Suzanne Miles is ill, worried and a little confused. Miles, 55, and her husband, both vaccinated against COVID and boosted against the virus, who live in Brooklyn, New York, attended a weekend get-together with about 20 people at a friend’s house in early spring. On the Monday morning after the party, Miles woke up with a sore throat.
“I think maybe it’s a spring allergy,” she said. “Then I think I should get tested.” Her first at-home COVID test was negative. But by Wednesday, she was feeling worse — in addition to a sore throat and congestion, she had a terrible headache. She tested herself again and came back positive.
Miles has questions about how to take care of himself. She wondered if over-the-counter (OTC) cold medicine would help. Because she has type 1 diabetes, an additional risk factor for severe COVID, she wonders if she should try getting a prescription antiviral. Questions such as the number of cases and the rate of positivity testing are rising again are increasingly being raised. The situation is keeping thousands of people at home as they try to figure out how best to free themselves from a disease that may be moderate but also potentially transformative and kill about 1 million Americans.
To answer your questions about COVID self-care and when to seek medical help, scientific american Call doctors across the country who are treating COVID patients. We also reviewed recommendations from the U.S. Centers for Disease Control and Prevention and several public health experts to gather the latest recommendations for those who think or know they have the disease.
Pay attention to your symptoms
All current cases in the United States are caused by Omicron variants, specifically the Omicron lineage known as BA.2. The good news is that “Omicron appears to be less likely than Delta to cause serious illness,” said Timothy Brewer, a professor of medicine and epidemiology at UCLA. Omicron also tends to cause symptoms earlier than Delta — about two to three days after infection, rather than four to five days.
The range of possible symptoms is wide, but centered on the upper respiratory system. Because BA.2 replicates more in the airways above the lungs, rather than deeper inside these organs, doctors see less inflammation in the chest and lungs, and more sore throats and congestion. Pain, cough, shortness of breath, and fever are also common.
Take the test
People should have a rapid antigen or PCR test 48 to 72 hours after potential COVID exposure or at the first sign of any symptoms. “There should be a very low threshold for testing if you have COVID-19 or if you have another disease,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. COVID looks a lot like a cold, flu or allergies , but each treatment is different.
Experts say PCR tests are more sensitive but more difficult to obtain, and a rapid antigen test at home is often sufficient. If the first test is negative, people should wait two days (while exercising caution) and do it again, as Myers did. In the case of COVID, the viral load increases during this time. “Nothing in life is perfect, and neither are rapid antigen tests, but they are very good at detecting infectious virus levels,” says Lucy McBride, a licensed primary care physician in Washington, D.C. (a list of free testing locations is available at test treatment The locator website is provided by the U.S. Department of Health and Human Services. )
When people test positive, if they have a primary care physician, they better call the primary care physician. Doctors can provide treatment guidance and update medical history. They will also report the results to public health authorities so they can be included in the case count. At the very least, people should keep track of the date symptoms started and the date of the positive test.
Most people with COVID will be fine at home. “If you’re vaccinated and boosted, and generally healthy, people are doing just fine,” McBride said. Over-the-counter medicines do not directly treat COVID, but they can help manage symptoms. Doctors recommend acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Advil or Motrin), to lower fever and relieve pain.Early in the pandemic, there were reports that ibuprofen made COVID worse, but those not proven. However, NSAIDs are only intended for short-term use because they have more side effects than acetaminophen, and they are not safe for everyone. People taking other medications should consult their doctor before taking NSAIDs. Antihistamines or cold medicines such as DayQuil can be used to relieve congestion and cough.
All over-the-counter medicines should be taken as needed and within recommended dosage instructions (some cold medicines already contain acetaminophen). “The dose and frequency do depend on the patient’s underlying medical condition and should be discussed with the patient’s physician,” McBride said.
TLC is as important as over-the-counter drugs. Getting enough rest is important, as is drinking enough fluids to prevent dehydration and reduce coughing. Classic remedies like hot honey tea can also relieve sore throats and coughs.
it’s time to isolate
Even if people are only mildly unwell, they should isolate for at least five days. This means eating and sleeping alone, rather than sharing a bathroom. If that level of isolation isn’t possible, experts say focus on ventilation (open windows where possible) and get everyone in the household to use masks discreetly and consistently. N95 and KN95 masks are the most protective and it is important that they fit properly. “Minimize time together and maximize [physical] Distance,” Brewer said. “Transmission is a function of time, distance, viral load and mitigating factors. “Regular hand washing is also key.
During her illness, Miles and her husband slept in separate bedrooms, but they still had to share a bathroom. She avoided the living room and kitchen and switched on an air purifier on that floor. Her husband and 18-year-old son remained healthy but went out together after her 15-year-old daughter fell ill within days. That’s usually fine, Adjala said. When you contract the virus yourself, there is little benefit in isolating yourself from other people with the virus.
using prescription drugs
One of the most significant recent changes in the COVID space is wider availability Authorized outpatient treatment. Antiviral drug Paxlovid Reduced risk of hospitalization and death 89% reduction in clinical trials, and it’s a pill that’s relatively easy to take. However, this medication cannot be taken with many common medications such as statins or blood thinners. Monoclonal antibodies can also significantly reduce the risk of serious disease, but they require an injection or infusion. Not every patient is eligible for these treatments. Both are authorized for use in people who are at higher risk of serious illness because of their age (65 years and older) or underlying medical conditions, such as high blood pressure or lung disease. To date, there is no evidence that these treatments are beneficial in younger or otherwise healthy individuals. Either treatment is available by prescription and is also available to eligible individuals on the Test to Treat website nationwide.
To be effective, these drugs must be started as soon as symptoms begin (within 5 and 7 days, respectively). “[People who might be eligible] Their provider should be called right away,” said Raymund Razonable, an infectious disease specialist at the Mayo Clinic. “These treatments work best when patients are not feeling as bad. Side effects of Paxlovid are uncommon, but include diarrhea and a metallic taste in the mouth.
if you live alone
Anyone infected with the new coronavirus should watch for signs that they are deteriorating. “People can feel good for a while and then quickly go downhill,” Brewer said. When this happens, it is usually 8 to 10 days after the onset. If an infected person lives alone, “it would be a very sensible thing to have someone call you every day to check,” Brewer said. Regular check-ins can also reduce anxiety and the loneliness that isolation can bring. While friends and family should not be physically near someone who is isolating, they can and should help by providing meals, Tylenol and other over-the-counter medications (if needed), and books and magazines to pass the time.
when to worry
Doctors say that when patients have trouble breathing, their greatest fear is that the disease will get serious. If people are easily out of breath when walking around the house, they should see a doctor. Pulse oximeters, available at most major pharmacies, can be a useful non-invasive way to test oxygen levels in the blood — it’s like a high-tech clothespin that clips to your fingertips — but the device not necessary. Other worrisome symptoms that should send someone to urgent care or the emergency room are chest pain, blue lips, persistent fever, or “an inability to drink fluids and get enough food and water,” said Rasika Karnik, post-COVID medical director in Chicago. Rehabilitation Clinic at the University Medical Center.
When are you safe again?
If someone is feeling well and has had no fever for at least 24 hours without medication, it is usually safe to reappear after five days of isolation. But the CDC recommends wearing a mask for five more days. Ideally, people should start retesting at home five days after their first positive test until they get a negative test. All in all, this could take 10 days or more. (Myers was negative on the ninth day.) “Using antigen testing to adjust or precisely guide the quarantine period may be the best course of action,” Adjala said.