Wednesday, November 25, 2020

How Long To Quarantine? When to Covid test? It's Thanksgiving!

So I'm sure everybody is reading about the recent spike in Covid cases. From my experience, it truly just hit that second weekend in November when I was "the doc on-call" and it has been a domino effect ever since. Calls started to come in from patients requesting testing as well as from the lab reporting positives back to me.

Back in the summer, we may get requests for Covid tests because folks were traveling and needed a negative result so they can enter another state or fly to some exotic island getaway. Few scattered calls came during August and September when college students went back to campus and we saw a small spike in that age group then. However, about a week after Halloween and Election Day, requests for covid testing due to positive contact or symptoms started to pour in. What's more, a lot of these tests are coming back positive.

So the big question everyone asks is, "How long do I need to quarantine?" Especially with the holidays around the corner, everyone is trying to decide what to do about family gatherings and travel. I will attempt to summarize it here as I feel like I'm having this conversation multiple times a day and every single day for the last 3 weeks. However, there are two things to note:

1)  guidelines change constantly and the CDC is actually in the process of officially decreasing the length of quarantine after positive exposure

2)  everybody's health and situation is different, so definitely consult with your physician for individual guidance.

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Symptoms of Covid can include all or only some of the following... but the first three symptoms seem to be consistent with most of my patients who end up with positive results. Fever, cough, and shortness of breath only in the more severe cases but I haven't been seeing those symptoms in the younger folks as much.

  • sore throat
  • headache
  • congestion
  • body aches
  • fever / chills
  • cough
  • loss of smell
  • GI symptoms (diarrhea etc)
If you have symptoms or just don't feel good -> self-quarantine for 10 days starting from the first day of symptoms REGARDLESS of a positive or negative covid swab.

If you do not have symptoms but you were in close contact (unmasked and less than 6 ft apart) with a confirmed positive -> self-quarantine for 14 days starting from the first day of the last contact REGARDLESS of a positive or negative covid swab

Why regardless of results you might ask?  It is because there is a possibility for a false negative test or you just tested too early. There is a 14-day window from exposure to symptoms and during that period, even if you have no symptoms, you are potentially contagious. In fact, most folks who are getting tested because they were around someone else who now tested positive will tell you that the person who tested positive was not having symptoms at the time they were together.

CDC is considering shortening the 14 days to 10 days because it is hard for folks who feel well to stay quarantined, so they are hoping for more compliance if the time is shortened. Stay tuned.

Now if you insist on testing for covid then timing is important.

If you have symptoms ->  test on day 3 or 4 of symptoms

If you do not have symptoms ->  test around day 7 from the last day of close contact with a confirmed positive covid case

If you did not have close contact with a confirmed positive covid case and...
  • yes symptoms ->  test on day 3 or 4 of symptoms
  • no symptoms -> chances are your test will be negative and hard to interpret if by chance it is positive then quarantine 10 days from day of positive covid swab
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So for details and more specific counseling, you should seek out your physician.

Happy Holidays everyone! Stay safe and smart. Despite the crazy year... can you think of things to be thankful for?


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