Someone in your family has COVID — so now what?

With persistently high case rates, and new extra-contagious omicron strains, what exactly are you supposed to do now in the growing eventuality that someone in your home tests positive for COVID-19?

Can you and others in your home avoid infection? And when are you in the clear?

The answers to some of these questions have changed with the dominant BA.4 and BA.5 variants often evading immunity for even the double-boosted. So let's revisit what we know now, and how best to use the new tools available amid this latest, lengthy surge.

QSomeone in your home was exposed to a person who tested positive. What should you do?

AStep one, wear a mask and stock up on athome rapid tests. Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley's School of Public Health, says that your response to a COVID-19 exposure or a positive case in your home should depend on how vulnerable members of your house are to severe disease, hospitalizations and death.

He suggests finding a “sweet spot” between isolating and continuing your normal behavior, that matches that vulnerability. Homes with elderly family members, immunocompromised residents, or unvaccinated people should fall on the more careful side of the spectrum, while others might choose to isolate less severely or for less time.

QAre you doomed to get COVID-19 if somebody else at home tests positive?

AEven with close contact with infected family members, secondary infection is not guaranteed. So if someone in your home is sick or tests positive, but others in your house aren't feeling sick and are negative on a rapid test, it's worth it to try to prevent further exposure.

Masking, opening windows and using a HEPA air filter are all good tools, as well as isolation when space allows it.

“Best practice is not what everyone can do, which is (to isolate the sick family member in) a dedicated bedroom and bathroom,” said Dr. Peter Chin-Hong, UCSF professor of medicine who specializes in infectious diseases.

“That one's easy these days,” said Chin-Hong. “They're still at risk.” Even if you had COVID-19 as recently as early June, he said, “that's the superpower of BA.5,” someone who had COVID-19 just four weeks ago is at risk of reinfection, while early in the pandemic those infected could expect up to three months without a possibly reinfection.

Q

“If I was exposed,

I would test on day

A

three and day five,” Swartzberg Every household in the said, pointing out that U.S. should be able to the incubation period for order up to 16 free rapid the newer omicron strains tests from the federal government, is shorter than previous through the Covidtests.gov versions, and many people website, after who get infected feel sick the Biden administration within two or three days. “If recently announced a third you're testing negative after round of free tests kits. day five, you've probably You might also be able to avoided getting infected,” get free rapid tests through he said, but you might your healthcare provider. want to be careful for a few People covered by insurance extra days, especially if through Kaiser Permanente someone close to you is vulnerable. can request free tests, as can those covered

The CDC recommends by Medi-Cal and Medicare. five days of isolation and And most large pharmacy an additional five days chains have ways to request of masking for those free tests from their insurance with known exposures to for those with employer-provided COVID-19. plans.

QWhat's the best strategy for testing at home?

AQWhat if you've already had COVID-19?

AQWhere can I get free rapid tests?

You took a rapid test that showed negative.

Are you in the clear?

ANot if you're experiencing symptoms, says Swartzberg. “If you've got a cough, sore throat, runny nose,” he said “then you have a respiratory virus. It may not be COVID-19, but it could be, and if you have an infectious respiratory disease you should be staying away from other people.

Chin-Hong recommends swabbing both the back of the throat and the nose when doing a rapid test, which might help catch the virus earlier, a common practice in the UK but not yet officially recommended here.

Bottom line, if you or a family member has been exposed and is experiencing symptoms, it's best to assume you have COVID-19, even if a rapid test has shown negative in the first days of symptoms.

QDo you need a PCR test from a lab if you tested positive on a rapid test?

AChin-Hong and Swartzberg see little reason to seek a PCR test if you test positive on an athome test. You don't need a positive PCR to confirm the infection, or to seek treatment, and false positives are very rare.

QIs it important to notify your healthcare provider you tested positive for COVID-19?

AYes. “The most important thing is a pragmatic thing, your healthcare provider can help you decide if you need to take paxlovid,” the most common anti-viral for COVID-19, said Chin-Hong. And even if you aren't seeking treatments, “you should tell them and they can enter it officially” in your medical record.

QYou have COVID-19. How can you best recover?

AThe good news for those getting infected now is that you should be able to access therapeutics that lessen the severity of your illness.

“If you're a candidate for paxlovid or any of the other three treatments, make sure you avail yourself of them,” Swartzberg recommends. “Get plenty of rest, eat as well as you can, and drink fluids,” he said, sound advice for any viral respiratory infection.