I have exceeded the symptoms of COVID, but the test is still positive. Am I infectious?

As high levels of COVID-19 infection continue, people are wondering how much to quarantine after learning that they are infected.

One of the most annoying problems is what to do if your rapid antigen test continues to give positive results, but the symptoms go away after 5 days (or more).

So what is the reason why someone keeps the test positive?

Dr. Benjaminten Oever, a microbiologist at the NYU Grossman School of Medicine, said the weakening of the virus could be due to continued replication. Today’s MedPage.. It can also occur as a result of disruption of the viral genome.

He said that nucleocapsid proteins may increase in the back of the throat and nose, especially in vaccinated and boosted individuals, because the Omicron variant tends to remain localized in the upper respiratory tract. And the broken viral genome can continue to exist even after the virus has made a bad version of itself.

“If you’re testing for antigen positivity, you should assume low levels of viral infection,” says ten Oever. “You are probably contagious.”

This possibility may be difficult to address following the recently updated guidance from the CDC.

Last month, the CDC announced that people who test positive for COVID-19 can be isolated for just five days from the previous 10-day recommendation if they are asymptomatic. The CDC has since revealed that rapid antigen testing towards the end of the period is the best approach, but authorities have not instructed people to look for it.

This approach is different from this week’s only UK approach. Update your own guidance It means that quarantine can be stopped after 5 days only if the rapid antigen test is negative twice on consecutive days.

The UK Health and Safety Agency says the first test should not be done within 5 days after the onset of symptoms (or the day the test was done if there are no symptoms). The quarantine period remains 10 days if two tests for two consecutive days do not give a negative result.

CDC shortens the quarantine period, Suggest most transmissions “It occurs early in the disease, generally 1-2 days before and 2-3 days after the onset of symptoms.”

paper Was announced in Lancet In December, when the CDC quoted in the updated guidance, “[e]Evidence from 113 studies conducted in 17 countries is that SARS-CoV-2 viral RNA can be detected 6 days before the onset of symptoms and concentrations peak before or a few days after the onset of symptoms. It shows that it reaches and is usually undetectable from the upper respiratory tract, with airway samples about 2 weeks after the onset of symptoms, and there is no substantial difference between adults and children. “

These studies suggest that “the average duration of infectivity and risk of infection may be limited to a period of 2-3 days to 8 days after the onset of symptoms.”

However, these data are before the Omicron surge. And CDC’s latest isolation approach is not absolutely certain.

A New research Harvard University examined a small number of cases from the National Basketball Association’s COVID-19 test program. More than half of Omicron cases Those identified within 1 day of the previous negative test were still infectious 5 days after the first positive test, dropping to 25% on day 6 and 13% on day 7. This study, which has not been peer-reviewed, used PCR testing.

The duration of quarantine, their testing, and the potential for prolonged infectivity are definitely being debated in the medical community, said Jeffrey Baird, MD, chair of the Department of Clinical Laboratory Medicine and Pathology at the University of Washington School of Medicine in Seattle. rice field. Today’s MedPage.. This is especially relevant for staff shortages occurring across the country.

Overall, the question remains, “What is the true value of a particular day’s test?” Baird said. “This is a public health challenge.”

He added that it was about balancing “medically correct and accepted by the public.”

Ultimately, he said, the country will need to decide how to use rapid antigen testing in the future, and whether it includes non-quarantine testing.

TenOever pointed out that the proportion of people who continue to be tested for days or weeks after their symptoms have subsided is likely to be very limited. If it is well over 10 days and is still positive, it may be justified to seek further medical advice or evaluation.