If you are at home with COVID, you may be wondering how long you have been really infected. You don’t want to isolate yourself more than you need to, but you also don’t want to jeopardize the health of your friends and co-workers, or vulnerable strangers.
In Australia, people with COVID should be isolated for seven days, unless they have significant ongoing or new symptoms (then the small print of state and territorial regulations says they should stay out for longer).
So what’s the risk of leaving home after a week and still being contagious?
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What does research say about Omicron’s infectious period?
The incubation period of Omicron, the period from infection to onset of symptoms, is about three days, with the person often being infected a day or two before symptoms appear.
The average duration of Omicron symptoms is also quite short, often 5 to 6 days compared to 7 to 10 days with Delta and earlier variants. Omicron is more infectious because the increase in the number of mutations in its spike protein makes it better for evading the body’s immune system.
The Omicron variant seems to cause milder illnesses and more asymptomatic infections, and it’s best to dodge our immune system; therefore, one must expect the high rate of innovative cases with the Omicron variant.
What if I continue to test positive for RAT on the 6th or 7th?
Omicron outbreak data suggest that rapid antigen testing (RAT) may not detect COVID until at least two days after exposure to the virus.
And the Therapeutic Assets Administration (TGA) says RATs aren’t as accurate if you don’t have symptoms. Therefore, you may not be positive on an RAT until a few days after exposure. And, if you have no symptoms, you may get a false negative result in the next few days.
PCR testing is likely to detect the virus earlier than RATs because of its high sensitivity, and PCR will also continue to detect virus particles for longer. Relying on this test could prolong the period of isolation even if the person is not infectious. That said, a PCR test is still considered the “gold standard” for detecting SARS-CoV-2 infection.
Most states do not require a clear RAT or PCR test to get rid of isolation, but they say that those who still have certain symptoms (such as sore throat, cough, shortness of breath, or runny nose) should lengthen your insulation. If you have symptoms and take a RAT test, a positive result may indicate that you are still infectious to others.
The goal of COVID testing is to identify people who are currently transmitting the virus. Thus, RATs are able to detect the vast majority of contagious cases and work well in crowded settings, such as long-term care centers, workplaces, or schools.
A positive RAT can be a sign of infection. Shutterstock
Meanwhile, emerging science (including data from the [National Basketball Association’s extensive COVID testing program] suggests that with the Omicron variant, half of those infected could still be infected on day five (the end of the recommended isolation period in the United States), and possibly beyond.
In Australian states and territories, isolation is seven days, as long as the person has no symptoms.
It has been suggested that it may be safer to isolate yourself for eight days and wear a mask to protect others for a total of ten days. In the Northern Territory, those who leave solitary confinement are asked to wear a mask for an additional seven days. South Australians are being asked to mask for three days after isolation.
What about masks after that?
Therefore, people may be infectious beyond their seven-day isolation if they are still symptomatic. After ten days, most people are not infectious. Several studies have shown that there is very little or no transmission after day ten, regardless of the variant.
However, for those who are immunocompromised, it is recommended to wait 20 days to get out of isolation, as these patients have been shown to tend to clear the virus longer.
Once recovered, you probably won’t need to wear a mask for a while. Image AAP / Bianca De Marchi
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Once people have fully recovered from the disease and are showing no symptoms, they are considered non-infectious as the load of viruses they carry is very low.
A person who has recently recovered from COVID does not need to wear a mask, as there is no risk of them becoming infected again with the same variant. Consequently, they do not pose a threat to COVID to others.
However, they should reconsider this advice after 12 weeks, when reinfection is possible.
Your level of protection against vaccination or previous COVID infection may also depend on factors such as your age and immune status. It’s also worth noting that Omicron’s recovery won’t protect anyone from seasonal colds and flu or later variants of COVID, but a mask does.
Read more: VOCID vaccination recommendations evolve over time. Who should get the dose now?
Tips for taking home about when to leave home
Protecting ourselves and the community from communicable diseases, including COVID, depends on early detection of infection and the implementation of public measures to prevent infection.
Until RAT tests are sensitive enough to detect the absence of the virus with certainty, we need to supplement these tests with preventative measures such as isolating until symptoms subside and wearing masks indoors and at public events.