Suzanne Myers was sick, worried and a little confused. Myers, a 55-year-old woman living in Brooklyn, New York, and her husband were vaccinated and fortified against COVID, and in the early spring they went to a weekend party with about 20 other people at a friends house. On Monday morning after the party Myers woke up with a sore throat.
“I thought maybe it was a spring allergy,” she says. “Then I thought I needed to check.” Her first home test on COVID was negative. But on Wednesday she felt worse – in addition to a sore throat and congestion she had a severe headache. She tested herself again and was positive.
Myers had questions about how to take care of themselves. She wondered if over-the-counter (OTC) cold medications would help. Because she has type 1 diabetes, an additional risk factor for severe COVID, she wanted to know if she should try to get prescription antiviral drugs. More and more people with issues such as the number of cases and the number of positive tests are growing again. The situation leaves thousands of people at home as they try to figure out how best to overcome a disease that can be moderate but can also take a major turn and has killed about a million Americans.
To answer questions about self-care at COVID and when you should seek medical attention, Scientific American called doctors across the country treating patients with COVID. We also reviewed the recommendations of the U.S. Centers for Disease Control and Prevention, as well as several health experts, to gather the most up-to-date advice for people who think or know they have the disease.
Pay attention to your symptoms
All current cases in the US are caused by the Omicron variant and in particular the Omicron pedigree known as BA.2. The good news is that “Omicron seems less likely than Delta to cause serious illness,” says Timothy Brewer, a professor of medicine and epidemiology at the University of California, Los Angeles. Omicron also tends to cause symptoms a little earlier than Delta – about two to three days after infection, rather than four or five.
The range of possible symptoms is wide but focused on the upper respiratory tract. Because BA.2 multiplies more in the airways above the lungs rather than deeper inside those organs, doctors see less inflammation of the chest and lungs and more sore throats and congestion. Soreness, cough, shortness of breath and fever are also common.
Take the test
Between 48 and 72 hours after potential exposure to COVID or at the first sign of any symptoms, people should undergo a rapid test for antigen or PCR. “There has to be a very low threshold to test yourself to see if you have COVID or if you have something else,” says Amesh Adal, a senior scientist at the Johns Hopkins Health Center. COVID-19 may look like a cold, flu or allergy, but the treatment for each is different.
PCR tests are more sensitive, but harder to obtain, and are usually fairly quick to test for antigen at home, experts say. If the first test is negative, people have to wait two days (behaving cautiously in the meantime) and go through another one, as Myers did. If it is COVID, the viral load during this time will increase. “Nothing in life is as perfect as a quick antigen test, but they’re damn good at detecting infectious levels of the virus,” said Lucy McBride, a primary care practitioner in Washington, D.C. testing: available at Test for treatment locator website provided by the US Department of Health and Human Services.)
If the test is positive in people, it will be good for them to call a primary care doctor if they have one. Doctors can give treatment recommendations and update the medical history. They will also report the result to health authorities so that it can be included in the case count. At a minimum, people should keep track of the onset date of symptoms and the date of a positive test.
Most people who get COVID will be fine at home. “When you’re vaccinated and strengthened and generally healthy, people are doing very well,” McBride says. Over-the-counter medications will not treat COVID directly, but may help cope with symptoms. Doctors recommend acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin) to relieve fever and relieve pain. At the start of the pandemic, there were reports that ibuprofen worsened COVID, however they were not substantiated. NSAIDs are only prescribed for a short period of time because they have more side effects than acetaminophen and they are not safe for everyone. People taking other medications should consult a doctor before taking NSAIDs. Antihistamines or cold medications, such as DayQuil, can be used to relieve congestion and cough.
All over-the-counter medications should be taken as needed and should not exceed the recommended dosage (some cold medications already include acetaminophen). “The dose and frequency really depend on the patient’s underlying health and should be discussed with the doctor,” McBride says.
TLC is just as important as over-the-counter medications. It is important to rest as well as drink enough fluids to prevent dehydration and reduce coughing. Classic remedies, such as hot tea with honey, also relieve sore throats and coughs.
Time to isolate
Even if people feel insignificant, they should be isolated for at least five days. This means eating and sleeping alone rather than sharing a bathroom. If such a level of insulation is not possible, experts say to focus on ventilation (opening windows where possible) and careful and consistent use of masks by everyone in the family. Masks N95 and KN95 are the most protective, and it is important that they fit well. “Try to minimize the time spent together [physical] distance, ”Brewer says. “Transmission depends on time, proximity, viral load and mitigating factors.” Regular hand washing is also important.
While she was ill, Myers and her husband slept in separate bedrooms, but they still had to share a bathroom. She avoided the living room and kitchen, and on this floor launched an air purifier. Her husband and 18-year-old son remained healthy, but after their 15-year-old daughter fell ill a few days later, they hung out together. This is generally normal, Ajala says. Isolating from other people with COVID is of little use if you have yourself.
Prescription drugs are available
One of the most significant recent changes in the COVID landscape is greater availability permitted outpatient treatment. The antiviral drug Paxlovid reducing the risk of hospitalization and death 89 percent in a clinical trial, and it’s a pill that makes it relatively easy to take. However, the drug should not be taken with many common medications such as statins or blood thinners. Monoclonal antibodies also significantly reduce the risk of serious disease, but they require injection or infusion. And not every patient is entitled to such treatment. Both have been allowed for people who are at greater risk for serious illness due to age (65 and older) or underlying illnesses such as high blood pressure or lung disease. To date, there is no evidence that these treatments benefit people who are young or otherwise healthy. Any treatment is available by prescription or on Test to Treat sites nationwide for eligible people.
To be effective, these medications need to be started immediately after the onset of symptoms (within five and seven days respectively). «[People who might be eligible] should call your provider immediately, “says Raymond Rosaneble, an infectious disease specialist at the Mayo Clinic.” These treatments work best when patients are not feeling bad. “Side effects of Paxlovid are rare, but include diarrhea and a metallic taste in the mouth.
If you live alone
Anyone with COVID should watch for signs of deterioration. “People can feel good for a while and then go down quickly,” Brewer says. When this happens, it often happens about 8-10 days after the illness. If an infected person lives alone, Brewer says, “if someone could call you once a day to check, it would be very reasonable.” Regular inspections can also reduce the anxiety and loneliness that isolation can bring. And while friends and family don’t have to be physically close to someone in isolation, they can – and should – help by providing food, tylenol, and other over-the-counter medications as needed, and perhaps books and magazines to fill time.
If you worry
Doctors say their biggest concern is that the disease becomes serious, occurring when a patient has trouble breathing. If people are easily ventilated while moving around the house, they should call a doctor. A pulse oximeter, available at most major pharmacies, can be a useful non-invasive way to check blood oxygen levels – it’s like a high-tech pin that is clamped at your fingertip – but the device isn’t necessary. Other alarming symptoms that should refer someone to an emergency room or emergency department are chest pain, blue lips, persistent fever, or “inability to drink fluids and get enough food and water,” said Rasika Karnik, medical director of the department. after COVID-19. recovery clinic at the University of Chicago Medical Center.
When are you safe again?
If someone is feeling well enough and has not had a fever without medication for at least 24 hours, it is usually safe to leave after five days of isolation. But the CDC recommends wearing the mask for another five days. Ideally, people should re-analyze at home starting five days after the first positive test until they get a negative. In total it can take 10 days or more. (Myers was negative on the ninth day.) “Using antigen tests for the right size or accurate indication of isolation periods is probably the best thing that can be done,” Ajala says.