LOS ANGELES — The government is ready to declare COVID-19 over: The nationwide state of emergency is set to end on May 11. Johns Hopkins University shut down its nationwide COVID-19 data tracking this month.
But COVID-19 isn’t gone. Though cases and deaths are on a downswing, plenty of people are still testing positive, especially as mask usage dwindles and pandemic restrictions end. Hundreds of people still die of COVID worldwide every day, according to the World Health Organization.
“It’s really hard to not catch omicron,” said Paula Cannon, a virology professor at USC. “It’s so freaking infectious, even if you’ve been boosted and vaccinated.”
After three years and what feels like a thousand public health proclamations about testing and isolating, you might find yourself falling down a frantic Google hole after that second line shows up on an at-home test.
Here are the latest protocols for what you should do if you test positive for COVID in 2023.
How long after exposure do you develop COVID symptoms?
If you’ve been exposed to COVID, symptoms of infection can show up two to 14 days later, according to a 2020 survey of reported cases. Most infected people began showing symptoms three to six days after exposure; the median length of time between exposure and infection was five days. Of course, you won’t necessarily know if or when you’ve been exposed.
Back in 2020, one hallmark of COVID was a sudden loss of taste and smell. But now, “anything going on in your head, nose or throat, you should absolutely suspect COVID,” Cannon said. Sniffles, fatigue, cough, sore throat, fever, stuffy nose, muscle aches — they could all point to COVID, though they could also be signs of any of the plethora of respiratory illnesses floating around in this tripledemic winter.
Loss of taste is a lot less prevalent now but could still be a symptom. In a more severe case, symptoms could include shortness of breath, racing heart, nausea, vomiting and diarrhea.
When should you take a COVID test?
If you’ve done something during which you could have been exposed to COVID — such as traveled by plane or gone maskless in a large crowd — it’s a good idea to test after a few days even if you don’t have any symptoms.
Home antigen tests are widely available and can reliably determine if you have a significant enough viral load to be contagious. You do not need to take a follow-up PCR test if you’ve had a positive result on a home test.
You aren’t required to report your result to the county or anywhere else, though experts recommend letting your health care provider know.
The new isolation guidelines for COVID
The most recent recommendation from the U.S. Centers for Disease Control and Prevention is to isolate for five full days after symptoms begin. That means the first day you start to feel sick is Day Zero; your five-day countdown begins the next day. If you tested positive but are asymptomatic, the recommendation is to isolate for five full days after the positive test.
Those first five days represent the period during which you are the most infectious, said Georges Benjamin, the executive director of the American Public Health Assn.
“Certainly the first five days, you should definitely isolate,” he said.
But that’s the minimum, not the maximum. Getting to Day Six doesn’t mean you can abandon all precautions. That’s the first day you can evaluate how you’re feeling to determine if you need to continue isolation: Are your symptoms improving? Have you been fever-free for at least 24 hours without using an over-the-counter fever-reducing medicine (acetaminophen or ibuprofen)?
If you are feeling better and are fever-free without medication, you can end your isolation, Davis said. If not, you need to continue, for up to 10 days.
While you are isolating, you should stay home and limit contact with anyone who’s not infected, both inside your home and out. If you need to leave your house for a necessary reason — for instance, to pick up a medication or grocery delivery from your lobby — Benjamin said you should wear a tight-fitting N95 mask.
How long do COVID symptoms last?
The length of your symptoms will depend on a lot of factors, including whether you’re up to date on vaccinations and boosters and whether you take Paxlovid. Some people will feel better after a few days and some people will still have symptoms after 10 days, possibly even weeks later.
Beyond taking Paxlovid, there isn’t much you can actively do to make COVID symptoms go away. Do what you’d normally do when you’re sick: Rest; drink lots of fluids; eat healthy meals; take acetaminophen to control aches and fever. In other words, take good care of yourself.
If you start to experience severe symptoms, even if you’re fully vaccinated and boosted, you should go to the hospital.
Who should get Paxlovid, and how do you get it?
Paxlovid is an antiviral treatment for COVID-19. There is a broad evidence-based scientific consensus that using it reduces the risk of being hospitalized or dying. Paxlovid may also reduce the chance of developing long COVID in some patients, Benjamin said.
How long are you immune after recovering from COVID?
We don’t have a solid answer to this question yet either. Davis, the L.A. County health officer, said the guidance used to be that you were considered immune and shouldn’t have to test again within 90 days after you had an infection; now, he said, it’s 30 days. But that’s just a guideline, not a definitive scientific consensus.
A CDC study of seroprevalence — testing for the presence of antibodies in people’s blood — showed that as of May 2022, almost 95% of Americans had either had COVID, gotten vaccinated for COVID, or both. At this point, it’s unlikely we will ever reach a point where herd immunity will wipe out COVID entirely. Some scientists are working on tests that look at T-cell immunity, instead of antibody levels, to assess whether someone is immune. For now, it’s impossible to say how long you can stop worrying about getting COVID after recovering from it.