As the omicron variant spreads through Vermont, and health officials report record-breaking case counts day after day, here are some tips for what to do if you or someone you know tests positive for COVID. This FAQ was compiled in (and accurate as of) early January, 2022.
Someone I spent time with has COVID. Now what?
You got the dreaded call: You’re a close contact. The Vermont Department of Health defines this as "being within 6 feet, for a total of 15 minutes or more over a 24-hour period, of someone with COVID-19 during their infectious period." You’re still considered a close contact even if you and the other person were wearing masks and even if your interaction was outside.
If you are feeling sick, you should immediately isolate yourself from others and assume you may have the virus. You should call your primary care doctor, if you have one, and they may be able to help you schedule a PCR test. You could also try taking a rapid test, but be aware that antigen tests are less sensitive. So if you're feeling ill at all, you should take precautions — even if your first antigen test is negative. And tests only give you a picture of what's happening now, not whether you'll develop the virus in a day or two. So be cautious.
Start making a list now of all the people you’ve been around in the last few days; you will probably have to do your own contact tracing if you test positive. The Centers for Disease Control and Prevention says, “People you have been around during the two-day period prior to the start of your symptoms (or if you are asymptomatic, two days before your positive COVID-19 specimen collection date), through to the time you start isolation, are at greatest risk of infection and should be prioritized for notification.”
If you’ve tested negative and you’re feeling well, what you’re supposed to do next depends on your vaccine status:
- Fully vaccinated (and boosted, if eligible) individuals can follow new CDC guidelines that say you no longer have to quarantine. But wait! You should still wear a mask for 10 days after exposure when you’re around other people. And keep an eye out for symptoms. Taking a test five days after exposure can be helpful, since that covers the most common incubation period.
- If you are NOT fully vaccinated, state and federal guidelines advise you to quarantine away from others for five days. On day four, you can start testing (two antigen tests 24 hours apart or one PCR/LAMP test). If test results are positive, see below. If the test results are negative, and you still feel well, you can resume contact with others after day five, but only if you can remain masked for the next five days.
Federal guidance for health care workers after an exposure differs. You can see those details here.
There are also different guidelines for Vermont children exposed at school. Children who are fully vaccinated do not have to stay home from school unless they experience symptoms. For unvaccinated children (and staff), many schools have enrolled in the Test to Stay program, where those who wish to continue in-person learning can take a rapid test supplied by the school at home each morning for five consecutive days post-exposure. These students and staff are expected to quarantine when not in school.
Unvaccinated close contacts who choose not to participate in the program, or who attend schools that are not participating, are expected to quarantine and will not be allowed to attend school in-person. See full details here.
My rapid test is negative. What should I do?
Rapid tests aren’t as sensitive at detecting COVID-19 infections as PCR tests. (PCR tests can detect a lower viral load.) So just because your rapid test result is negative doesn’t necessarily mean you’re in the clear.
Some vaccinated individuals are experiencing symptoms before their viral load is high enough to be picked up by these rapid antigen tests. (Read more about why, here.)
If your rapid test is negative and you’re feeling well, you can cautiously go about your business, but if you’re experiencing any COVID-like symptoms, you should assume you have it and isolate away from others. You can schedule a PCR test, or wait 24-48 hours and take another rapid test.
One thing you might be wondering: Should you go to the hospital to confirm whether you have COVID or not?
"The general answer to that is no," says Josh White, chief medical officer at Gifford Health Care, which runs health centers in central Vermont and the Upper Valley. "It is almost never emergent to get a confirmatory test."
Driving yourself to the emergency department because you suspect you have COVID can put further strain on an already stretched medical system. Dr. White, who is also an emergency room doctor, advises that if you are showing signs or have a positive antigen test, you should feel confident you have the virus and don’t need to go anywhere to confirm the diagnosis. You can, however, call your primary care physician to talk over your options.
I have COVID. Now what?
First things first: isolate away from others. (This can be tricky, we know!) Try to stay in a spare room and use a separate bathroom, if possible. If you need to be in the same space as others, always wear a mask.
Start reaching out to your close contacts to let them know; the state is not able to trace contacts for all positive cases.
Call your doctor. There are treatments available, including monoclonal antibody treatment for those at high risk. But it’s key to get treatment early in the course of the virus, while your symptoms are mild or nonexistent. (Here, for example, is information from Copley Hospital about monoclonal antibody treatment.) It’s also helpful to talk over your next steps with a trusted health care professional. If you don't have a doctor, reach out to one of Vermont's community health centers.
