CLEVELAND — If you're one of the thousands in Ohio who have tested positive for COVID-19 over the last two weeks and you're nearing the end of your isolation, when is it actually safe to leave home?
The CDC updated its guidelines last week recommending people isolate themselves for five days and then wear a mask for the next five if they don't have symptoms, but those guidelines have been criticized and left some patients with questions, like Mallory McMaster.
McMaster tested positive for COVID-19 a week before Christmas.
“I started to get fevers. I was extremely fatigued. I had to go to bed. My chills were uncontrollable,” said McMaster. “My fevers were really high, around 103, for the full couple of days that I was really sick. I, luckily, didn't have to go to the hospital. But I did keep in touch with my doctor and he told me that if at any point I started to get worse I had to go. Did not sound appealing. But luckily I got better kind of quickly after that, probably because I'm vaccinated and then I just was fatigued for a long time.”
McMaster had to be isolated from her husband, 4-year-old son, and immunocompromised mom over the holidays.
“We had told my mother that she couldn't celebrate Christmas. That was really hard. My sister died over the summer and this would have been our first Christmas without her so it was important to be together,” said McMaster.
McMaster followed the 10-day isolation that was required at the time. Her symptoms improved and went away altogether, but on day 11 she still tested positive on a rapid test.
“I was worried about being around other people and infecting my son or my husband or my mother. All of the guidance I could find said that I could just leave isolation and go out into the world. And I didn't know where to turn so I asked Twitter,” said McMaster. “It's maybe a good thing and a bad thing that that's a source of medical information for a lot of people and I got some interesting information, but I know that a lot of other people are probably confused about that too, especially since the CDC shortened recommended isolation.”
An epidemiologist responded to her tweet telling her to stay put until she tested negative, which she did two days later, but other doctors say in most cases that’s not necessary.
“As long as it's been 10 days since the onset of symptoms, you've been fever free for at least 24 hours and your symptoms are improving, except taste and smell, those don’t necessarily have to improve,” said Dr. Amy Edwards, a pediatric infectious disease specialist at Rainbow Babies and Children’s Hospital. “If you've met all three of those criteria, then you are no longer contagious and you're done.”
Edwards said both rapid and PCR tests can turn up positive even after you’re feeling better, but it doesn’t necessarily mean you’re still contagious.
"I would not recommend testing. After you've gotten your initial positive tests, there's not any clinical significance to it," said Edwards. “You might still have some amount of low level viral replication going on in order to shed bits of virus, but you can also just be shedding bits of dead virus leftovers from the battle between the virus in your body, and the test might still be able to pick those up."
With the CDC expected to update its guidance on its recommended isolation and quarantine guidelines again, Edwards said to expect different rules for different people.
“As the science has evolved, it no longer makes sense to treat everybody exactly the same because we know that that's just not reality anymore,” said Edwards.
“Both the delta variant and now the omicron variant have very clearly shown that they have shorter incubation periods and that they then cycle a little bit faster, especially for people with asymptomatic or mild disease. They appear to kind of get through things quicker. And so, the 10 day period is probably not appropriate for every single person,” said Edwards. “And so what the CDC is going to start doing is they're going to start making categories, which in some ways is actually going to make it more confusing for a lot of people. And I think it's going to be very frustrating for some people, but it is based on reality and clinical facts.”
McMaster is concerned about the messaging from officials, worried about more infections, especially among vulnerable people and is pleading for more clarity.
“I'm just worried. And I was also incredibly frustrated that we live in a country with the best healthcare in the world. You know, we have the Cleveland Clinic here, world class care. And we lack access to this basic piece of information during a pandemic that's been happening for two years,” said McMaster. “It should be simple to tell us at this point in this pandemic. Is it safe for us to go outside after we've had it or not? How long are we actually contagious? And how do we find out?”
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