If I can’t get a test how will I know if I’ve got Covid?

. . . and answers to all your other questions on living with the virus

QIf I can’t get tested any more, how will I know if I’ve got Covid?

AAs of April 1, free Covid tests will be available only for a small number of vulnerable people who develop bad symptoms and those in hospital with the virus. Everyone else will have to buy them from pharmacies.

According to guidance from the Government, it is likely that you have Covid if you’re suffering one of the three official symptoms – a continuous cough, loss of smell and/or taste and a fever. But experts say the Omicron variant can cause a whole range of other symptoms, most of which are not much different from a mild cold.

There’s little point testing for Covid every time you have a scratchy throat, say experts – it’s unlikely you will be infectious, so a lateral flow test won’t spot the virus.

Rapid, lateral flow tests are accurate at detecting Covid only if used when the person is at their most infectious.

‘But if the symptoms get worse and you become more coldy – usually two or three days later – it’s likely you’ve become infectious and a lateral flow should pick up the virus,’ says Professor Paul Hunter, public health expert at the University of East Anglia.

Even so, Prof Hunter says, for most people there is little point in knowing if you have Covid anyway.

He adds: ‘Now, 90 per cent of the population have some protection against severe illness. The consequences of people walking around with the virus and passing it on unknowingly are no longer serious for most people.’

Q Do I really have to self-isolate if I just feel a bit under the weather?

A

Officially, from April 1 the decision to self-isolate at home if you have Covid (either proven via a test or not) will be your choice rather than a legal obligation.

Public health officials advise that, similar to other respiratory illnesses such as flu, you should voluntarily stay at home if you don’t feel well, to stop you from infecting others. But scientists say this depends on the symptoms you have and when you have them.

‘If you wake up with a sore throat it’s probably a good idea to stay at home for the morning at least,’ says Dr

Julian Tang, a virus expert at the University of Leicester.

‘If your symptoms don’t get worse, you’ll know it was just a sore throat, and it should be fine to go in to the office.

‘But if it gets worse, or you develop new symptoms, it’s likely to be Covid and you’ll be happy you didn’t go to work and infect your colleagues.’

Currently, people with

Covid must isolate for five days – the average period of infectiousness. But Dr Tang says you can feel safe to leave isolation if you’re feeling better.

‘If you see an improvement in your symptoms from one day to the next, you shouldn’t rush back. But if the same happens the following day, it is unlikely you’re still carrying a large amount of virus that will infect others.’

Q If Test and Trace is being wound down, will we miss new variants? A

No, the UK will still continue to screen for new, emerging variants of Covid-19.

Test and Trace is not the only way the UK keeps tabs on the level of virus in the population and any mutations.

A study conducted by the Office for National Statistics, which regularly distributes Covid tests to 240,000 homes, will continue. Covid test results from hospital patients will also continue to be logged, and roughly ten per cent of all positive cases will still be genetically sequenced to look for new variants.

But fewer tests among the general public means that spotting concerning new variants may take longer.

‘The fewer tests that people are doing, the less likely we are to spot a variant before it has had a chance to infect a large number of people,’ says Dr Penny Ward, visiting Professor in Pharmaceutical Medicine at King’s College London.

While there is no guarantee that future variants will be as mild as Omicron, Prof Hunter believes it is unlikely that any new variant will scupper the protection offered by the vaccine. He adds: ‘The vaccine is still very likely to protect against severe disease, because that’s been the case with every variant so far.’

Q Should I still wear a mask sometimes?

A There are some places where mask-wearing is required, such as in GP practices and hospitals.

Everywhere else – such as public transport, shops and cinemas – masks are no longer required by law.

Health experts say people should consider wearing a mask if they are feeling unwell but have to leave the house.

Dr Tang says: ‘Some people can’t stay at home if they feel sick because of the nature of their work, or others may just be feeling slightly under the weather but have an event they don’t want to miss.

‘In these situations, wear a mask in crowded places which have little ventilation, such as on public transport.’

Studies have shown that mask-wearing is most effective for reducing spread in the local community when more than 80 per cent of the public are wearing one. Without the mandate, however, it is likely that the proportion of mask-wearers will dwindle, reducing the impact of wearing one for those around you.

Q Are some people still at risk from Covid?

A

Yes, an estimated three million Britons have serious health conditions that make the Covid vaccines less effective.

Despite restrictions on the public being lifted, this immunocompromised group – which includes people with blood cancer and organ

transplant patients – is still considered to be vulnerable to Covid-19. But Dr Raghib Ali, an epidemiology researcher at the University of Cambridge, says: ‘These changes are unlikely to significantly increase the risk to those who are most vulnerable to Covid.’

There are a number of reasons for this.

Experts believe infection rates aren’t likely to rise dramatically because the public will, when ill, continue to self-isolate, work remotely and socially distance – despite no longer being required to by law.

Data from the start of December showed that Britons cut social mixing when the Omicron wave began – even before the Plan B restrictions were implemented by the

Government. More than

90 per cent of respondents to a University of Bristol poll said that they voluntarily took precautions when cases started to rise in December.

‘When the Government removed Plan B in January, people thought everything would be dreadful with infections soaring,’ says Dr Ward. ‘But that didn’t happen. People continued to stay at home when they were unwell, be careful around vulnerable people and there was still a lot of remote working.

‘When people see high levels of infection in their area, they behave even more cautiously.’

Dr Ward adds that while Omicron is far milder than previous versions of Covid, ‘that doesn’t mean it is completely harmless to everyone – it will still make small numbers of the most vulnerable people very ill’.

Q

If I am in a high-risk group, what should I do now? A

Experts do not advise immunocompromised people to continue shielding, but they should take extra precautions. This includes wearing a well-fitting, ultraprotective mask in crowded places – such as an FFP2/3 mask, available online and at some high-street pharmacies.

‘Vulnerable people may also want to avoid indoor, crowded spaces like cinemas if the level of infection is particularly high in the local areas,’ says Dr Ward.

If high-risk people do become unwell and think it might be Covid, they should contact their GP for information about anti-viral medicines.

Vulnerable patients now have access to five of these drugs which, when taken soon after Covid symptoms develop, can cut the risk of hospitalisation and death by up to 88 per cent.

And they are advised to top up waning immunity by taking up the Government’s offer of a fourth vaccine dose, which is planned for the spring.

Q If I’m not eligible for another vaccine booster, will I become more vulnerable over time? A

Yes – but there’s no need to panic. Data published last week showed that while the booster is initially 90 per cent protective against serious Covid illness, this drops to 75 per cent after four months.

But the study included only over-75s, who lose immunity faster than younger people.

Professor Martin Hibberd, an infectious diseases expert at the London School of Hygiene and Tropical Medicine, says: ‘I suspect that in the future we will all need boosters once a year, in the same way that we have an influenza booster each year. Hopefully that will start this coming autumn.’