For those who have coronavirus, how do you determine when you are no …

STATEN ISLAND, N.Y. As President Joe Biden comes in and out of isolation following recent coronavirus (COVID-19) infections and antigen tests, you may be asking yourself how to know for sure its OK to return to normal life after testing positive for the virus.

Biden had two negative antigen tests before leaving isolation the first time, after taking the antiviral medication Paxlovid, yet he still experienced a rebound infection and tested positive again, requiring a return to isolation.

And while Moderna and Pfizer two-dose vaccine series still offer protection against severe illness and death from COVID-19, and vaccine makers are looking to create booster vaccine doses that target the extremely contagious subvariants of omicron, BA.4 and BA.5, even vaccinated New Yorkers continue to test positive in their own home, leaving the question of isolating and ending quarantine a very private one.

Are antigen tests required to end quarantine?

So, what about ordinary citizens who get infected with COVID-19? Are we expected to take as many tests as Biden before ending isolation?

Well, no, according to the Centers for Disease Control and Prevention (CDC), whose guidance does not specifically recommend a negative antigen test, which is performed at home and provides results in less than 20 minutes after collecting samples with a nasal swab, in order to end isolation after testing positive for COVID-19.

CDC protocols call for children and adults who have tested positive for COVID and experienced mild symptoms to isolate for a minimum of five days with day one being the day after the positive test and end isolation at that time, as long as they have been fever-free for at least 24 hours.

They are expected to wear a mask around others for five additional days, the CDC advises.

People who test positive but remain asymptomatic can end isolation at least five days after the first positive test, with day 0 being the date their specimen was collected for the positive test. This is only for people who can continue to wear a properly well-fitted mask around others for five additional days. However, if symptoms develop after a positive test, their five-day isolation period should start over, and day 0 changes to the first day of symptoms, the CDC says.

The recommendations change for those who are severely ill, requiring hospitalization. They are expected to extend isolation to al least 10 days and up to 20 days after symptom onset and after fever ends without a fever reducer, the CDC says.

Benefits of a negative test

For those who prefer the confirmation of a rapid antigen test, the CDC suggests they take such a test later in your infection period for the most reliable results.

And some medical experts, and your own private doctor, may suggest that an at-home rapid antigen test should be negative before a person returns to work and social gatherings. And it might make you feel better too.

Given that a substantial portion of people do have a rapid positive test after five days, I think an updated recommendation should include people having a negative rapid test before coming out of isolation for COVID, Tom Inglesby, director of the Johns Hopkins Center for Health Security, told The Washington Post. Inglesby was formerly the Biden administrations senior adviser on testing.

Another twist that makes spread control difficult, medical experts say, is that the COVID-19 virus is most transmissible a day or two before symptoms even arrive, continuing for two or three days after.

And the CDC says it is very unlikely to pass along the virus after 10 days, even if a patient still is testing positive.

Yet, a negative at-home test can be very reassuring, Amy Barczak, an infectious-diseases expert at Massachusetts General Hospital who has researched how long patients with COVID can shed virus, told The Washington Post.

And the tests are much more available now than they were when the CDC first released its guidance and provided its online self-checking calculator for patients to determine where they are in the isolation process.

When should you test?

If you have COVID-like symptoms, the CDC recommends testing with an at-home antigen test immediately.

If you are negative, it is unlikely you have COVID.

If youve been exposed to someone who tests positive, the CDC suggests a PCR test to be certain.

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For those who have coronavirus, how do you determine when you are no ...