If you experience shortness of breath, blue lips, confusion or any other symptoms that are worrying you, you should call your doctor. Go to the emergency department if these symptoms are severe. Here is advice from the CDC on when to seek emergency treatment.
When is it safe for me to be around other people?
At the end of Dec. 2021, the CDC shortened the quarantine period for people experiencing mild or no symptoms, advising that "people with COVID-19 should isolate for five days and if they are asymptomatic or their symptoms are resolving (without fever for 24 hours), follow that by five days of wearing a mask when around others to minimize the risk of infecting people they encounter."
These CDC guidelines remain controversial. Some public health experts believe they are not strong enough and have called for a negative test requirement added before people should feel free to leave quarantine. On Jan. 4, the CDC added language about testing, but stopped short of recommending it.
The new language says, "If an individual has access to a test and wants to test, the best approach is to use an antigen test towards the end of the five-day isolation period. Collect the test sample only if you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved. (Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation.)"
If the test comes back positive, continue to isolate until your symptoms have receded and you have completed the 10-day period. Those who have a negative result can end isolation but will need to continue wearing a mask until the end of the 10-day period.
But what if I am still feeling quite sick?
You should wait to end your isolation until your symptoms have abated and you have been fever-free for at least 24 hours without taking fever-reducing medication. The CDC says most people are no longer contagious 10 days after symptoms started, but in rare cases you could still be contagious for longer. This particularly applies to severely immunocompromised people, and you should talk to your doctor if you’re in this situation. If you’re still feeling significantly sick after 10 days, you should talk to your doctor anyway.
We’re not going to dive into long COVID here, but a significant minority of people continue to suffer from the effects of COVID well after they are through the infectious stage. Again, you should talk to a healthcare professional if you find yourself in this situation. Both Dartmouth-Hitchcock Medical Center and UVM Medical Center have resources for people suffering with long COVID.
I thought the vaccine was supposed to prevent infections. What gives?
While the vaccines do not stop ALL new infections, studies show they continue to provide protection. Breakthrough cases are far more common with the dominant omicron variant. But vaccination still appears to protect people against severe symptoms. As of Jan. 4, Vermont officials reported that "not fully vaccinated [adults age 18+] remain at significantly increased risk of the most severe outcomes at 22x more likely to be hospitalized and 23x more likely to die."
The length from your last shot is important. As NPR health reporter Michaeleen Doucleff reported in December, recent booster shots provide significant protection against the omicron variant compared with two shots received several months ago.
OK, what else do I need to know? School guidelines, mask rules, vaccine mandates and more.
Here in Vermont, as around the country, cases are sharply rising. As of Jan. 4, Gov. Phil Scott has declined to impose a statewide mask mandate, indicating he doesn’t think a mandate would lead to more compliance. However, several municipalities and many individual businesses have implemented their own mask policies. Vermont schools are nearly universally still requiring masks for all staff and students, regardless of vaccination status. Some restaurants, music venues and other businesses are also requiring proof of vaccination. And a wide variety of employers also require vaccination.
Many public health officials, including Vermont Health Commissioner Dr. Mark Levine, say that while “a mask is better than no mask,” single- or double-layer cloth masks aren’t as effective against omicron. Levine recommends a KN95 mask. If that's not possible, another option is to double up and wear two cloth masks or a cloth mask over surgical mask. On January 12th, the state said it was working on getting 50,000 masks to child care programs around the state.
New guidelines from the U.S. Food and Drug Administration makes 12- to 15-year-olds eligible for boosters. It also authorizes a third dose for certain immunocompromised 5- to 11-year-olds. The federal agency has also recently reduced the time between the second dose and eligibility for a booster dose of both the Pfizer and Moderna vaccines from six months to five months.
Those who got the Johnson & Johnson vaccine are still eligible for a Pfizer or Moderna booster after two months.
On Jan. 7, the Vermont Agency of Education announced changes to school guidelines for testing and tracing. Schools are advised to stop surveillance testing and contact tracing. Instead, when there's a positive case in a classroom setting, everyone in the class will be informed. Vaccinated students can continue to attend school unless they show symptoms. Unvaccinated students will be given rapid tests to be administered at home for five consecutive days post-exposure.
In mid-January, the state began implementing a new testing protocol called Tests for Tots. Children age 2 to 5 who are exposed to a positive case will be allowed to continue attending their child care program if they test negative on daily rapid tests supplied by the child care program (similar to the Test to Stay program). As of Jan. 11, more than 470 child care centers had enrolled in the new program.
To keep yourself up to date with the latest information, continue to follow the news at vpr.org, check out daily Vermont stats on the Health Department’s COVID dashboard here, and find vaccine and booster information here.
