COVID rules have changed: What to do if you feel sick
An epidemiologist offers advice on masks, testing, and boosters, even though symptoms are now much less severe
COVID cases are on the rise again, but treating the virus looks different this year than it has in years past.
Previously, a spike in positive cases may have meant quarantining for weeks or wearing masks in public to avoid spreading or contracting the illness.
But this season, for the first time, there is no federal or state public health emergency to dictate which services must be widely available or rules to be followed — those largely ended in May.
Generally, COVID symptoms are much less severe than they were at the beginning of the pandemic in 2020. That’s not because the virus has changed, but because people have built up “layers and layers of immunity over time,” said Dr. Michael Mina, an epidemiologist and former assistant professor of epidemiology at Harvard T. H. Chan School of Public Health.
“We’re seeing this shift away from symptoms like difficulty breathing and loss of taste and smell, though some people will still end up in the hospital,” he said. “The symptoms are much more cold-like — runny nose, congestion, and fever are now the first symptoms that people feel.”
Masks provide protection against the spread of COVID-19 and other respiratory infections, especially when indoors or in crowded spaces, according to the Massachusetts Department of Public Health. Guidance from the Centers for Disease Control and Prevention says anyone with COVID should wear a high-quality mask if they must be around others at home and in public.
When you should test depends on how accessible tests are to you, Mina said. If you only have one test at home and you are not able to immediately buy more, you should wait three days after first feeling symptomatic to test “because the virus will have grown enough to be detectable on any test by that point,” Mina said.
But if you have multiple tests at home, you should test immediately. If you test negative, you should not assume you are negative, Mina said, and you should plan to test after another two days.
From the state’s website you can link to the CDC’s testing locator site, which shows CVS, Walgreens, Quest, and other locations that conduct tests within 5 miles of where you live. If you have a flexible spending account or a health savings account, you can use that money to purchase at-home testing kits.
And thanks to a recent expansion of the federal government’s Home Test to Treat program, many Americans can receive dual influenza and COVID-19 tests, as well as free telehealth services and treatment delivered to their homes.
“It’s really hard to distinguish the flu from COVID from symptoms alone, especially now that we have immunity, so testing is a way doctors can decipher what options are on the table for treatment,” said Mina, who is also the chief science officer at eMed.
Adult Americans who are negative for COVID, are uninsured or underinsured, on Medicare, Medicaid, enrolled in the Veterans Affairs healthcare system or the Indian Health Services can receive two dual test kits by registering for the program online.
Don’t toss out your tests without checking the government’s site for updated expiration dates. Many of the
FDA-authorized at-home COVID tests are actually effective for up to a year past the date stamped on the carton.
If you test positive, you should try to get additional tests and continue testing each day so that you can know when you are negative. Once you test negative, you are safe to no longer quarantine, Mina said. But if you test negative relatively quickly, such as after one day, Mina recommends waiting another day to stop quarantining out of caution.
Mina said that quarantining might look different for everyone today — isolation does not necessarily mean locking yourself in a room away from your immediate family like it did in 2020.
The CDC recommends more stringent precautions, including staying at home and isolating from those in your home for at least five days after the start of symptoms or a positive test for COVID-19. After day five, you may end isolation if your symptoms are improving and you have been fever-free for 24 hours without the use of medication, but you should continue to mask when around others until at least day 11, according to the agency. For full recommendations, visit the CDC’s website.
Talk to your doctor within two days of feeling sick if you test positive for COVID, Mina said. If symptoms continue to escalate, Mina recommends taking Paxlovid, an antiviral COVID medication developed by Pfizer, after consulting with a physician.
“My view is that anything you can do to support your body is probably going to be more beneficial than not,” Mina said. “There seems to be a benefit to taking Paxlovid, and it could be beneficial for long COVID.”
Massachusetts residents can call 833-450-3461 for a free telehealth consultation, regardless of insurance status. Free virtual telehealth appointments are also available through the Massachusetts Department of Public health in more than a dozen languages.
The CDC offers more recommendations on what to do if you’re feeling sick.
It is not too late to get a booster shot, according to Mina. The benefits of a booster start working after a few days of receiving a dose and last “a few months,” Mina said.
And even though the booster may not be perfectly matched to protect from every variant that is circulating, Mina said the booster can still provide protection.
“It will provide our bodies with additional benefits and protection for at least a few months,” Mina said.
“Going into the holidays, if people haven’t been exposed, I’d say a booster is a really good idea right now,” Mina said.