How long should I isolate after I test positive for COVID? UChicago’s Dr. Landon gives us a timeline.

·3 min read

Two and a half years and counting. That’s how long the pandemic has wreaked havoc on individuals, communities, health systems and every aspect of our society. With Lollapalooza here and the start of the next school year on the horizon, Dr. Emily Landon, chief health care epidemiologist at the University of Chicago, said isolating/quarantining has become important again with the BA. 5 variant being the most dominant strain of COVID-19 in the country, according to the Centers for Disease Control and Prevention.

“It’s gonna be a tough six weeks or so with BA. 5 and the continuing ongoing spread,” she said. “We’re seeing variants come out faster and faster. And there’s no reason why we should expect that to stop. I think we’re gonna see more variants, more disruption, and more difficulty with absenteeism.”

Given that, CDC guidance says one needs to isolate for at least five days from the onset of symptoms. And if you are feeling better by day six, you may return to regular activities, but you must wear a mask 100% of the time outside of the house and around others. If you test positive on day six, you should stay in isolation until day 10.

“I think we all understand that people are not wearing masks days six to 10, and that’s a problem,” Landon said. “If you’re unvaccinated, we really think you probably need 10 days — all evidence suggests. We found 80% of people were still positive on days five and six. Those rapid antigen tests, at the end of illness are pretty good and go along with contagiousness. That’s what Dr. Fauci did. He didn’t return to work and outside his house until his rapid antigen test was negative.”

Landon recommends having rapid antigen tests stocked to make sure that they’re at the ready for testing during a positive COVID test.

“Evidence shows that 80% of people are negative on day eight,” Landon said of recent research. “If you only got one antigen test on hand, save it for day eight and test then. Hopefully, it will be negative. If not, your line should either be decreasing and less bright. And then you could feel pretty confident that tomorrow you’ll be better. If you really need to get back to work and you only got one or two tests, wait until day eight to start testing.”

Landon does say there are those people who test positive weeks after a diagnosis, but that positivity usually shows with PCR tests. She said PCR tests are much more sensitive and can pick up tiny amounts of coronavirus, including virus debris in the sputum. Landon said in the beginning of illness, the best way to tell if you’ve got COVID is to use a PCR test. If you want to know when you’re no longer contagious, the best thing to use is a rapid antigen test.

“The vast majority of people are no longer contagious after day eight or nine, and most people are better and able to return to work. Historically, if you’re not immunocompromised after day 10, we’re really not seeing very much spread from those individuals. We are seeing spread from people who come back on day six who are positive and who are not wearing masks.”

Landon says this moment is a real test for all people to prove that we can limit spread by being careful without a mask mandate.

“If our workplaces want to be able to continue operating, the best way to do that is for people to wear masks indoors, and when they’re up close in crowded events, even outside,” Landon said. “The choices here are either we take a few measures to live with this disease and allow everybody to continue having their live’s basically the way it was before or we put up with tons of absenteeism and businesses having problems keeping their doors open and needing to staff up a lot more to account for the fact that people are now going to be absent a lot.”

drockett@chicagotribune.com