiravir, has been authorized for people 18 and older, and is meant to be taken as 40 pills over five days.

To calculate your five-day isolation period, count your first day of symptoms as Day 0. If you never had symptoms but have a confirmed positive test, count Day 0 as the day you tested.

You can leave isolation after five days if you don’t have a fever and any symptoms you had are getting better. If your symptoms persist or get worse, if you are immunocompromised or are severely ill with Covid, consult with your health care provider about when to leave isolation, which may last between 10 and 20 days.

After isolation, the C.D.C. advises that you keep wearing a mask around others for an additional five days. Don’t remove your mask to eat or drink around other people, don’t travel and don’t spend time around high risk people until the masking period has ended.

Although the agency didn’t recommend testing after isolation, the new guidelines say people should take a rapid antigen test after the five day isolation period if they have “access to a test and want to test.”

Vaccinated adults who had booster shots and fully vaccinated children don’t need to quarantine after a potential exposure, but they should get tested five days later and wear masks around other people for 10 days.

People who are unvaccinated should quarantine for five days after exposure and then get tested. Wear masks around other people for 10 days. This also applies to people who are eligible for booster shots but have not received them yet.

The C.D.C. has said that unvaccinated students who are exposed to the virus do not need to miss school after a potential exposure as long as two tests taken during the next week are negative. Read more about the “test to stay” protocol.

Yes. The degree of protection you get from a previous infection varies widely. You’re more protected if you’ve also been vaccinated. Early studies suggest antibodies from a past Covid infection alone are not a strong defense against Omicron.

“Unfortunately, reinfection after people have had Covid before, can occur, and the protection of previous infections is very variable and unpredictable,” said Dr. David Rubin, the director of PolicyLab at Children’s Hospital of Philadelphia and a professor of pediatrics at the University of Pennsylvania’s Perelman School of Medicine. “So some people seem to be very protected and don’t get Covid again, and other people can get it again and even get quite severe disease again.”